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  1. May 5, 2023 · During the coronavirus disease 2019 (COVID-19) pandemic that was declared on March 11, 2020 Footnote 12, changes in hospital infection prevention and control and antimicrobial stewardship efforts had varied impacts on the rates of HAIs and AMR Footnote 13 Footnote 14. Coordinated global public health action and improved antibiotic stewardship and public awareness are crucial to identify ...

    • Abstract
    • Introduction
    • Methods
    • Results
    • Discussion
    • Authors' Statement
    • Acknowledgements
    • Annex A: Surveillance Case Definitions and Eligibility Criteria, 2020
    • Annex B: List of Supplementary Figure and Tables

    Background:Canadians experience increased morbidity, mortality and healthcare costs due to healthcare-associated infections (HAIs) and antimicrobial resistance (AMR). The Canadian Nosocomial Infection Surveillance Program (CNISP) collects and utilizes epidemiologic and laboratory surveillance data to inform infection prevention and control and anti...

    Healthcare-associated infections (HAIs), including those caused by antimicrobial resistant organisms (AROs), are an ongoing threat to the health and safety of patients. The morbidity and mortality caused by HAIs place significant burden on patients and healthcare resources Footnote 1 Footnote 2 Footnote 3 Footnote 4 Footnote 5 . A 2017 Canadian poi...

    Design

    The Canadian Nosocomial Infection Surveillance Program conducts prospective, sentinel surveillance for HAIs (including AROs).

    Case definitions

    Standardized case definitions for healthcare-associated (HA) and community-associated (CA) infections were used. Refer to Annex Afor full case definitions.

    Data sources

    Between January 1, 2016, and December 31, 2020, participating hospitals submitted epidemiologic data on cases meeting the respective case definitions for Clostridioides difficile infection (CDI), methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA BSI), vancomycin-resistant Enterococci bloodstream infections (VRE BSI) and carbapenemase-producing Enterobacterales (CPE) infections and colonizations. In 2020, 87 hospitals across Canada participated in HAI surveillance and ar...

    Clostridioides difficile infection

    Between 2016 and 2020, overall CDI rates significantly decreased by 8.5% (5.77–5.28 infections per 10,000 patient days, p=0.050); however, a similar increase of 8.0% in CDI rates (4.89–5.28 per 10,000 patient days) was observed in 2020 compared to 2019 (Table 2). Stratified by source of infection, the incidence of HA-CDI significantly decreased by 13.4% from 4.39–3.80 infections per 10,000 patient days (p=0.050) (Table S1.1). Community-associated-CDI (Annex A) rates have decreased 3.0% when c...

    Methicillin-resistant Staphylococcus aureus bloodstream infections

    Between 2016 and 2019, overall MRSA BSI rates significantly increased by 33.3% (0.84–1.12 infections per 10,000 patient days, p=0.037), and remained stable in 2020 during the COVID-19 pandemic (Table 3). Stratified by case type, a continued steady increase (75%,p=0.023) was observed from 2016 to 2020 in CA-MRSA BSI (Annex A) compared to HA-MRSA BSI, which fluctuated over time (Table S2.1). In 2020, HA-MRSA BSI and CA-MRSA BSI rates were highest in Western Canada (0.46 and 0.79 infections per...

    Vancomycin-resistant Enterococci bloodstream infections

    From 2016 to 2020, VRE BSI rates increased 72.2%, from 0.18 to 0.31 infections per 10,000 patient days, with the highest rate of 0.35 infections per 10,000 patient days observed in 2018 (Table 4). During the COVID-19 pandemic in 2020, VRE BSI rates in the CNISP network remained stable compared to 2019. Regionally, VRE BSI rates were highest in Western and Central Canada (0.36 and 0.33 infections per 10,000 patient days in 2019, respectively) with few VRE BSIs reported in Eastern Canada (range...

    Surveillance data collected via CNISP have shown that between 2016 and 2020 infection rates (including both HA and CA-cases) in Canada have decreased 8.5% for CDI, but increased for MRSA BSI and VRE BSI (33.3% and 72.2%, respectively). The CPE infection rates increased, but remained low; however, colonizations increased 85.7%. The COVID-19 pandemic...

