Vascular Access–Related Bloodstream Infections in Hemodialysis Patients
Surveillance results: 2013-2014

From April 1st, 2013, to March 31st, 2014, 44 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 54,878 patient-periods (Table 1). Participating units reported 157 VARBSIs in 149 patients. Patient-periods involving a fistula accounted for 44.9% of patient-periods. The VARBSI incidence rate was 0.10 cases per 100 patient-periods for patients with an arteriovenous (AV) fistula, 0.22 for patients with a synthetic fistula (graft), 0.38 for patients with a permanent catheter and 6.20 for patients with a temporary catheter. In 2013-2014, incidence rates were stable for patients with a graft and for patients with a temporary catheter compared to 2009-2013, while incidence rates decreased significantly for patients with an AV fistula as well as patients with a permanent catheter. In 2013-2014, three HD units opened up and joined the program; one HD unit carried out the surveillance but could not report its results so these were excluded from analysis. Data was extracted on May 15, 2014. 

Update: March 9, 2017

Table 1 – Participation of Hemodialysis Units in the Surveillance of VARBSIs in Hemodialysis Patients, Québec, 2009-2010 to 2013-2014

 

2009-2010

2010-2011

2011-2012

2012-2013

2013-2014

Units (N) 

26

30

42

42

44

Patients monitored (average number per period)

3,035

3,337

3,871

3,977

4,221

Patient-periods* (N)

39,458

43,387

50,327

51,697

54,878

Patient-months (N)

36,947

40,607

47,245

48,340

51,362

Dialysis sessions (N)

475,033

522,087

607,436

621,516

660,365

Catheter-days (N)

592,317

659,463

753,432

798,816

847,947

VARBSIs (cat. 1a, 1b and 1c, N)

199

191

216

218

157

   VARBSIs with AV fistulas or grafts (N)

35

30

38

46

27

   VARBSIs with permanent or temporary catheters (N)

164

161

178

172

130

Infected patients (N)

186

182

208

209

149

* A period corresponds to 28 days for a total of 13 periods per year.

In 2013-2014, the VARBSI incidence rate was 0.10 cases per 100 patient-periods for patients with an AV fistula, 0.22 for patients with a graft, 0.38 for patients with a permanent catheter and 6.20 for patients with a temporary catheter (Figure 1). The VARBSI incidence rate was higher when the buttonhole technique was used (0.25 per 100 patient-periods versus 0.02, p < 0.01). Incidence rates were not statistically different between patients with permanent catheter, graft nor AV fistula with buttonhole.

Therefore, compared with an AV fistula without buttonhole, the incidence rate with a temporary catheter was 305.0 [88.9 ; 1046.6] times greater, with a permanent catheter, 18.5 [6.0 ; 58.9] times greater, with a graft 10.7 [2.6 ; 44.8] times greater and with an AV fistula with a buttonhole, the incidence rate was 12.3 [3.6 ; 41.5] times greater (all p values < 0.01). The incidence rate with a temporary catheter was 16.3 [9.7 ; 27.5] times higher than with a permanent catheter (< 0.01).

Figure 1 – VARBSI Incidence Rate by Type of Vascular Access, Québec, 2013-2014 (Incidence Rate per 100 Patient-periods [95% CI])

95% CI: 95% confidence interval

Permanent catheters are the most commonly used type of vascular access, followed by AV fistulas without the use of the buttonhole technique (Figure 2).

Figure 2 – Breakdown of Patient-periods by Type of Vascular Access, Québec, 2013-2014 (%)

In 2013-2014, the incidence rates for patients with a graft and patients with a temporary catheter were comparable to 2009-2013 rates (Table 2 and Figures 3 and 4). However, the incidence rate for patients with AV fistula decreased significantly (p < 0.01) just as for patients with permanent catheter (p < 0.01). This decrease, observed with the two most frequently used types of vascular access, must be viewed in parallel with the sharp drop of VARBSI cases reported in 2013-2014 (Tables 2 and 3).

