title: Assessing the magnitude and trends in hospital acquired infections in Canadian hospitals through sequential point prevalence surveys.
abstract: BACKGROUND
  Healthcare acquired infections (HAI) are an important public health problem in developed countries, but comprehensive data on trends over time are lacking. Prevalence surveys have been used as a surrogate for incidence studies and can be readily repeated.
  
  
  METHODS
  The Canadian Nosocomial Infection Surveillance Program conducted prevalence surveys in 2002 and 2009 in a large network of major Canadian acute care hospitals. NHSN definitions of HAI were used. Use of isolation precautions on the survey day was documented.
  
  
  RESULTS
  In 2009, 9,953 acute care inpatients were surveyed; 1,234 infections (124/1000) were found, compared to 111/1000 in 2002, (p < 0.0001). There was increased prevalence of urinary tract infection (UTI) and Clostridium difficile, offset by decreases in pneumonia and bloodstream infection. Use of isolation precautions increased from 77 to 148 per 1000 patients (p < 0.0001), attributable to increased use of contact precautions in patients infected or colonized with antimicrobial resistant organisms.
  
  
  CONCLUSIONS
  Between 2002 and 2009 HAI prevalence increased by 11.7 % in a network of major Canadian hospitals due to increases in Clostridium difficile and urinary tract infection. The use of isolation precautions increased by 92.2 % attributable to increased contact isolation. National prevalence surveys are useful tools to assess evolving trends in HAI.
authors.affiliation: University of Alberta Hospital, 1-127 CSB, T6G 2G3 Edmonton, Alberta Canada.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Taylor
authors.affiliation: Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario Canada ; University of Alberta Hospital, Edmonton, Alberta Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Gravel
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Matlow
authors.affiliation: Health Sciences Centre, Winnipeg, Manitoba Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Embree
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: LeSaux
authors.affiliation: Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia Canada.
authors.forename: Lynn
authors.initials: L
authors.lastname: Johnston
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario Canada.
authors.forename: Kathryn N
authors.initials: KN
authors.lastname: Suh
authors.affiliation: Health Sciences Centre, London, Ontario Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: John
authors.affiliation: Health Sciences Centre, Winnipeg, Manitoba Canada.
authors.forename: John
authors.initials: J
authors.lastname: Embil
authors.affiliation: Alberta Heath Services, Calgary, Alberta Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Henderson
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario Canada.
authors.forename: Virginia
authors.initials: V
authors.lastname: Roth
authors.affiliation: Royal University Hospital, Saskatoon, Saskatchewan Canada.
authors.forename: Alice
authors.initials: A
authors.lastname: Wong
keywords: Canada; Healthcare acquired infection; Isolation precaution; Prevalence