Hospital-Wide Healthcare-associated Bloodstream Infections
Surveillance results: 2016-2017

From April 1st, 2016, to March 31st, 2017, 89 healthcare facilities took part in the hospital-wide surveillance of bloodstream infections (BSIs), for a combined total of 4,830,348 patient days (Table 1). Participating facilities reported 3,167 BSIs in 2,982 patients. The total incidence rate was 5.43 cases per 10,000 patient days. The incidence rate in 2016–2017 is stable compared with the average rate for 2012–2016. Two non-teaching facilities joined the program in 2016–2017. Data were extracted on May 5th, 2017.

Update: October 5, 2017
Version française

Table 1 – Participation of Healthcare Facilities in the Hospital-Wide Surveillance of BSIs, Québec, 2012–2013 to 2016–2017

 

2012-2013

2013-2014

2014-2015

2015-2016

2016-2017

Participating facilities (N)

64

73

89

87

89

Admissions (N)

482,354

520,772

633,252

649,458

677,083

Patient days (N)

3,791,482

3,998,173

4,740,371

4,771,179

4,830,348

BSIs (cat. 1a, 1b and 1c, N)

2,537

2,457

3,008

3,126

3,167

Infected patients (N)

2,428

2,295

2,806

2,899

2,982

In 2016–2017, the total incidence rate is 5.43 BSIs per 10,000 patient days. The incidence rates remain much higher in intensive care units (ICUs) than in other units (Table 2). They are also higher in teaching facilities than in non-teaching facilities (Figure 1 and Table 2). Catheter-related bloodstream infections (CRBSIs) are the most common BSIs in teaching ICUs; in non-teaching ICUs, it is rather non-catheter-related primary bloodstream infection (non-CRBSI) (Figure 2). In other units, the incidence rates also vary depending on the type of healthcare facility: non-CRBSI are the most common BSIs in teaching facilities, while BSIs secondary to urinary tract infections are the most common in non-teaching facilities (Figure 3). In teaching facilities, in non-intensive care units, the CRBSI incidence rate (1.11 case / 10,000 patient days) increases to 1.54 case / 10,000 patient days when CRBSI associated with a mucosal barrier injury (MBI) are also considered (Figure 3 and Table 2).

Figure 1 – BSI Incidence Rate for Each Type of Infection, by Type of Healthcare Facility, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 1 – BSI Incidence Rate for Each Type of Infection, by Type of Healthcare Facility, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 2 – BSI Incidence Rate in ICUs, For Each Type of Infection, by Type of Healthcare Facility and Type of ICU, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 2 – BSI Incidence Rate in ICUs, For Each Type of Infection, by Type of Healthcare Facility and Type of ICU, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 3 – BSI Incidence Rate in Non-ICU Units, for Each Type of Infection, by Type of Healthcare Facility, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 3 – BSI Incidence Rate in Non-ICU Units, for Each Type of Infection, by Type of Healthcare Facility, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Table 2 – BSI Incidence Rate for Each Type of Infection, by Type of Healthcare Facility, Type of Unit and Type of ICU, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

 

 

Primary BSIs

Secondary BSIs

Total

CRBSI-MBI

CRBSI

Non-CRBSI

HD

Urinary tract

Abdominal

Pulmonary

SSI

Other**

Total hospitalized

0.22
[0.18 - 0.27]

0.96
[0.88 - 1.05]

1.16
[1.07 - 1.26]

0.04
[0.02 - 0.06]

1.08
[0.99 - 1.18]

0.54
[0.48 - 0.61]

0.49
[0.43 - 0.55]

0.59
[0.53 - 0.66]

0.35
[0.30 - 0.40]

5.43
[5.22 - 5.64]

Teaching

0.41
[0.34 - 0.50]

1.53
[1.38 - 1.70]

1.49
[1.34 - 1.65]

0.06
[0.04 - 0.10]

1.20
[1.06 - 1.34]

0.79
[0.68 - 0.91]

0.65
[0.56 - 0.76]

0.92
[0.80 - 1.05]

0.43
[0.35 - 0.52]

7.47
[7.14 - 7.83]

Non-teaching

0.03
[0.01 - 0.06]

0.40
[0.33 - 0.49]

0.84
[0.73 - 0.96]

0.01
[0.00 - 0.03]

0.97
[0.86 - 1.10]

0.30
[0.23 - 0.37]

0.32
[0.26 - 0.40]

0.27
[0.22 - 0.35]

0.27
[0.21 - 0.34]

3.42
[3.19 - 3.66]

ICUs

0.19
[0.08 - 0.42]