Figure 3 – VARBSI Incidence Rates by Type of Vascular Access, Québec, 2009-2013 and 2013-2014 (Incidence Rate per 100 Patient-periods [95% CI])

Table 2 – VARBSI Incidence Rates by Type of Vascular Access, Québec, 2009-2013 and 2013-2014 (Incidence Rate per 100 Patient-periods and per 1,000 Vascular-Access Days [95% CI])

Type of Vascular Access

Incidence Rate/100 Patient-periods
[95% CI]

Incidence Rate/1,000 Vascular-Access Days
[95% CI]

2009-2013

2013-2014

2009-2013

2013-2014

AV fistula or graft

0.18 [0.15 ; 0.20]

0.11 [0.07 ; 0.16]

---

---

   AV fistula

0.17 [0.14 ; 0.20]

0.10 [0.06 ; 0.14]

---

---

   Graft

0.25 [0.16 ; 0.36]

0.22 [0.07 ; 0.45]

---

---

Permanent or temporary catheter

0.68 [0.63 ; 0.73]

0.43 [0.36 ; 0.51]

0.24 [0.22 ; 0.26]

0.15 [0.13 ; 0.18]

   Permanent catheter

0.61 [0.56 ; 0.65]

0.38 [0.32 ; 0.46]

0.22 [0.20 ; 0.23]

0.14 [0.11 ; 0.16]

   Temporary catheter

5.77 [4.57 ; 7.11]

6.20 [3.54 ; 9.61]

2.05 [1.63 ; 2.53]

2.19 [1.25 ; 3.40]

Total

0.45 [0.42 ; 0.48]

0.29 [0.24 ; 0.33]

0.24 [0.22 ; 0.26]

0.15 [0.13 ; 0.18]

Figure 4 – VARBSI Incidence Rates by Type of Vascular Access, for Units Participating Since 2009-2010 (N = 26), Québec, 2009-2010 to 2013-2014 (Incidence Rate per 100 Patient-periods)

Despite recommendations to increase the use of fistula, the proportion of patients who receive hemodialysis through a catheter, either temporary or permanent, increased in 2013-2014 compared with 2009-2013. However, the proportion of patients with a temporary catheter, which is the form of vascular access most likely to lead to a VARBSI, decreased significantly (p < 0.01).

Table 3 – Breakdown of Patient-periods by Type of Vascular Access, 2009-2013 and 2013-2014 (%)

Type of Vascular Access

Québec (%)

2009-2013

2013-2014

AV fistula 

41.2

40.8

   With buttonhole

 

13.9

   Without buttonhole

 

26.9

Graft

4.8

4.2

Permanent catheter

53.2

54.6

Temporary catheter 

0.7

0.5

Fistule artérioveineuse ou synthétique

46.0

44.9

Cathéter permanent ou temporaire

54.0

55.1

   Catheterized for < 90 days

-

-

   Catheterized for ≥ 90 days - -

Total (N)

184,699

54,662

Patients who developed a VARBSI were aged between 0 and 93 years, with a median age of 68 years. The vast majority (83%, or 130 cases) of VARBSIs occurred in patients who received their hemodialysis treatment via catheter, even though they represented only 55% of the patient-periods monitored (Figure 5). For most of the cases that arose in patients receiving their hemodialysis through an AV fistula, the buttonhole technique was used (86%) even though this technique is used among 34% of patients with AV fistula.

Figure 5 – Breakdown of VARBSIs by Type of Vascular Access, Québec, 2013-2014 (N = 156)

Overall, 15% of VARBSI cases resulted in death within 30 days following the onset of bacteremia. Death occurred in 39% of cases of VARBSI among hospitalized patients (Table 4 and Figure 6), compared with 11% of cases among patients receiving ambulatory care (p = 0.003). A total of 59% of ambulatory patients who developed a VARBSI required hospitalization.

Table 4 – 30-Day Case Fatality, Percentage of Transfers to ICU and Percentage of Hospitalizations and Rehospitalizations During a VARBSI Episode, by Origin of Acquisition, Québec, 2013-2014 (N, %)

Origin of Acquisition

Complication

Number of VARBSI Cases Monitored

Presence of complication

N

%

During hospitalization

Death within 10 days

23

5

22

  Death within 30 days

23

9

39

  Transfer to ICU

19

2

11

 

Rehospitalization

23

6

26

During ambulatory care

Death within 10 days

134

9

7

  Death within 30 days

134

14

11

  Transfer to ICU

133

18

14

 

Hospitalization

134

79

59

Figure 630-Day Case Fatality, Percentage of Transfers to ICU and Percentage of Hospitalizations and Rehospitalizations During a VARBSI Episode, by Origin of Acquisition, Québec, 2013-2014 (%)

Figure 7 shows that Staphylococcus aureus was the most frequently isolated microorganism in all VARBSI cases (54%). This was followed by coagulase-negative Staphylococcus (CoNS, 11%) and Enterobacteriaceae (other than Escherichia coli and Klebsiella sp., 9%). Three of the CoNS cases (n = 18) involved S. lugdunensis. S. aureus was the most frequently isolated microorganism in cases resulting in death (70%).

