Antimicrobial Resistant Organisms (ARO) Surveillance SURVEILLANCE REPORT FOR DATA FROM JANUARY TO DECEMBER

Transcription

1 Antimicrobial Resistant Organisms (ARO) Surveillance SURVEILLANCE REPORT FOR DATA FROM JANUARY TO DECEMBER

2 TO PROMOTE AND PROTECT THE HEALTH OF CANADIANS THROUGH LEADERSHIP, PARTNERSHIP, INNOVATION AND ACTION IN PUBLIC HEALTH. Également disponible en français sous le titre : Surveillance des micro-organismes résistants aux antimicrobiens: Rapport de surveillance sur les résultats du 1 janvier 2007 au 31 décembre 2011 This publication can be made available in alternative formats upon request. Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2013 Publication date: November, 2013 Cat.: HP5-116/2013E-PDF ISBN: Pub.: Updated September 2013

3 Antimicrobial Resistant Organisms (ARO) Surveillance SURVEILLANCE REPORT FOR DATA FROM JANUARY TO DECEMBER Updated September 2013

4 1 Antimicrobial Resistant Organisms (ARO) Surveillance Introduction The (The Agency) collects national data on antimicrobial resistant organisms (AROs) through the Canadian Nosocomial infection Surveillance Program (CNISP), a collaborative effort of the Centre for Communicable Diseases and Infection Control (CCDIC), the National Microbiology Laboratory (NML) and sentinel hospitals across Canada who participate as members of the Canadian Hospital Epidemiology Committee (a subcommittee of the Association of Medical Microbiology and Infectious Disease Canada). CNISP surveillance provides key information that informs the development of federal and provincial infection prevention and control programs and policies and provides rates and trends on antimicrobial resistant organisms. In addition, if carried out in a uniform manner, surveillance provides a measure of the burden of illness, establishes benchmark rates for internal and external comparison, identifies potential risk factors, and allows assessment of specific interventions. Surveillance for AMR is considered an important measure of the quality of patient care. The enclosed ARO tables are intended to provide up to date/timely CNISP rates to the provincial and territorial health authorities. The results are subject to change as new data is made available by the participating hospitals. The rates include Clostridium difficile Infection (CDI), Methicillin-Resistant Staphylococcus aureus (MRSA), Vancomycin-Resistant Enterococci (VRE) and Carbapenem-Producing Enterobacteriaceae (CPO). Case definitions and eligibility criteria for CNISP ARO surveillance are provided in Appendix A. Interpretation and discussion of the results can be found in the Agency fact sheets and surveillance reports. The surveillance reports are published every two years. At present, CNISP conducts surveillance in 57 largely, university-affiliated tertiary care hospitals (i.e. major hospitals that offer a range of specialist services) from 10 provinces. When possible, rates are provided by the type of facility (adult, adult/mixed and pediatric) and the region such as Western (British Columbia, Alberta, Saskatchewan and Manitoba), Central (Ontario and Quebec), and Eastern (Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland and Labrador). The territories do not currently submit data to the Agency and Prince Edward Island only began submitting data in The list of participating CNISP hospitals and their corresponding CHEC members is provided in Appendix B. The publication of this report would not be possible without the submission of ARO data from all participating hospitals listed in Appendix B. Their ongoing contributions to national ARO surveillance are gratefully acknowledged. For questions or more information on these rates or for a copy of the most recent Agency surveillance report, please contact the Centre for Communicable Disease and Infection Control, by sending an to ccdic-clmti@phac-aspc.gc.ca

5 2 Antimicrobial Resistant Organisms (ARO) Surveillance 1. Healthcare-Associated-Clostridium difficile Infection (HA-CDI) Table 1 Number of Healthcare-Associated-Clostridium difficile infection cases and incidence rates per 1,000 patient admissions by region , , , , , , , , , , , , , , Table 2 Number of Healthcare-Associated-Clostridium difficile infection cases and incidence rate per 10,000 patient days by region Rate per 10,000 patient days , , , , , , , , , , , , , ,

6 3 Antimicrobial Resistant Organisms (ARO) Surveillance Table 3 Number of Healthcare-Associated-Clostridium difficile infection cases and incidence rates per 1,000 patient admissions by type of facility Type of Facility Adult and mixed Pediatric stand-alone Overall No.cases Rate No.cases Rate No.cases Rate , , , , , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population. Table 4 Number of Healthcare-Associated-Clostridium difficile infection cases and incidence rate per 10,000 patient days by type of facility Rate per 10,000 patient days Type of Facility Adult and mixed Pediatric stand-alone Overall No.cases Rate No.cases Rate No.cases Rate , , , , , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population. Table 5 Attributable mortality rate 30 days after date of positive culture per 100 HA-CDI cases Number of death* Mortality rate per 100 HA-CDI cases *Deaths directly and indirectly related to HA-CDI 30 days after onset of HA-CDI