4.66
[3.97 - 5.47]

2.43
[1.94 - 3.03]

0.06
[0.02 - 0.25]

1.24
[0.91 - 1.70]

1.34
[0.99 - 1.80]

2.36
[1.89 - 2.96]

1.18
[0.86 - 1.62]

0.59
[0.38 - 0.93]

14.05
[12.82 - 15.41]

Adult teaching

0.15
[0.04 - 0.59]

3.88
[2.97 - 5.08]

2.49
[1.78 - 3.49]

0.15
[0.04 - 0.59]

1.76
[1.18 - 2.62]

1.17
[0.72 - 1.91]

3.30
[2.46 - 4.42]

2.20
[1.54 - 3.14]

0.88
[0.50 - 1.55]

15.97
[13.99 - 18.24]

Adult non-teaching

0.11
[0.02 - 0.80]

2.58
[1.71 - 3.88]

3.37
[2.35 - 4.81]

-

1.68
[1.01 - 2.79]

1.12
[0.60 - 2.09]

2.58
[1.71 - 3.88]

0.67
[0.30 - 1.50]

0.45
[0.17 - 1.20]

12.56
[10.44 - 15.12]

Pediatric

1.50
[0.37 - 5.98]

14.21
[9.07 - 22.28]

2.24
[0.72 - 6.96]

-

-

0.75
[0.11 - 5.31]

-

0.75
[0.11 - 5.31]

0.75
[0.11 - 5.31]

20.20
[13.85 - 29.45]

Neonatal

0.12
[0.02 - 0.86]

6.65
[5.11 - 8.67]

1.33
[0.74 - 2.4]

-

0.12
[0.02 - 0.86]

1.94
[1.19 - 3.16]

0.97
[0.48 - 1.94]

0.12
[0.02 - 0.86]

0.24
[0.06 - 0.97]

11.49
[9.40 - 14.06]

Non ICU units

0.22
[0.18 - 0.27]

0.70
[0.63 - 0.78]

1.07
[0.98 - 1.17]

0.03
[0.02 - 0.06]

1.07
[0.98 - 1.17]

0.48
[0.42 - 0.55]

0.35
[0.30 - 0.41]

0.55
[0.49 - 0.62]

0.33
[0.28 - 0.39]

4.81
[4.61 - 5.02]

Teaching

0.43
[0.36 - 0.53]

1.11
[0.98 - 1.26]

1.43
[1.27 - 1.59]

0.06
[0.03 - 0.10]

1.21
[1.07 - 1.36]

0.72
[0.61 - 0.84]

0.48
[0.39 - 0.58]

0.87
[0.75 - 1.00]

0.40
[0.33 - 0.50]

6.70
[6.36 - 7.05]

Non-teaching

0.03
[0.01 - 0.06]

0.32
[0.25 - 0.40]

0.75
[0.64 - 0.86]

0.01
[0.00 - 0.03]

0.95
[0.83 - 1.08]

0.26
[0.21 - 0.34]

0.24
[0.18 - 0.31]

0.26
[0.20 - 0.33]

0.26
[0.21 - 0.34]

3.07
[2.86 - 3.30]

* When the incidence rate is 0, the confidence interval [CI] is not calculated.
** The “Other” column also includes HD-related BSIs and secondary BSIs arising from a skin, soft tissue, bone or joint infection.

The BSI incidence rate in 2016–2017 remains stable compared with the 2012–2016 pooled rate (p > 0.05, Table 3). This is observed in both teaching and non-teaching facilities. This stability is also observed for every BSI type except for non-CRBSIs and BSIs secondary to an abdominal infection (p < 0.05, Figure 4). The apparent variation in rates of BSIs secondary to a urinary infection is not statistically significant.

Figure 4 – Evolution of BSI Incidence Rates, by Type of Infection, in Facilities that Previously participated in Surveillance (N = 89), Québec, 2012–2016 and 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 4 – Evolution of BSI Incidence Rates, by Type of Infection, in Facilities that Previously participated in Surveillance (N = 89), Québec, 2012–2016 and 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Table 3 – Evolution of BSI Incidence Rates, by Type of Healthcare Facility, in Facilities that Previously participated in Surveillance (N = 89), Québec, 2012–2016 and 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Facility

Number of facilities

Incidence rate

2012-2013

2016-2017

Teaching

26

7.20 [7.02 ; 7.38]

7.47 [7.14 ; 7.83]

Non-teaching

63

3.49 [3.36 ; 3.61]

3.43 [3.20 ; 3.67]

Total

89

5.35 [5.24 ; 5.46]

5.43 [5.23 ; 5.64]

Patients who developed a BSI are aged between 0 and 101 years, with a median age of 69 years. Forty-one percent of BSIs (41%) occurred in women. Although the incidence rates are higher in ICUs, most BSIs occurred in non-ICU units (68%, Table 4 and Figure 5). Non-CRBSIs are the most commonly encountered BSIs in both teaching and non-teaching facilities (Table 4 and Figure 6).