Figure 7 – Categories of Isolated Microorganisms in All Reported Cases (N = 162) and Cases Resulting in Death Within 30 Days (N = 23), Québec, 2013-2014 (%)

In 2013-2014, 12% of S. aureus strains were oxacillin-resistant, which is not significantly different compared with 2009‑2013 mean percentage (Table 5 and Figure 8).

Table 5 – Percentage of Strains Tested and Percentage of Resistance to Antibiotics for Certain Isolated Microorganisms, Québec, 2013-2014 (N, %)

Microorganism

Antibioti

Isolated

Tested

Resistant

N

n

%

n

%

Staphylococcus aureus

Oxacillin

94

94

100.0

11

11.7

Enterococcus faecium

Vancomycin

2

2

100.0

0

0.0

Enterococcus faecalis

Vancomycin

7

7

100.0

0

0.0

Klebsiella (pneumoniae-oxytoca)

CSE 4

0

-

-

-

-

Imipenem or meropenem

0

-

-

-

-

Multiresistant 1

0

-

-

-

-

Escherichia coli

CSE 4

2

1

50.0

1

100.0

Fluoroquinolones 3

2

2

100.0

1

50.0

Imipenem or meropenem

2

0

0.0

0

-

Multiresistant 1

2

1

50.0

0

0.0

Enterobacter sp.

CSE 4

3

3

100.0

0

0.0

Imipenem or meropenem

3

3

100.0

0

0.0

Multiresistant 1

3

3

100.0

0

0.0

Pseudomonas sp.

Amikacin, gentamicin or tobramycin

3

2

66.7

0

0.0

CSE 2

3

3

100.0

0

0.0

Fluoroquinolones 2

3

3

100.0

0

0.0

Imipenem or meropenem

3

3

100.0

0

0.0

Piperacillin/tazobactam

3

3

100.0

0

0.0

Multiresistant 2

3

3

100.0

0

0.0

Acinetobacter sp.

Imipenem or meropenem

1

1

100.0

0

0.0

Multiresistant 3

1

1

100.0

0

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 8 – Percentage of Antibiotic Resistance in Certain Gram-Positive Bacteria, Certain Gram-Negative Bacteria and Pseudomonas sp., Québec, 2013-2014 (%)

Figures 9 and 10 show the breakdown of patient-periods monitored in 2013-2014, by type of vascular access and by healthcare facility. In 2013-2014, the percentage of fistulas decreased in 15 healthcare facilities and increased in 6 (Table 6). Twelve facilities reported a rate of 0 VARBSI per 100 patient-periods, and only one reported a rate higher than the 90th-percentile mark for 2009-2013 (Figure 11 and Table 7). Facilities with an incidence rate of 0 had small dialysis units of 4 to 12 chairs.

Figure 9 – Breakdown of Patient-periods Monitored by Type of Vascular Access and by Healthcare Facility, Québec, 2013-2014 (N)

Figure 10 – Percentage of Patient-periods Involving a Fistula, by Healthcare Facility, Québec, 2013-2014 (%)

Figure 11 – VARBSI Incidence Rate per Healthcare Facility (2013-2014) and Incidence Rate Percentile (2009-2010 to 2012-2013), Québec, 2013-2014 (Incidence Rate per 100 Patient-periods)

Table 6 – Number of Patient-periods Monitored and Percentage of Fistulas, by Healthcare Facility, Québec, 2009-2013 and 2013-2014 (N, % [95% CI])

Facility

2009-2013

2013-2014

Variations
(p < 0.05)

Patients-periods (n)

% with fistula

Patients-periods (n)

% with fistula

1

HÔPITAL CHARLES LEMOYNE

15,278

53 [52 ; 54]

4,061

38 [36 ; 39]

diminution

3

HÔPITAL ROYAL VICTORIA

7,570

43 [41 ; 44]

1,789

41 [39 ; 44]

 

4

HÔPITAL NOTRE-DAME DU CHUM

8,522

62 [61 ; 63]

2,553

67 [65 ; 69]

augmentation

5

HÔPITAL GÉNÉRAL JUIF

4,808

28 [26 ; 29]

2,614

21 [20 ; 23]

diminution

7

PAVILLON L'HÔTEL-DIEU DE QUÉBEC

14,241

51 [50 ; 51]

