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Prevalence of Colonization and Infection with Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus and of Clostridium difficile Infection in Canadian Hospitals

Published online by Cambridge University Press:  02 January 2015

Andrew E. Simor ,
Victoria Williams ,
Allison McGeer ,
Janet Raboud ,
Oscar Larios ,
Karl Weiss ,
Zahir Hirji ,
Felicia Laing ,
Christine Moore  and
Denise Gravel
...Show all authors
Andrew E. Simor*
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
Victoria Williams
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Allison McGeer
Affiliation:
University of Toronto, Toronto, Ontario, Canada Mount Sinai Hospital, Toronto, Ontario, Canada
Janet Raboud
Affiliation:
University of Toronto, Toronto, Ontario, Canada University Health Network, Toronto, Ontario, Canada
Oscar Larios
Affiliation:
University of Saskatchewan and Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
Karl Weiss
Affiliation:
Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
Zahir Hirji
Affiliation:
Bridgepoint Health, Toronto, Ontario, Canada
Felicia Laing
Affiliation:
Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
Christine Moore
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Denise Gravel
Affiliation:
Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada
*
Department of Microbiology, Sunnybrook Health Sciences Centre, B103-2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada ([email protected]).
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Abstract

Objective.

To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile infection (CDI) in Canadian hospitals.

Design.

National point prevalence survey in November 2010.

Setting.

Canadian acute care hospitals with at least 50 beds.

Patients.

Adult inpatients colonized or infected with MRSA or VRE or with CDI.

Methods.

The prevalence (per 100 inpatients) of MRSA, VRE, and CDI was determined. Associations between prevalence and institutional characteristics and infection control policies were evaluated.

Results.

One hundred seventy-six hospitals (65% of those eligible) participated. The median (range) prevalence rates for MRSA and VRE colonization or infection and CDI were 4.2% (0%–22.1%), 0.5% (0%–13.1%), and 0.9% (0%–8.6%), respectively. Median MRSA and VRE infection rates were low (0.3% and 0%, respectively). MRSA, VRE, and CDI were thought to have been healthcare associated in 79%, 96%, and 84% of cases, respectively. In multivariable analysis, routine use of a private room for colonized/infected patients was associated with lower median MRSA infection rate (prevalence ratio [PR], 0.44 [95% confidence interval (CI), 0.22–0.88]) and VRE prevalence (PR, 0.26 [95% CI, 0.12–0.57]). Lower VRE rates were also associated with enhanced environmental cleaning (PR, 0.52 [95% CI, 0.36–0.75]). Higher bed occupancy rates were associated with higher rates of CDI (PR, 1.02 [95% CI, 1.01–1.03]).

Conclusions.

These data provide the first national prevalence estimates for MRSA, VRE, and CDI in Canadian hospitals. Certain infection prevention and control policies were found to be associated with prevalence and deserve further investigation.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 7 , July 2013 , pp. 687 - 693
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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