Figure 5 – Breakdown of Cases Based on Type of Unit and Type of ICU, Québec, 2016–2017 (%)

Figure 5 – Breakdown of Cases Based on Type of Unit and Type of ICU, Québec, 2016–2017 (%)

Figure 6 – Breakdown of Cases Based on Type of BSI, for Teaching and Non-Teaching Healthcare Facilities, Québec, 2016–2017 (%)

Figure 6 – Breakdown of Cases Based on Type of BSI, for Teaching and Non-Teaching Healthcare Facilities, Québec, 2016–2017 (%)

Table 4 – Number of Cases for Each Type of BSI, by Type of Healthcare Facility, Type of Unit and Type of ICU, Québec, 2016–2017 (N)

 

 

Primary BSIs

Secondary BSIs

Total

CRBSI-MBI

CRBSI

Non-CRBSI

HD

Urinary tract

Abdominal

Pulmonary

SSI

Other*

Total

111

551

778

130

580

275

240

310

192

3,167

Teaching

103

434

488

83

302

195

157

233

116

2,111

Non-teaching

8

117

290

47

278

80

83

77

76

1,056

Total hospitalized

106

465

561

17

523

260

235

286

168

2,621

Teaching

99

367

356

15

286

188

156

219

102

1,788

Non-teaching

7

98

205

2

237

72

79

67

66

833

ICU

6

150

78

2

40

42

78

38

19

452

Teaching

2

53

34

2

24

16

45

30

12

218

Non-teaching

1

23

30

0

15

10

23

6

4

112

pédiatriques

2

19

3

0

0

1

0

1

1

27

néonatales

1

55

11

0

1

16

8

1

2

95

Non-ICU hospitalization

100

315

483

15

483

217

159

248

149

2,169

Teaching

94

240

308

13

261

155

103

187

87

1,448

Non-teaching

6

75

175

2

222

62

56

61

62

721

Ambulatory

5

86

217

113

57

15

5

24

24

546

Teaching

4

67

132

68

16

7

1

14

14

323

Non-teaching

1

19

85

45

41

8

4

10

10

223

* The “Other” column also includes BSIs secondary to skin, soft tissue, bone or joint infection.

Three hundred and thirty four (334) procedures that occurred in the seven days preceeding the BSI are reported for the 778 non-CRBSIs (Table 5). Urologic procedures are the most frequently reported procedures, representing 42% of all reported procedures.

Table 5 – Distribution of Invasive Procedures Reported for Non-CRBSIs, by Type, Québec, 2016-2017 (N, %)

Type of invasive procedure

Procedures

N

%

Urologic

141

42.2

    Prostate biopsy

47

14.1

    Ureteral double J stent placement

47

14.1

    Cystoscopy / retrograde ureteroscopy

32

9.6

    Percutaneous nephrostomy

15

4.5

Abdominal

39

11.7

    Colonoscopy

10

3

    Upper gastrointestinal endoscopy

8

2.4

    Paracentesis – Ascitic tap

10

3

    Other abdominal

11

3.3

Cardiovascular

16

4.8

    Angiography with / without angioplasty or stent

9

2.7

    Other cardiovascular

7

2.1

Hepatobiliary

62

18.6

    ERCP with / without biliary stent

59

17.7

    Other hepatobiliary

3

0.9

Musculoskeletal

0

0

    Arthrocentesis (joint tap)

0

0

Cutaneous

0

0

Gynecological

0

0

Neurologic

0

0

Respiratory

9

2.7

Other

67

20.1

Total

334

100

Overall, 18% of BSI cases resulted in death within 30 days of bacteremia onset (Table 6). Case fatality is highest in patients with a BSI secondary to a pulmonary infection (Table 6 and Figure 7).