4,897

67 [66 ; 68]

augmentation

8

PAV. MAISONNEUVE/PAV. MARCEL-LAMOUREUX

18,927

50 [49 ; 51]

4,954

43 [42 ; 45]

diminution

9

HÔPITAL DU HAUT-RICHELIEU

5,046

44 [43 ; 46]

1,554

42 [40 ; 45]

 

11

HÔPITAL PIERRE-LE GARDEUR

4,148

45 [43 ; 46]

1,055

42 [39 ; 45]

 

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE

160

24 [18 ; 31]

80

15 [7 ; 23]

 

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

4,544

27 [26 ; 28]

1,235

23 [21 ; 26]

diminution

15

HÔPITAL FLEURIMONT

6,315

34 [32 ; 35]

1,222

32 [29 ; 34]

 

16

HÔPITAL RÉGIONAL DE RIMOUSKI

1,985

59 [57 ; 61]

687

62 [58 ; 65]

 

18

HÔTEL-DIEU DE LÉVIS

3,768

47 [45 ; 48]

1,123

46 [43 ; 49]

 

19

HÔPITAL CITÉ DE LA SANTÉ

5,647

68 [67 ; 69]

2,869

66 [64 ; 68]

diminution

20

HÔPITAL DE CHICOUTIMI

4,005

65 [63 ; 66]

922

51 [48 ; 55]

diminution

21

HÔPITAL SAINT-LUC DU CHUM

7,281

62 [60 ; 63]

1,868

58 [56 ; 60]

diminution

23

HÔTEL-DIEU D'ARTHABASKA

1,487

39 [36 ; 41]

296

33 [28 ; 39]

 

25

HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL

7,538

26 [25 ; 27]

2,517

32 [30 ; 33]

augmentation

26

HÔPITAL DE VERDUN

6,416

51 [50 ; 52]

1,610

46 [44 ; 49]

diminution

29

HÔPITAL GÉNÉRAL DE MONTRÉAL

6,558

29 [28 ; 30]

1,390

35 [32 ; 37]

augmentation

31

PAVILLON SAINT-JOSEPH

8,352

28 [27 ; 29]

2,027

27 [25 ; 29]

 

35

HÔPITAL HONORÉ-MERCIER

1,889

53 [50 ; 55]

1,125

49 [47 ; 52]

 

36

HÔPITAL GÉNÉRAL DU LAKESHORE

3,314

40 [38 ; 42]

1,428

35 [33 ; 38]

diminution

37

HÔTEL-DIEU DE SOREL

2,499

52 [50 ; 54]

560

58 [54 ; 62]

augmentation

40

HÔPITAL DE HULL

9,297

33 [32 ; 34]

2,281

30 [28 ; 32]

diminution

44

HÔPITAL SAINTE-CROIX

2,038

42 [40 ; 44]

483

38 [34 ; 43]

 

46

HÔPITAL DE GRANBY

1,477

60 [58 ; 63]

665

49 [45 ; 53]

diminution

47

HÔPITAL DE ROUYN-NORANDA

854

64 [61 ; 68]

138

72 [65 ; 80]

 

48

CENTRE HOSPITALIER DE ST. MARY

2,973

44 [42 ; 46]

1,113

46 [43 ; 49]

 

49

CSSS MEMPHRÉMAGOG

374

48 [43 ; 53]

192

47 [40 ; 54]

 

51

HÔPITAL DE MANIWAKI

394

39 [34 ; 44]

230

32 [26 ; 38]

 

53

HÔPITAL DE CHANDLER

-

-

25

56 [37 ; 75]

 

58

HÔPITAL DU SUROÎT

4,012

59 [57 ; 60]

1,009

55 [52 ; 58]

diminution

63

HÔPITAL DE SAINT-GEORGES

245

53 [46 ; 59]

199

49 [42 ; 56]

 

65

HÔPITAL ET CLSC DE VAL-D'OR

810

54 [51 ; 58]

394

46 [41 ; 51]

diminution

70

CENTRE DE SOINS DE COURTE DURÉE LA SARRE

240

67 [61 ; 73]

94

46 [36 ; 56]

diminution

72

HÔPITAL ET CENTRE D'HÉBERGEMENT DE SEPT-ÎLES

138

48 [39 ; 56]

143

53 [45 ; 61]

 

74

HÔPITAL DE DOLBEAU-MISTASSINI

-

-

96

42 [32 ; 52]

 

81

HÔPITAL DE MONT-LAURIER

1,448

48 [45 ; 50]

