Vascular Access–Related Bloodstream Infections in Hemodialysis Patients
Surveillance results: 2015-2016

From April 1st, 2015, to March 31st, 2016, 45 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 54,717 patient-periods (Table 1), slightly less than the preceding year. Participating units reported 136 VARBSIs in 129 patients. Patient-periods involving a fistula account for 41.0% of patient-periods. The 2015-2016 VARBSI incidence rates are 0.06 cases per 100 patient-periods for patients with an arteriovenous (AV) fistula, 0.32 for patients with a synthetic fistula (graft), 0.33 for patients with a permanent catheter and 3.34 for patients with a temporary catheter. In 2015–2016, incidence rates are significantly lower than in 2011-2015. This decrease is mainly attributable to a decrease in VARBSIs on AV fistula with buttonhole (rates per 100 patient-periods) and to a decrease of VARBSIs on permanent catheters (rate per 1,000 catheter-days). A minimum of 11 periods of data are to be provided for facilities’ data to be included in this surveillance report. Data were extracted on May 31st, 2016.

Updated : March 3, 2017
Version française

Table 1 – Participation of Hemodialysis Units in the Surveillance of VARBSIs in Hemodialysis Patients, Québec, 2011–2012 to 2015–2016

 

2011 - 2012

2012 - 2013

2013 - 2014

2014 - 2015

2015 - 2016

Units (N) 

40

42

42

45

45

Patients monitored (average number per period)

3,855

3,976

3,984

4,303

4,209

Patient-periods* (N)

50,111

51,693

51,791

55,939

54,717

Patient-months (N)

47,037

48,336

48,469

52,316

51,363

Dialysis sessions (N)

604,766

621,465

623,172

672,639

660,376

Catheter-days (N)

750,919

798,816

824,834

891,802

909,792

VARBSIs (cat. 1a, 1b and 1c, N)

214

218

151

154

136

VARBSIs with AV fistulas or grafts (N)

38

46

25

23

19

VARBSIs with permanent or temporary catheters (N)

176

172

126

131

117

Infected patients (N)

205

209

143

141

129

The 2015-2016 VARBSI incidence rate is 0.25 cases per 100 patient-periods. The incidence rates are 0.06 for patients with an AV fistula, 0.32 for patients with a graft, 0.33 for patients with a permanent catheter and 3.34 for patients with a temporary catheter (Figure 1).

In patients with AV fistulas, the VARBSI incidence rate is higher when the buttonhole technique is used (0.13 per 100 patient-periods versus 0.05). Incidence rate for patients with a graft (0.32) is higher than for patients with an AV fistula (0.06); incidence rates for patients with AV fistulas remain much lower than for patients with a permanent catheters (0.33). The incidence rate for patients with a temporary catheter is still the highest; it is, however, the least frequently used vascular access (Figures 1 and 2). Patients with a temporary catheter (3.34) present an incidence rate much higher than patients with a permanent catheter (0.33).

Figure 1 – VARBSI Incidence Rate by Type of Vascular Access, Québec, 2015–2016 (Incidence Rate per 100 Patient-periods [95% CI])

Note: 95% CI: 95% confidence interval

Permanent catheters were 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, 2015–2016 (%)

In 2015–2016, incidence rates are significantly lower than in 2011-2015. This decrease is mainly attributable to a decrease in VARBSIs on AV fistula with buttonhole and to a decrease of VARBSIs on permanent catheters (Table 2 and Figures 3 and 4).

Figure 3 – VARBSI Incidence Rates by Type of Vascular Access, Québec, 2011–2015* and 2015–2016 (Incidence Rate per 100 Patient-periods [95% CI])

*Incidence rates for AV fistulas, with and without buttonhole, are limited to data from 2013-2014 to 2015-2016, as information on the use of the buttonhole technique was not collected before 2013-2014.
¥ : Significant difference (p ˂ 0.05) between 2011-2015 and 2015-2016.