Figure 7 – 30-Day Case Fatality for Each Type of Infection, Québec, 2016–2017 (%)

Figure 7 – 30-Day Case Fatality for Each Type of Infection, Québec, 2016–2017 (%)

Table 6 – 10-Day and 30-Day Case Fatality for Each Type of Infection, 2016–2017 (N, %)

 

 

BSIS

10-day case fatality

30-day case fatality

(n)

n

%

n

%

Primary BSIs

         

   CRBSI-MBI

111

6

5

10

9

   CRBSI

551

32

6

64

12

   Non-CRBSI

778

127

16

171

22

   HD

130

9

7

18

14

Secondary BSIs

       

   Urinary tract

580

48

8

89

15

   Abdominal

275

38

14

55

20

   Pulmonary

240

61

25

79

33

   SSI

310

17

5

34

11

   Skin and soft tissue

99

12

12

20

20

   Bone and joint

16

1

6

3

19

   Other

77

8

10

19

25

Total

3,167

359

11

562

18

The three most frequently isolated microorganisms in reported cases and in cases resulting in death within 30 days are Escherichia coli, Staphylococcus aureus and Klebsiella sp. (Figure 8 and Table 7). Staphylococcus aureus is the most frequently isolated microorganisms in patients with CRBSIs, hemodialysis-related BSIs and in BSIs secondary to a pulmonary infection or a SSI (Figure 9 and Table 7). In patients with a non-CRBSI, CRBSI-MBI or a BSI secondary to a urinary tract or abdominal infection, Escherichia coli is the most common microorganism. A polymicrobial infection occurred in 11% of cases; this proportion reaches 21% in BSIs secondary to an abdominal infection and 14% in BSIs secondary to a SSI.

Figure 8 – Breakdown of Categories of Isolated Microorganisms in All Cases (N = 3,579) and Cases of Fatality Within 30 Days (N = 635), Québec, 2016–2017 (%)

Figure 8 – Breakdown of Categories of Isolated Microorganisms in All Cases (N = 3,579) and Cases of Fatality Within 30 Days (N = 635), Québec, 2016–2017 (%)

Figure 9 – Breakdown of Categories of Isolated Microorganisms, for Each Type of BSI, Québec, 2016–2017 (%)

Figure 9 – Breakdown of Categories of Isolated Microorganisms, for Each Type of BSI, Québec, 2016–2017 (%)

Table 7 – Breakdown of Microorganisms associated with BSIs, for each Type of BSI, for all BSIs and for those associated with a Fatality Within 30 Days, Québec, 2016–2017 (N, %)

Microorganism

Primary BSIs

Secondary BSIs

Overall*

30-day case fatality

CRBSI-MBI

CRBSI

Non-CRBSI

HD

Urinary tract

Abdominal

Pulmonary

SSI

n

%

Enterobacteria

82

86

395

15

458

176

88

92

1431

226

15.8

   E. coli

44

19

205

3

282

88

26

55

739

76

10.3

   Klebsiella sp.

24

36

115

2

97

50

34

21

387

105

27.1

   Other enterobacteria

14

31

75

10

79

38

28

16

305

45

14.8

S. aureus

0

195

111

87

23

10

66

98

672

124

18.5

CNS

0

158

41

15

5

5

1

13

250

31

12.4

Enterococcus sp.

13

55

95

6

45

55

10

35

328

61

18.6

Candida sp.

1

48

31

1

16

6

7

19

133

47

35.3

Anaerobic

6

2

35

1

2

28

7

52

152

30

19.7

Pseudomonas sp.

0

22

42

3

42

9

26

7

155

40

25.8

Other

19

57

148

4

37

61

55

44

458

76

16.6

Total

121

623

898

132

628

350

260

360

3579

635

17.7

*  This column includes the sum of the other columns as well as secondary BSIs arising from a skin, soft tissue, bone or joint infection, or another source.

Methicillin-resistant S. aureus (MRSA) account for 12% (80 / 671) of S. aureus BSIs in all geographic areas (Table 8 and Figure 10); this represents a significant decrease compared to the 2012-2016 proportion (16%, p < 0.05). BSIs associated with carbapenem-resistant enterobacteriaceae continue to be relatively rare in Québec (13 / 997 or 1% of tested strains) and the apparent increase in resistance in 2015-2016 and 2016-2017 is not statistically significant. Please note that results presented in the second graph of Figure 10 exclude Pseudomonas sp.

Table 8 – Proportion of Strains Tested and Proportion of Resistance to Antibiotics for Selected Isolated Microorganisms, Québec, 2016–2017 (N, %)

Microorganism

Antibiotic

Isolated

Tested

Resistant

N

N

%

N

%

Staphylococcus aureus

Oxacillin

672

671

99.9

80

11.9

Enterococcus faecium

Vancomycin

109

108

99.1

11

10.2

Enterococcus faecalis

Vancomycin

180

180

100

1

0.6

Klebsiella sp.

