title: Is the prevalence of antibiotic-resistant organisms changing in Canadian hospitals? Comparison of point-prevalence survey results in 2010 and 2012.
abstract: A national point-prevalence survey for infection or colonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), and for Clostridium difficile infection (CDI) was done in Canadian hospitals in 2010. A follow-up survey was done in November 2012 to determine whether there were any changes in the prevalence of these organisms; we also determined the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CREs). Associations between prevalence and infection prevention and control policies were evaluated in logistic regression models. A total of 143 (67% of eligible facilities) hospitals with 29 042 adult inpatients participated in the survey, with representation from all 10 provinces; 132 hospitals participated in 2010 and 2012. There were no significant changes in the median prevalence of MRSA in 2010 (4.3%) compared to 2012 (3.9%), or of CDI in 2010 (0.8%) compared to 2012 (0.9%). A higher median prevalence of VRE was identified in 2012 (1.3%) compared to 2010 (0.5%) (p 0.04), despite decreased VRE screening in 2012. The median prevalence of ESBLs was 0.7% and was 0 for CREs; CREs were reported from only 10 hospitals (7.0%). A policy of routinely caring for patients with MRSA or VRE in a private isolation room was associated with lower prevalence of these organisms. Targeted screening of high-risk patients at admission was associated with lower MRSA prevalence; better hand hygiene compliance was associated with lower VRE prevalence. These data provide national prevalence rates for antibiotic-resistant organisms among adults hospitalized in Canadian hospitals. Certain infection prevention and control policies were associated with prevalence.
authors: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors: V
authors: V
authors: Williams
authors: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: andrew.simor@sunnybrook.ca.
authors: A E
authors: AE
authors: Simor
authors: Institute of Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: A
authors: A
authors: Kiss
authors: Mount Sinai Hospital, Toronto, Ontario, Canada.
authors: A
authors: A
authors: McGeer
authors: The Scarborough Hospital, Toronto, Ontario, Canada.
authors: Z
authors: Z
authors: Hirji
authors: University of Calgary, Calgary, Alberta, Canada.
authors: O E
authors: OE
authors: Larios
authors: Mount Sinai Hospital, Toronto, Ontario, Canada.
authors: C
authors: C
authors: Moore
authors: Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada.
authors: K
authors: K
authors: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D002170:Canada / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D005260:Female; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Clostridium difficile infection; MRSA; VRE; carbapenem resistance