7 4 Antimicrobial Resistant Organisms (ARO) Surveillance 7.00 CNISP HA-CDI per 1,000 patient admissions West Central East Overall CNISP HA-CDI per 10,000 patient days West Central East Overall

8 5 Antimicrobial Resistant Organisms (ARO) Surveillance 2. Methicillin-Resistant Staphylococcus aureus (MRSA) Table 1 Number of Methicillin-Resistant Staphylococcus aureus rate (infection and colonization) cases and incidence rate per 1,000 admissions by region , , , , , , , , , , , , Table 2 Number of Methicillin-Resistant Staphylococcus aureus rate (infection and colonization) cases and incidence rate per 10,000 patient days by region Rate per 10,000 patient days , , , , , , , , , , , ,

9 6 Antimicrobial Resistant Organisms (ARO) Surveillance Table 3 Number of Methicillin-Resistant Staphylococcus aureus rate (infection and colonization) cases and incidence rate per 1,000 patient admissions by type of facility Adult stand-alone Pediatric stand-alone Type of Facility Adult and mixed Overall , , , , , , , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population. Table 4 Number of Methicillin-Resistant Staphylococcus aureus rate (infection and colonization) cases and incidence rate per 10,000 patient days by type of facility Adult stand-alone Rate per 10,000 patient days Pediatric stand-alone Type of Facility Adult and mixed Overall , , , , , , , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population.

10 7 Antimicrobial Resistant Organisms (ARO) Surveillance Table 5 Methicillin-Resistant Staphylococcus aureus infection rate per 1,000 patient admissions by region , , , , , Table 6 Methicillin-Resistant Staphylococcus aureus infection rate per 10,000 patient days by region Rate per 10,000 patient days , , , , ,

11 8 Antimicrobial Resistant Organisms (ARO) Surveillance Table 7 Methicillin-Resistant Staphylococcus aureus infection rate per 1,000 patient admissions by type of facility Adult stand-alone Pediatric stand-alone Type of Facility Adult and mixed Overall , , , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population. Table 8 Methicillin-Resistant Staphylococcus aureus infection rate per 10,000 patient days by type of facility Adult stand-alone Rate per 10,000 patient days Pediatric stand-alone Type of Facility Adult and mixed Overall , , , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population.

12 9 Antimicrobial Resistant Organisms (ARO) Surveillance CNISP MRSA infections per 1,000 patient admissions West Central East Overall CNISP MRSA infections per 10,000 patient days West Central East Overall

13 10 Antimicrobial Resistant Organisms (ARO) Surveillance Table 9 Healthcare-Associated* Methicillin-resistant Staphylococcus aureus infection rate per 1,000 patient admissions by region , , , , *HA-MRSA includes all cases identified within the CNISP hospital and any other healthcare setting (clinics, LTC) Table 10 Healthcare-Associated* Methicillin-resistant Staphylococcus aureus infection rate per 10,000 patient days by region Rate per 10,000 patient days , , , , *HA-MRSA includes all cases identified within the CNISP hospital and any other healthcare setting (clinics, LTC)

14 11 Antimicrobial Resistant Organisms (ARO) Surveillance Table 11 Healthcare-Associated* Methicillin-resistant Staphylococcus aureus (HA-MRSA) infection rate per 1,000 patient admissions by type of facility Adult stand-alone Pediatric stand-alone Type of Facility Adult and mixed Overall , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population. *HA-MRSA includes all cases identified within the CNISP hospital and any other healthcare setting (clinics, LTC) Table 12 Healthcare-Associated* Methicillin-resistant Staphylococcus aureus (HA-MRSA) infection rate per 10,000 patient days by type of facility Adult stand-alone Rate per 10,000 patient days Pediatric stand-alone Type of Facility Adult and mixed Overall , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population. *HA-MRSA includes all cases identified within the CNISP hospital and any other healthcare setting (clinics, LTC)

15 12 Antimicrobial Resistant Organisms (ARO) Surveillance 3.50 CNISP HA-MRSA infections per 1,000 patient admissions West Central East Overall CNISP HA-MRSA infections per 10,000 patient days West Central East Overall

16 13 Antimicrobial Resistant Organisms (ARO) Surveillance Table 13 Community-Associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infection rate per 1,000 patient admissions by region Table 14 Community-Associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infection rate per 10,000 patient days by region Rate per 10,000 patient days

17 14 Antimicrobial Resistant Organisms (ARO) Surveillance Table 15 Community-Associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infection rate per 1,000 patient admissions by type of facility Adult stand-alone Pediatric stand-alone Type of Facility Adult and mixed Overall Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population. Table 16 Community-Associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infection rate per 10,000 patient days by type of facility Adult stand-alone Rate per 10,000 patient days Pediatric stand-alone Type of Facility Adult and mixed Overall Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population.