CSE 4

387

294

76

22

7.5

Imipenem  ou meropenem

387

257

66.4

3

1.2

Multiresistant 1

387

327

84.5

5

1.5

Escherichia coli

CSE 4

739

590

79.8

67

11.4

Fluoroquinolones 3

739

669

90.5

188

28.1

Imipenem  ou meropenem

739

520

70.4

2

0.4

Multiresistant 1

739

657

88.9

26

4

Enterobacter sp.

CSE 4

122

93

76.2

26

28

Imipenem  ou meropenem

122

97

79.5

2

2.1

Multiresistant 1

122

93

76.2

3

3.2

Pseudomonas sp.

Amikacin, gentamicin or tobramycin

155

125

80.6

4

3.2

CSE 2

155

144

92.9

8

5.6

Fluoroquinolones 2

155

145

93.5

11

7.6

Imipenem  ou meropenem

155

134

86.5

15

11.2

Piperacillin/tazobactam

155

128

82.6

4

3.1

Multiresistant 2

155

146

94.2

9

6.2

Acinetobacter sp.

Imipenem  ou meropenem

14

12

85.7

1

8.3

Multiresistant 3

14

6

42.9

0

0

CSE 2: cefepime or ceftazidime;
CSE 4: cefepime, cefotaxime, ceftazidime or ceftriaxone;
Fluoroquinolones 2: ciprofloxacin or levofloxacin;
Fluoroquinolones 3: ciprofloxacin, levofloxacin or moxifloxacin;
Multiresistant 1: intermediate or resistant to an agent in three of the following five categories: cephalosporins 4, fluoroquinolones 3, aminoglycosides, carbapenems, piperacillin or piperacillin/tazobactam.
Multiresistant 2: intermediate or resistant to an agent in three of the following five categories: cephalosporins 2, fluoroquinolones 2, aminoglycosides, carbapenems, piperacillin or piperacillin/tazobactam.
Multiresistant 3: intermediate or resistant to an agent in three of the following six categories: cephalosporins 2, fluoroquinolones 2, aminoglycosides, carbapenems, piperacillin or piperacillin/tazobactam, ampicillin/sulbactam.

Figure 10 – Antibiotic Resistance in Gram-Positive Bacteria, Gram-Negative Bacteria and Pseudomonas sp., Québec, 2012–2013 to 2016–2017 (%)

Figure 10 – Antibiotic Resistance in Gram-Positive Bacteria, Gram-Negative Bacteria and Pseudomonas sp., Québec, 2012–2013 to 2016–2017 (%)

Three teaching and four non-teaching facilities have an incidence rate above the 90th percentiles of 2012-2016 incidence rates (Figures 11 and 12). Tables 9 and 10 present 2016-2017 rates of CRBSI and of BSIs secondary to urinary tract infections and SSIs, per healthcare facility.

Figure 11 – BSI Incidence Rate per Facility (2016–2017) and Percentile Ranking (2012–2013 to 2015–2016) for Teaching Healthcare Facilities, Québec, 2016–2017

Figure 11 – BSI Incidence Rate per Facility (2016–2017) and Percentile Ranking (2012–2013 to 2015–2016) for Teaching Healthcare Facilities, Québec, 2016–2017

Figure 12 – BSI Incidence Rate per Facility (2016–2017) and Percentile Ranking (2012–2013 to 2015–2016) for Non-Teaching Healthcare Facilities, Québec, 2016–2017

Figure 12 – BSI Incidence Rate per Facility (2016–2017) and Percentile Ranking (2012–2013 to 2015–2016) for Non-Teaching Healthcare Facilities, Québec, 2016–2017

Table 9 – Incidence Rates of CRBSI and of BSIs Secondary to Urinary Tract and Pulmonary Infections per Facility and Percentile Ranking, for Teaching Healthcare Facilities, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Facility

CRBSI

Urinairy tract

SSI

Cases (n)

Incidence rates

Cases (n)

Incidence rates

Cases (n)

Incidence rates

1 HÔPITAL CHARLES LEMOYNE

5

0.39 [0.16 - 0.94]

5

0.39 [0.16 - 0.94]

7

0.55 [0.26 - 1.15]

2 HÔPITAL DE L'ENFANT-JÉSUS

19

1.46 [0.93 - 2.29]

10

0.77 [0.41 - 1.43]

7

0.54 [0.26 - 1.13]

3 GLEN - ROYAL VICTORIA

35

3.24 [2.33 - 4.51]

20

1.85 [1.19 - 2.87]

22

2.04 [1.34 - 3.09]

4 HÔPITAL NOTRE-DAME DU CHUM

23

2.21 [1.47 - 3.32]

14

1.34 [0.80 2.27]