409

47 [42 ; 52]

 

82

PAVILLON SAINTE-FAMILLE

234

60 [54 ; 66]

102

84 [77 ; 91]

augmentation

96

CENTRE DE SANTÉ DE CHIBOUGAMAU

490

40 [35 ; 44]

239

31 [25 ; 37]

diminution

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

9,048

45 [44 ; 46]

2,322

43 [41 ; 45]

 

111

HÔPITAL DE PAPINEAU

-

-

95

29 [20 ; 39]

 

113

HÔPITAL DE THETFORD MINES

329

58 [53 ; 64]

213

60 [54 ; 67]

 

Table 7 – Number of VARBSI Cases and Incidence Rate by Healthcare Facility, and Percentile Ranking, Québec, 2009-2013 and 2013-2014 (Incidence Rate per 100 Patient-periods [95% CI])

Facility

2009-2013*

2013-2014

Number of cases

Mean Number of cases per year

Rate/100 pp

Number of cases

Rate/100 pp

1

HÔPITAL CHARLES LEMOYNE

41

10.3

0.27 [0.19 ; 0.36]

8

0.20 [0.08 ; 0.36]

3

HÔPITAL ROYAL VICTORIA

49

12.3

0.65 [0.48 ; 0.84]

12

0.67 [0.34 ; 1.10]

4

HÔPITAL NOTRE-DAME DU CHUM

33

8.3

0.39 [0.27 ; 0.53]

10

0.39 [0.19 ; 0.67]

5

HÔPITAL GÉNÉRAL JUIF

12

6.0

0.25 [0.13 ; 0.41]

2

0.08 [0.01 ; 0.22]

7

PAVILLON L'HÔTEL-DIEU DE QUÉBEC

59

14.8

0.41 [0.32 ; 0.53]

15

0.31 [0.17 ; 0.48]

8

PAV. MAISONNEUVE/PAV. MARCEL-LAMOUREUX

85

21.3

0.45 [0.36 ; 0.55]

16

0.32 [0.18 ; 0.50]

9

HÔPITAL DU HAUT-RICHELIEU

45

11.3

0.89 [0.65 ; 1.17]

1

0.06 [0.00 ; 0.25]

11

HÔPITAL PIERRE-LE GARDEUR

26

6.5

0.63 [0.41 ; 0.89]

4

0.38 [0.10 ; 0.84]

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE

5

1.7

3.13 [0.99 ; 6.46]

7

8.75 [3.47 ; 16.43]

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

24

6.0

0.53 [0.34 ; 0.76]

2

0.16 [0.02 ; 0.46]

15

HÔPITAL FLEURIMONT

34

8.5

0.54 [0.37 ; 0.73]

7

0.57 [0.23 ; 1.08]

16

HÔPITAL RÉGIONAL DE RIMOUSKI

6

1.5

0.30 [0.11 ; 0.59]

1

0.15 [0.00 ; 0.57]

18

HÔTEL-DIEU DE LÉVIS

13

3.3

0.35 [0.18 ; 0.56]

1

0.09 [0.00 ; 0.35]

19

HÔPITAL CITÉ DE LA SANTÉ

16

8.0

0.28 [0.16 ; 0.44]

4

0.14 [0.04 ; 0.31]

20

HÔPITAL DE CHICOUTIMI

16

4.0

0.40 [0.23 ; 0.62]

3

0.33 [0.06 ; 0.80]

21

HÔPITAL SAINT-LUC DU CHUM

48

12.0

0.66 [0.49 ; 0.86]

8

0.43 [0.18 ; 0.78]

23

HÔTEL-DIEU D'ARTHABASKA

5

1.3

0.34 [0.11 ; 0.70]

0

0.00

25

HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL

43

10.8

0.57 [0.41 ; 0.75]

6

0.24 [0.09 ; 0.47]

26

HÔPITAL DE VERDUN

24

6.0

0.37 [0.24 ; 0.54]

5

0.31 [0.10 ; 0.64]

29

HÔPITAL GÉNÉRAL DE MONTRÉAL

35

8.8

0.53 [0.37 ; 0.73]

4

0.29 [0.07 ; 0.64]

31

PAVILLON SAINT-JOSEPH

25

6.3

0.30 [0.19 ; 0.43]

6

0.30 [0.11 ; 0.58]

35

HÔPITAL HONORÉ-MERCIER

10

5.0

0.53 [0.25 ; 0.91]

6

0.53 [0.19 ; 1.05]

