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Prevalence of antibiotic-resistant organisms in Canadian Hospitals. Comparison of point-prevalence survey results from 2010, 2012, and 2016

Published online by Cambridge University Press:  05 November 2018

Philippe Martin ,
Claire Nour Abou Chakra ,
Victoria Williams ,
Kathryn Bush ,
Myrna Dyck ,
Zahir Hirji ,
Alex Kiss ,
Oscar E. Larios ,
Allison McGeer  and
Christine Moore
...Show all authors
Philippe Martin*
Affiliation:
Department of Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Claire Nour Abou Chakra
Affiliation:
Department of Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Victoria Williams
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
Kathryn Bush
Affiliation:
Alberta Health Services, Calgary, Alberta, Canada
Myrna Dyck
Affiliation:
Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
Zahir Hirji
Affiliation:
The Scarborough Hospital, Toronto, Ontario, Canada
Alex Kiss
Affiliation:
Institute of Clinical Evaluative Sciences, Toronto, Ontario, Canada
Oscar E. Larios
Affiliation:
University of Calgary, Calgary, Alberta, Canada
Allison McGeer
Affiliation:
University of Toronto, Toronto, Ontario, Canada Mount Sinai Hospital, Toronto, Ontario, Canada
Christine Moore
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Karl Weiss
Affiliation:
Jewish General Hospital, Montreal, Quebec, Canada
Andrew E. Simor
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
Infection Prevention and Control Canada
Affiliation:
Department of Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, Quebec, Canada Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada Alberta Health Services, Calgary, Alberta, Canada Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada The Scarborough Hospital, Toronto, Ontario, Canada Institute of Clinical Evaluative Sciences, Toronto, Ontario, Canada University of Calgary, Calgary, Alberta, Canada Mount Sinai Hospital, Toronto, Ontario, Canada Jewish General Hospital, Montreal, Quebec, Canada
*
Author for correspondence: Dr Philippe Martin, Department of Microbiology and Infectious Diseases–CHUS, 3001, 12ème Avenue Nord, Sherbrooke, Quebec, Canada J1H 5N4. E-mail: Philippe.Martin@USherbrooke.ca
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Abstract

Objective

Point-prevalence surveys for infection or colonization with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae (CREs), and for Clostridium difficile infection (CDI) were conducted in Canadian hospitals in 2010 and 2012 to better understanding changes in the epidemiology of antimicrobial-resistant organisms (AROs), which is crucial for public health and care management.

Methods

A third survey of the same AROs in adult inpatients in Canadian hospitals with ≥50 beds was performed in February 2016. Data on participating hospitals and patient cases were obtained using standard criteria and case definitions. Associations between ARO prevalence and institutional characteristics were assessed using logistic regression models.

Results

In total, 160 hospitals from 9 of the 10 provinces with 35,018 adult inpatients participated in the survey. Median prevalence per 100 inpatients was 4.1 for MRSA, 0.8 for VRE, 1.1 for CDI, 0.8 for ESBLs, and 0 for CREs. No significant change occurred compared to 2012. CREs were reported from 24 hospitals (15%) in 2016 compared to 10 hospitals (7%) in 2012. Routine universal or targeted admission screening for VRE decreased from 94% in 2010 to 74% in 2016. Targeted screening for MRSA on admission was associated with a lower prevalence of MRSA infection. Large hospitals (>500 beds) had higher prevalences of CDI.

Conclusion

This survey provides national prevalence rates for AROs in Canadian hospitals. Changes in infection control and prevention policies might lead to changes in the epidemiology of AROs and our capacity to detect them.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 1 , January 2019 , pp. 53 - 59
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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Footnotes

PREVIOUS PRESENTATION: Preliminary results of this study were presented at the annual meeting of the Infectious Diseases Society of America, 2016 IDWeek on October 28, 2016, in New Orleans, Louisiana (abstract no. 1491).

Cite this article: Martin P, et al. (2018). Prevalence of antibiotic-resistant organisms in Canadian Hospitals. Comparison of point-prevalence survey results from 2010, 2012, and 2016. Infection Control & Hospital Epidemiology 2019, 40, 53–59. doi: 10.1017/ice.2018.279

References

1. Watkins, RR, Bonomo, RA. Overview: global and local impact of antibiotic resistance. Infect Dis Clin North Am 2016;30:313–322.Google Scholar
2. Public Health Agency of Canada. Canadian Antimicrobial Resistance Surveillance System—Report 2016. Guelph ON: PHAC; 2016.Google Scholar
3. Williams, V, Simor, AE, Kiss, A, et al. Is the prevalence of antibiotic-resistant organisms changing in Canadian hospitals? Comparison of point-prevalence survey results in 2010 and 2012. Clin Microbiol Infect 2015;21:553–559.Google Scholar
4. Simor, AE, Williams, V, McGeer, A, et al. Prevalence of colonization and infection with methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus and of Clostridium difficile infection in Canadian hospitals. Infect Cont Hosp Epidemiol 2013;34:687–693.Google Scholar
5. CDC/NHSN. Surveillance Definitions for Specific Types of Infections. Atlanta: CDC; 2015.Google Scholar
6. Public Health Agency of Canada. Federal Action Plan on Antimicrobial Resistance and Use in Canada. Guelph ON: PHAC; 2015.Google Scholar
7. House, TW. National Action Plan for Combating Antibotic-Resistant Bacteria. Atlanta: CDC; 2015.Google Scholar
8. Magill, SS, Edwards, JR, Bamberg, W, et al. Multistate point-prevalence survey of health care-associated infections. New Engl J Med 2014;370:1198–1208.Google Scholar
9. Martin, JS, Monaghan, TM, Wilcox, MH. Clostridium difficile infection: epidemiology, diagnosis and understanding transmission. Nat Rev Gastroenterol Hepatol 2016;13:206–216.Google Scholar
10. Polage, CR, Gyorke, CE, Kennedy, MA, et al. Overdiagnosis of Clostridium difficile infection in the molecular test era. JAMA Intern Med 2015;175:1792–1801.Google Scholar
11. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Methicillin-Resistant Staphylococcus aureus. Atlanta: CDC; 2014.Google Scholar
12. Weiner, LM, Webb, AK, Limbago, B, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011–2014. Infect Cont Hosp Epidemiol 2016;37:1288–1301.Google Scholar
13. European Centre for Disease Prevention and Control. Antimicrobial Resistance surveillance in Europe 2015. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Solna, Sweden: ECDC; 2017.Google Scholar
14. Tamma, PD, Goodman, KE, Harris, AD, et al. Comparing the outcomes of patients with carbapenemase-producing and non-carbapenemase-producing carbapenem-resistant enterobacteriaceae bacteremia. Clin Infect Dis 2017;64:257–264.Google Scholar
15. Jeannot, K, Bolard, A, Plesiat, P. Resistance to polymyxins in gram-negative organisms. Int J Antimicrob Agents 2017;49:526–535.Google Scholar
16. Centers for Disease Control and Prevention. FAQs About Choosing and Implementing a CRE Definition. Atlanta: CDC; 2015.Google Scholar
17. Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States. Atlanta: CDC; 2013.Google Scholar
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