11

1.06 [0.58 - 1.91]

5 HÔPITAL GÉNÉRAL JUIF

31

1.84 [1.29 - 2.61]

32

1.9 [1.34 - 2.68]

7

0.42 [0.20 0.87]

6 GLEN - ENFANTS

44

10.34 [7.70 13.9]

1

0.24 [0.03 - 1.67]

0

0

7 PAVILLON L'HÔTEL-DIEU DE QUÉBEC

14

1.65 [0.98 - 2.79]

29

3.42 [2.38 - 4.93]

22

2.6 [1.71 - 3.94]

8 PAVILLON MAISONNEUVE/PAVILLON MARCEL-LAMOUREUX

28

1.5 [1.04 - 2.17]

15

0.8 [0.48 - 1.33]

13

0.7 [0.40 1.20]

12 CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE

45

5.15 [3.84 - 6.90]

3

0.34 [0.11 - 1.06]

2

0.23 [0.06 - 0.91]

13 INSTITUT DE CARDIOLOGIE DE MONTRÉAL

3

0.67 [0.22 - 2.09]

4

0.9 [0.34 - 2.40]

8

1.8 [0.90 3.60]

15 HÔPITAL FLEURIMONT

17

1.61 [1.00 2.59]

8

0.76 [0.38 - 1.51]

7

0.66 [0.32 - 1.39]

18 HÔTEL-DIEU DE LÉVIS

0

0

14

1.82 [1.08 - 3.08]

0

0

20 HÔPITAL DE CHICOUTIMI

2

0.29 [0.07 - 1.16]

8

1.16 [0.58 - 2.31]

5

0.72 [0.30 1.74]

21 HÔPITAL SAINT-LUC DU CHUM

13

1.28 [0.74 - 2.20]

12

1.18 [0.67 - 2.08]

23

2.26 [1.50 3.41]

22 HÔTEL-DIEU DU CHUM

10

1.49 [0.80 2.77]

6

0.89 [0.40 1.99]

19

2.83 [1.81 - 4.44]

24 HÔPITAL DU SAINT-SACREMENT

0

0

5

0.96 [0.40 2.30]

2

0.38 [0.10 1.53]

25 HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL

25

1.71 [1.15 - 2.52]

29

1.98 [1.37 - 2.85]

8

0.55 [0.27 - 1.09]

27 PAVILLON CENTRE HOSPITALIER DE L'UNIVERSITÉ LAVAL

7

0.6 [0.29 - 1.26]

7

0.6 [0.29 - 1.26]

0

0

28 PAVILLON SAINT-FRANCOIS D'ASSISE

5

0.56 [0.23 - 1.35]

12

1.34 [0.76 - 2.37]

5

0.56 [0.23 - 1.35]

29 HÔPITAL GÉNÉRAL DE MONTRÉAL

23

3.22 [2.14 - 4.84]

4

0.56 [0.21 - 1.49]

21

2.94 [1.91 - 4.50]

30 HÔTEL-DIEU DE SHERBROOKE

3

0.44 [0.14 - 1.35]

7

1.02 [0.48 - 2.13]

3

0.44 [0.14 - 1.35]

31 PAVILLON SAINTE-MARIE

9

0.71 [0.37 - 1.37]

14

1.11 [0.66 - 1.87]

8

0.63 [0.32 - 1.26]

33 INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC

3

0.3 [0.10 0.93]

6

0.6 [0.27 - 1.34]

18

1.81 [1.14 - 2.87]

48 CENTRE HOSPITALIER DE ST. MARY

3

0.4 [0.13 - 1.23]

16

2.12 [1.30 3.45]

0

0

76 HÔPITAL DE LACHINE

0

0

4

2.24 [0.84 - 5.96]

0

0

Tableau 10 – Incidence Rates of CRBSI and of BSIs Secondary to Urinary Tract and Pulmonary Infections per Facility and Percentile Ranking, for Non-Teaching Healthcare Facilities, Québec, 2016–2017 (Incidence Rate per 10,000 Patient Days [95% CI])

Facility

CRBSI

Urinairy tract

SSI

Cases (n)

Incidence rates

Cases (n)

Incidence rates

Cases (n)

Incidence rates

9 HÔPITAL DU HAUT-RICHELIEU

5

0.57 [0.24 - 1.38]

11

1.26 [0.70 2.28]

1

0.11 [0.02 - 0.81]

10 HÔPITAL PIERRE-BOUCHER

0

0

15

1.31 [0.79 - 2.17]

2

0.17 [0.04 - 0.70]

11 HÔPITAL PIERRE-LE GARDEUR

3

0.27 [0.09 - 0.82]