    Canadian Nosocomial Infection Surveillance Program hospitals provided expertise in the development of protocols in addition to the collection and submission of epidemiological data and lab isolates. The National Microbiology Laboratory completed the laboratory analyses and contributed to the interpretation and revision of the paper. Epidemiologists...

    We gratefully acknowledge the contribution of the physicians, epidemiologists, infection control practitioners and laboratory staff at each participating hospital: Vancouver General Hospital (VGH), Vancouver, British Columbia (BC); Richmond General Hospital, Richmond, BC; UBC Hospital, Vancouver, BC; Lion's Gate, North Vancouver, BC; Powell River G...

    Clostridioides difficile infection

    A “primary” episode of Clostridioides difficileinfection (CDI) is defined either as the first episode of CDI ever experienced by the patient or a new episode of CDI that occurs greater than eight weeks after the diagnosis of a previous episode in the same patient. A patient is identified as having CDI if: 1. The patient has diarrhea or fever, abdominal pain and/or ileus AND a laboratory confirmation of a positive toxin assay or positive polymerase chain reaction (PCR) for C. difficile (withou...

    Methicillin-resistant Staphylococcus aureus (MRSA) infection

    MRSA bloodstream infection (BSI) case definition: 1. Isolation of Staphylococcus aureusfrom blood AND 1. Patient must be admitted to the hospital AND 1. Is a "newly identified S. aureusinfection" at a Canadian Nosocomial Infection Surveillance Program (CNISP) hospital at the time of hospital admission or identified during hospitalization. Infection inclusion criteria 1. Methicillin-susceptible Staphylococcus aureus(MSSA) or MRSA BSIs identified for the first time during this current hospital...

    Vancomycin-resistant Enterococci (VRE) infection

    VRE BSI case definition: 1. Isolation of Enterococcus faecalis or faecium from blood AND 1. Vancomycin MIC at least 8 µg/ml AND 1. Patient must be admitted to the hospital AND 1. Is a "newly” identified VRE BSI at a CNISP facility at the time of hospital admission or identified during hospitalization A newly identified VRE BSIis defined as a positive VRE blood isolate more than 14 days after completion of therapy for a previous infection and felt to be unrelated to previous infection in accor...

    These documents can be accessed on the Supplemental material file . Figure S1: Number and proportion of patient admissions included in the Canadian Nosocomial Infection Surveillance Program by hospital type and size, 2020 Table S1.1: Cases and incidence rates of healthcare-associated and community-associated Clostridioides difficile infection by re...

  2. May 5, 2020 · A 2017 point prevalence survey among participating Canadian hospitals estimated that 7.9% of patients had at least one HAI; results that are similar to those from a 2016–2017 study by the European Centre for Disease Prevention and Control that estimated HAI prevalence among tertiary care hospitals to be 7.1% (5,6).

  3. Jan 4, 2024 · The Canadian Nosocomial Infection Surveillance Program: Keeping an eye on antimicrobial resistance in Canadian hospitals since 1995; Trends in Severe Outcomes Among Adult and Pediatric Patients Hospitalized With COVID-19 in the Canadian Nosocomial Infection Surveillance Program, March 2020 to May 2022

  4. Nov 5, 2020 · Results: A total of 4,300 device-associated infections were reported. Central line-associated bloodstream infections were the most common device-associated HAI reported (n=2,973, 69%) and hip and knee arthroplasty infections were the most common SSIs reported (66% of SSIs). Our findings show decreasing CLABSI rates in neonatal intensive care ...

  5. Jul 7, 2022 · Conclusion: Surveillance findings from a national network of Canadian acute care hospitals indicate that rates of MRSA and VRE bloodstream infections, CPE infections and colonizations have increased substantially between 2016 and 2020 while rates of CDI have decreased. The collection of detailed, standardized surveillance data and the consistent application of infection prevention and control ...

  6. The Canadian Nosocomial Infection Surveillance Program (CNISP) is a sentinel surveillance system which collects epidemiologic and linked microbiology data from 106 Canadian acute-care hospitals across 10 provinces and one territory. CNISP summarizes trends in national incidence rates, antimicrobial resistance and molecular characterization for ...