36

HÔPITAL GÉNÉRAL DU LAKESHORE

6

2.0

0.18 [0.07 ; 0.35]

3

0.21 [0.04 ; 0.52]

37

HÔTEL-DIEU DE SOREL

19

4.8

0.76 [0.46 ; 1.14]

3

0.54 [0.10 ; 1.31]

40

HÔPITAL DE HULL

40

10.0

0.43 [0.31 ; 0.57]

5

0.22 [0.07 ; 0.45]

44

HÔPITAL SAINTE-CROIX

6

1.5

0.29 [0.11 ; 0.58]

3

0.62 [0.12 ; 1.52]

46

HÔPITAL DE GRANBY

4

1.3

0.27 [0.07 ; 0.60]

1

0.15 [0.00 ; 0.59]

47

HÔPITAL DE ROUYN-NORANDA

3

0.8

0.35 [0.07 ; 0.86]

0

0.00

48

CENTRE HOSPITALIER DE ST. MARY

6

2.0

0.20 [0.07 ; 0.40]

3

0.27 [0.05 ; 0.66]

49

CSSS MEMPHRÉMAGOG

1

0.5

0.27 [0.00 ; 1.05]

0

0.00

51

HÔPITAL DE MANIWAKI

3

1.5

0.76 [0.14 ; 1.87]

0

0.00

53

HÔPITAL DE CHANDLER

-

-

-

0

0.00

58

HÔPITAL DU SUROÎT

10

2.5

0.25 [0.12 ; 0.43]

1

0.10 [0.00 ; 0.39]

63

HÔPITAL DE SAINT-GEORGES

1

0.5

0.41 [0.00 ; 1.60]

0

0.00

65

HÔPITAL ET CLSC DE VAL-D'OR

4

2.0

0.49 [0.13 ; 1.10]

1

0.25 [0.00 ; 1.00]

70

CENTRE DE SOINS DE COURTE DURÉE LA SARRE

0

0.0

0.00

0

0.00

72

HÔPITAL ET CENTRE D'HÉBERGEMENT DE SEPT-ÎLES

1

0.5

0.72 [0.00 ; 2.84]

0

0.00

74

HÔPITAL DE DOLBEAU-MISTASSINI

-

-

-

0

0.00

81

HÔPITAL DE MONT-LAURIER

1

0.3

0.07 [0.00 ; 0.27]

1

0.24 [0.00 ; 0.96]

82

PAVILLON SAINTE-FAMILLE

0

0.0

0.00

0

0.00

96

CENTRE DE SANTÉ DE CHIBOUGAMAU

0

0.0

0.00

0

0.00

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

62

15.5

0.69 [0.53 ; 0.87]

7

0.30 [0.12 ; 0.57]

111

HÔPITAL DE PAPINEAU

-

-

-

0

0.00

113

HÔPITAL DE THETFORD MINES

2

1.0

0.61 [0.06 ; 1.74]

1

0.47 [0.00 ; 1.84]

10th

 

 

 

0.00

 

0.00

25th

 

 

 

0.19

 

0.00

50th

 

 

 

0.39

 

0.21

75th

 

 

 

0.57

 

0.32

90th

 

 

 

0.91

 

0.54

* Changes in rates within individual facilities were not subjected to statistical analysis, given the small number of cases involved

  1. Fistula First. Graphs of Prevalent AV Fistula Use Rates, By Network [online]. http://www.fistulafirst.org/AboutFistulaFirst/FisultaFirstCatheterLastFFCLData.aspx (last consulted: 2013-08-06).
  2. Ayzac, L., Machut, A., Russell, I., et al. Rapport final pour l’année 2011 du réseau de surveillance des infections en hémodialyse – DIALIN. CClin Sud-Est and RAISIN [online]. http://cclin-sudest.chu-lyon.fr/Reseaux/DIALIN/Resultats/rapport_annuel_2011_V2.pdf (last consulted: 2013-08-06).
  3. Patel, P. R., Yi, S. H., Booth, S., et al. Bloodstream Infection Rates in Outpatient Hemodialysis Facilities Participating in a Collaborative Prevention Effort: A Quality Improvement Report. American Journal of Kidney Diseases, Vol. 62, No. 2 (August 2013), p. 322–330.

Comité de surveillance provinciale des infections nosocomiales (SPIN) – bactériémies associées aux accès vasculaires en hémodialyse

Editorial Committee 

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

Charles Frenette, Centre universitaire de santé McGill

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

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

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