13

1.15 [0.67 - 1.98]

2

0.18 [0.04 - 0.71]

14 CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

4

0.39 [0.15 - 1.05]

11

1.08 [0.60 1.96]

6

0.59 [0.27 - 1.32]

16 HÔPITAL RÉGIONAL DE RIMOUSKI

1

0.19 [0.03 - 1.33]

6

1.13 [0.51 - 2.51]

0

0

19 HÔPITAL CITÉ DE LA SANTÉ

10

0.58 [0.31 - 1.07]

11

0.63 [0.35 - 1.14]

6

0.35 [0.16 - 0.77]

23 HÔTEL-DIEU D'ARTHABASKA

0

0

2

0.42 [0.10 1.66]

3

0.62 [0.20 1.93]

26 HÔPITAL DE VERDUN

13

1.58 [0.92 - 2.72]

16

1.94 [1.19 - 3.17]

3

0.36 [0.12 - 1.13]

32 CENTRE HOSPITALIER RÉGIONAL DU GRAND-PORTAGE

1

0.4 [0.06 - 2.80]

0

0

0

0

34 HÔPITAL SANTA CABRINI

2

0.2 [0.05 - 0.78]

14

1.37 [0.81 - 2.32]

3

0.29 [0.09 - 0.91]

35 HÔPITAL HONORÉ-MERCIER

4

0.61 [0.23 - 1.63]

7

1.07 [0.51 - 2.25]

3

0.46 [0.15 - 1.43]

36 HÔPITAL GÉNÉRAL DU LAKESHORE

1

0.13 [0.02 - 0.94]

9

1.2 [0.62 - 2.30]

1

0.13 [0.02 - 0.94]

37 HÔTEL-DIEU DE SOREL

2

0.43 [0.11 - 1.70]

8

1.7 [0.85 - 3.40]

0

0

38 HÔPITAL JEAN-TALON

4

0.82 [0.31 - 2.18]

4

0.82 [0.31 - 2.18]

4

0.82 [0.31 - 2.18]

39 HÔPITAL DE GATINEAU

0

0

10

1.64 [0.88 - 3.05]

0

0

40 HÔPITAL DE HULL

4

0.6 [0.22 - 1.60]

5

0.75 [0.31 - 1.80]

2

0.3 [0.07 - 1.20]

41 HÔPITAL DU CENTRE-DE-LA-MAURICIE

5

1.04 [0.43 - 2.49]

7

1.45 [0.69 - 3.04]

2

0.41 [0.10 1.66]

42 CENTRE HOSPITALIER ANNA-LABERGE

1

0.14 [0.02 - 0.96]

9

1.22 [0.63 - 2.34]

2

0.27 [0.07 - 1.08]

44 HÔPITAL SAINTE-CROIX

0

0

7

1.18 [0.56 - 2.48]

3

0.51 [0.16 - 1.57]

45 HÔPITAL DE SAINT-EUSTACHE

9

0.99 [0.52 - 1.91]

3

0.33 [0.11 - 1.03]

3

0.33 [0.11 - 1.03]

46 HÔPITAL DE GRANBY

1

0.22 [0.03 - 1.55]

8

1.74 [0.87 - 3.48]

0

0

47 HÔPITAL DE ROUYN-NORANDA

0

0

2

0.86 [0.21 - 3.42]

1

0.43 [0.06 - 3.04]

49 CSSS DE MEMPHREMAGOG 

0

0

0

0

0

0

51 HÔPITAL DE MANIWAKI

0

0

1

0.71 [0.10 5.04]

0

0

52 HÔPITAL D'AMOS

0

0

0

0

0

0

53 HÔPITAL DE CHANDLER

0

0

0

0

0

0

56 CENTRE DE SANTÉ ET DE SERVICES SOCIAUX D'ARGENTEUIL

0

0

3

2.11 [0.68 - 6.55]

0

0

58 HÔPITAL DU SUROÎT

1

0.17 [0.02 - 1.18]

11

1.82 [1.01 - 3.29]

1

0.17 [0.02 - 1.18]

59 HÔPITAL DE BAIE-SAINT-PAUL

0

0

0

0

0

0

61 HÔPITAL NOTRE-DAME-DE-FATIMA

0

0

1

1.26 [0.18 - 8.94]

0

0

63 HÔPITAL DE SAINT-GEORGES

0

0

0

0

0

0

64 HÔPITAL LE ROYER

1

0.47 [0.07 - 3.33]

3

1.41 [0.45 - 4.36]