Table 2 – VARBSI Incidence Rates by Type of Vascular Access, Québec, 2011–2015 and 2015–2016 (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]

Taux d'incidence / 1 000 j.-c. [I.C. 95 %]

2011-2015

2015-2016

2011-2015

2015-2016

AV fistula or graft

0.14 [0.12 ; 0.17]

0.09 [0.05 ; 0.13]¥

-

-

   AV fistula

0.14 [0.11 ; 0.16]

0.06 [0.03 ; 0.10]¥

-

-

      With buttonhole*

0.74 [0.59 ; 0.90]

0.13 [0.03 ; 0.28]¥

-

-

      Without buttonhole*

0.04 [0.03 ; 0.06]

0.05 [0.02 ; 0.09]

-

-

   Graft

0.19 [0.12 ; 0.29]

0.32 [0.13 ; 0.61]

-

-

Permanent or temporary catheter

0.52 [0.48 ; 0.56]

0.36 [0.30 ; 0.43]¥

0.19 [0.18; 0.19]

0.13 [0.12 ; 0.14]¥

   Permanent catheter

0.47 [0.43 ; 0.51]

0.33 [0.27 ; 0.40]¥

0.17 [0.15 ; 0.18]

0.12 [0.10 ; 0.14]¥

   Temporary catheter

5.64 [4.36 ; 7.08]

3.34 [1.59 ; 5.74]

2.01 [1.55 ; 2.52]

1.19 [0.57 ; 2.05]

Total

0.35 [0.33 ; 0.38]

0.25 [0.21 ; 0.29]¥

-

-

*   Incidence rates for AV fistulas, with and without buttonhole, are limited to data from 2013-2014 to 2015-2016, as information on the use of the buttonhole technique was not collected before 2013-2014.
¥   Significant difference (p ˂ 0,05) between 2011-2015 and 2015-2016.

Figure 4 – VARBSI Incidence Rates by Type of Vascular Access, for Units Participating Since 2011–2012 (N = 38)*, Québec, 2011–2012 to 2015–2016 (Incidence Rate per 100 Patient-periods)

* Data analyzed are data from dialysis units that participated at least 11 periods per year, for every year from 2011-2012 to 2015-2016.

Time trends in patient-periods are presented in Figure 5. As fistula use is decreasing, catheter use has increased through the last five years. Patient-periods with a temporary catheter, the vascular access presenting the highest incidence rate, had decreased in 2013-2014 and 2014-2015, to increase again in 2015-2016.

Figure 5 – Time Trends in Patient-periods by Type of Vascular Access, for Units Participating Since 2011–2012 (N = 38)*, Québec, 2011–2012 to 2015–2016

* Data analyzed are data from dialysis units that participated at least 11 periods per year, for every year from 2011-2012 to 2015-2016.

Table 3 – Breakdown of Patient-periods by Type of Vascular Access, 2011–2015 and 2015–2016 (%)

 

 

2011-2015

 

2015-2016

VARBSI (N)

Patient-periods (N, %)

VARBSI (N)

Patient-periods (N, %)

AV fistula or graft

132

92,980 (44.4 %)

19

22,435 (41.0 %)

   AV fistula

114

83,686 (40.0 %)

12

20,266 (37.0 %)

      With buttonhole*

83

11,262 (5.4 %)

4

3,209 (5.9 %)

      Without buttonhole*

31

72,650 (34.7 %)

8

17,057 (31.2 %)

   Graft

18

9,294 (4.4 %)

7

2,169 (4.0 %)

Permanent or temporary catheter

605

116,226 (55.6 %)

117

32,310 (59.0 %)

   Permanent catheter

539

115,165 (55.0 %)

107

32,011 (58.5 %)

   Temporary catheter

66

1,171 (0.6 %)

10

299 (0.5 %)

Total (N)

737

209,206

136

54,745

The vast majority (86%, or 117 cases) of VARBSIs occurred in patients who receive their hemodialysis treatment via catheter (Figure 6). Only 9% of cases occurred in patients with an AV fistula. The buttonhole technique is used in a third of cases.  

Figure 6 – Breakdown of VARBSIs by Type of Vascular Access, Québec, 2015–2016 (N = 136)

A majority of cases occurred in ambulatory care and two thirds (64.2%) of these cases were subsequently admitted. Overall, 11.8% of VARBSI cases resulted in death within 30 days following the onset of bacteremia. Death occurred in 18.8% of cases of VARBSI among hospitalized patients (Table 4 and Figure 7), compared with 10.8% of cases among patients receiving ambulatory care.

