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Information about national and state-level HAI data from 2022, measured using the standardized infection ratio (SIR).
Data from the National Healthcare Safety Network were analyzed to assess the impact of COVID-19 on the incidence of healthcare-associated infections (HAI) during 2021. Standardized infection ratios were significantly higher than those during the prepandemic period, particularly during 2021-Q1 and 2021-Q3.
This report, along with the detailed technical tables, provides national - and state-level data about HAI incidence during 2020. The report is designed to be accessible to many audiences.
Apr 15, 2024 · Why is data validation and why is it important? Validation is double-checking, or confirming, HAI data reported CDC's National Healthcare Safety Network (NHSN). This generally involves an assessment to ensure that all relevant infections were captured in the system.
- 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...
HAIs: Reports and Data. CDC publishes data reports to help track progress and target areas that need assistance. HAI Prevention and Control for Healthcare. HAI Prevention, Control and Outbreak Response for Public Health and Healthcare. Introduction to the Patient Notification Toolkit. Laboratory Resources for HAIs. New report.
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Data-driven strategies and tools to help prevent HAIs include improving infection control practices and hand hygiene, improving antibiotic use and prescribing practices, increasing attention to safety culture, and performing proper cleaning and disinfection at health care facilities.