0

0

65 HÔPITAL ET CLSC DE VAL-D'OR

0

0

0

0

0

0

67 HÔPITAL ET CENTRE DE RÉADAPTATION DE JONQUIÈRE

0

0

3

0.78 [0.25 - 2.41]

0

0

70 CENTRE DE SOINS DE COURTE DURÉE LA SARRE

0

0

0

0

0

0

71 HÔPITAL DE MATANE

0

0

1

0.85 [0.12 - 6.04]

0

0

72 HÔPITAL ET CENTRE D'HÉBERGEMENT DE SEPT-ÎLES

1

0.48 [0.07 - 3.39]

0

0

0

0

74 HÔPITAL DE DOLBEAU-MISTASSINI

0

0

0

0

0

0

75 CSSS DU GRANIT

0

0

1

1.01 [0.14 - 7.14]

0

0

77 HÔPITAL D'AMQUI

0

0

0

0

0

0

80 HÔPITAL FLEURY

4

1.01 [0.38 - 2.68]

7

1.76 [0.84 - 3.69]

4

1.01 [0.38 - 2.68]

81 HÔPITAL DE MONT-LAURIER

1

0.56 [0.08 - 4.00]

1

0.56 [0.08 - 4.00]

0

0

82 PAVILLON SAINTE-FAMILLE

1

1.5 [0.21 - 10.64]

0

0

0

0

83 HÔPITAL DE LASALLE

0

0

0

0

0

0

84 HÔPITAL DE NOTRE-DAME-DU-LAC

0

0

0

0

0

0

85 CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU HAUT-SAINT-MAURICE

0

0

0

0

1

1.32 [0.19 - 9.34]

86 HÔPITAL DE LA MALBAIE

0

0

0

0

0

0

88 HÔPITAL. CLSC ET CENTRE D'HÉBERGEMENT DE ROBERVAL

0

0

2

0.84 [0.21 - 3.35]

0

0

89 HÔPITAL DE MONTMAGNY

0

0

1

0.59 [0.08 - 4.18]

1

0.59 [0.08 - 4.18]

91 HÔPITAL HÔTEL-DIEU DE GASPÉ

0

0

1

0.92 [0.13 - 6.57]

0

0

95 HÔPITAL DU PONTIAC

0

0

0

0

0

0

96 CENTRE DE SANTÉ DE CHIBOUGAMAU

0

0

0

0

0

0

97 HÔPITAL DE MARIA

0

0

1

0.57 [0.08 - 4.01]

1

0.57 [0.08 - 4.01]

99 HÔPITAL BROME-MISSISQUOI-PERKINS

1

0.4 [0.06 - 2.85]

4

1.61 [0.60 4.28]

0

0

100 HÔPITAL DE LA BAIE

0

0

1

0.72 [0.10 5.09]

0

0

101 HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

14

1.29 [0.77 - 2.19]

8

0.74 [0.37 - 1.48]

11

1.02 [0.56 - 1.84]

103 HÔPITAL LAURENTIEN

2

0.64 [0.16 - 2.56]

3

0.96 [0.31 - 2.97]

0

0

107 HÔPITAL DE L'ARCHIPEL

1

1.28 [0.18 - 9.08]

0

0

1

1.28 [0.18 - 9.08]

109 HÔPITAL DE SAINTE-ANNE-DES-MONTS

0

0

0

0

0

0

111 HÔPITAL DE PAPINEAU

0

0

2

1 [0.25 - 3.98]

0

0

112 HÔPITAL D'ALMA

1

0.31 [0.04 - 2.20]

1

0.31 [0.04 - 2.20]

0

0

113 HÔPITAL DE THETFORD MINES

0

0

3

1.34 [0.43 - 4.16]

0

0

130 HÔPITAL BARRIE MÉMORIAL

0

0

0

0

0

0

95% CI: 95% confidence interval
BSI: bloodstream infection
CoNS: coagulase-negative Staphylococcus                                                                                                                    
CRBSI: catheter-related bloodstream infection
HD: hemodialysis
ICU: intensive care unit
MBI: mucosal barrier injury
Non-CRBSI: non-catheter-related primary bloodstream infection
SSI: surgical site infection

Comité de surveillance provinciale des infections nosocomiales (SPIN) – bactériémies panhospitalières

Editorial Committee 

Élise Fortin, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec

Muleka Ngenda-Muadi, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec

Isabelle Rocher, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec

Marc-André Smith, Hôpital du Sacré-Cœur de Montréal

Claude Tremblay, Centre hospitalier universitaire de Québec de Québec – Université Laval

Mélissa Trudeau, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec

Jasmin Villeneuve, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec

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