18 15 Antimicrobial Resistant Organisms (ARO) Surveillance 1.20 CNISP CA-MRSA infections per 1,000 patient admissions West Central East Overall CNISP CA-MRSA infections per 10,000 patient days West Central East Overall

19 16 Antimicrobial Resistant Organisms (ARO) Surveillance Table 17 Methicillin-resistant Staphylococcus aureus bloodstream (MRSA-BSI) infection rate per 1,000 patient admissions by region Table 18 Methicillin-resistant Staphylococcus aureus bloodstream (MRSA-BSI) infection rate per 10,000 patient days by region Rate per 10,000 patient days *Number of MRSA BSI cases used in rates may be < than total number of MRSA BSI as only those hospitals that provided both numerator and denominator data were used in calculation of rates Table 19 All-cause mortality rate 30 days after date of positive culture per 100 MRSA-BSI cases Number of deaths All-cause mortality rate per 100 MRSA-BSI cases

20 17 Antimicrobial Resistant Organisms (ARO) Surveillance 0.80 CNISP MRSA-BSI infections per 1,000 patient admissions West Central East Overall CNISP MRSA-BSI infections per 10,000 patient admissions West Central East Overall

21 18 Antimicrobial Resistant Organisms (ARO) Surveillance 3. Vancomycin-Resistant Enterococci (VRE) Table 1 Vancomycin-Resistant Enterococci infection rates per 1,000 patient admissions by region Table 2 Vancomycin-Resistant Enterococci infection rates per 1,000 patient admissions by facility type Type of Facility Adult and mixed Pediatric stand-alone Overall No.cases Rate No.cases Rate No.cases Rate Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population.

22 19 Antimicrobial Resistant Organisms (ARO) Surveillance Table 3 Vancomycin-Resistant Enterococci infection rates per 10,000 patient days by region Rate per 10,000 patient-days Table 4 Vancomycin-Resistant Enterococci infection rates per 10,000 patient days by facility type Rate per 10,000 patient-days Type of Facility Adult and mixed Pediatric stand-alone Overall No.cases Rate No.cases Rate No.cases Rate Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population.

23 20 Antimicrobial Resistant Organisms (ARO) Surveillance CNISP VRE infections per 1,000 patient admissions West Central East Overall CNISP VRE infections per 10,000 patient days West Central East Overall

24 21 Antimicrobial Resistant Organisms (ARO) Surveillance Table 5 Vancomycin-Resistant Enterococci colonization rates per 1,000 patient admissions by region , , , , , , , , , , , , , Table 6 Vancomycin-Resistant Enterococci colonization rates per 1,000 patient admissions by facility type Type of Facility Adult and mixed Pediatric stand-alone Overall No.cases Rate No.cases Rate No.cases Rate , , , , , , , , , , Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population.

25 22 Antimicrobial Resistant Organisms (ARO) Surveillance Table 7 Vancomycin-Resistant Enterococci colonization rates per 10,000 patient days by region Rate per 10,000 patient-days Table 8 Vancomycin-Resistant Enterococci colonization rates per 10,000 patient days by facility type Rate per 10,000 patient-days Type of Facility Adult and mixed Pediatric stand-alone Overall No.cases Rate No.cases Rate No.cases Rate Adult and mixed are comprised of hospitals that provide services to both adult and pediatric patients. Typically, the pediatric patients represent less than 10% of the hospital population.

26 23 Antimicrobial Resistant Organisms (ARO) Surveillance Table 9 Healthcare-associated Vancomycin-Resistant Enterococci infection rates per 1,000 patient admissions by region for the reporting CNISP hospitals* *site of acquisition was no longer collected after 2010 Note: data on community acquired (CA) VRE infections is not included as only 15 CA-VRE infections were reported from 2006 to Table 10 Healthcare-associated Vancomycin-Resistant Enterococci infection rates per 10,000 patient-days by region for the reporting CNISP hospitals* Rate per 10,000 patient days *site of acquisition was no longer collected after 2010 Note: data on community acquired (CA) VRE infections is not included as only 15 CA-VRE infections were reported from 2006 to 2010.

27 24 Antimicrobial Resistant Organisms (ARO) Surveillance Table 11 Healthcare-associated Vancomycin-Resistant Enterococci colonization rates per 1,000 patient admissions by region for the reporting CNISP hospitals* , , , , , , , , *site of acquisition was no longer collected after 2010 Table 12 Healthcare-associated Vancomycin-Resistant Enterococci colonization rates per 10,000 patient-days by region for the reporting CNISP hospitals* Rate per 10,000 patient days , , , , , , , , *site of acquisition was no longer collected after 2010

28 25 Antimicrobial Resistant Organisms (ARO) Surveillance 4. Carbapenemase-Producing Organisms (CPO) Table 1 Number of cases of Carbapenemase-Producing Organisms (CPO) by region Number of cases* Total *Rates are pending awaiting final denominator data Table 2 All-cause and attributable mortality rate 30 days after date of positive culture per 100 CPO cases Number of deaths All-cause mortality rate per 100 CPO cases Number of attributable deaths* Attributable mortality rate per 100 CPO cases* % 1 2.4% % % 2 3.7% Total % 3 1.9% *CPO was the primary or contributing cause of death 30 days after diagnosis