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, 2015–2016 (N, %)

Origin of Acquisition

Complication

Number of VARBSI Cases Monitored

Presence of Complication

N

%

During hospitalization Death within 10 days

16

1

6.3

Death within 30 days

16

3

18.8

Transfer to ICU

16

0

0

Rehospitalization

16

1

6.3

During ambulatory care Death within 10 days

120

8

6.7

Death within 30 days

120

13

10.8

Transfer to ICU

120

15

12.5

Hospitalization

120

77

64.2

Figure 7 – 30-Day Case Fatality, Percentage of Transfers to ICU and Percentage of Hospitalizations and Rehospitalizations During a VARBSI Episode, by Origin of Acquisition, Québec, 2015–2016 (%)

Figure 8 shows that Staphylococcus aureus was the most frequently isolated microorganism in all VARBSI cases (n=78; 53%); followed by coagulase-negative Staphylococcus (CoNS; n= 26; 14%) and enterobacteria. S. aureus was the most frequently isolated microorganism in cases resulting in death (62.5%).

Figure 8 – Categories of Isolated Microorganisms in All Reported Cases (N = 147) and Cases Resulting in Death Within 30 Days (N = 16), Québec, 2015–2016 (%)

In 2015–2016, among VARBSI cases, 15.4% of S. aureus strains are oxacillin-resistant and no vancomycin-resistant Enterococcus was identified (Table 5 and Figure 9). An important increase in resistance to quinolones and to third-generation cephalosporins can be observed in enterobacteria, but no resistance to carbapenems is reported.

Tableau 5 – Percentage of Strains Tested and Percentage of Resistance to Antibiotics for Certain Isolated Microorganisms, Québec, 2015–2016 (N, %)

Microorganism

Antibiotic

Isolated

Tested

Resistant

N

N

%

N

%

Staphylococcus aureus

Oxacilline

78

78

100.0

12

15.4

Enterococcus

Vancomycine

7

7

100.0

0

0.0

   Enterococcus faecalis

Vancomycine

5

5

100.0

0

0.0

   Enterococcus faecium

Vancomycine

2

2

100.0

0

0.0

Klebsiella sp.

CSE 4

2

2

100.0

0

0.0

Imipenem  ou meropenem

2

2

100.0

0

0.0

Multiresistant 1

2

2

100.0

0

0.0

Escherichia coli

CSE 4

5

5

100.0

2

40.0

Fluoroquinolones 3

5

4

80.0

2

50.0

Imipenem  ou meropenem

5

3

60.0

0

0.0

Multiresistant 1

5

5

100.0

1

20.0

Enterobacter sp.

CSE 4

1

1

100.0

0

0.0

Imipenem  ou meropenem

1

0

0.0

0

-

Multiresistant 1

1

1

100.0

0

0.0

Carbapenèmes

1

1

100.0

0

0.0

Pseudomonas sp.

Amikacine. gentamicine ou tobramycine

4

3

75.0

0

0.0

CSE 2

4

4

100.0

0

0.0

Fluoroquinolones 2

4

4

100.0

0

0.0

Imipenem  ou meropenem

4

4

100.0

0

0.0

Piperacilline-tazobactam

4

2

50.0

0

0.0

Multiresistant 2

4

4

100.0

0

0.0

Acinetobacter sp.

Imipenem  ou meropenem

0

0

-

0

-

Multiresistant 3

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 9 – Percentage of Antibiotic Resistance in Certain Gram-Positive Bacteria, Certain Gram-Negative Bacteria and Pseudomonas sp., Québec, 2011-2012 to 2015–2016 (%)

Note: Resistance proportion computations are based on small numbers, leading to a great volatility in results.

Figures 10 and 11 show the breakdown of patient-periods monitored in 2015–2016, by type of vascular access and by healthcare facility. In 2015–2016, the percentage of fistulas decreased in 13 healthcare facilities and increased in 7 (Table 6). Twelve facilities reported a rate of 0 VARBSI per 100 patient-periods, and five reported a rate higher than the 90th-percentile mark for 2011–2015 (Figure 12 and Table 7). Four of these five facilities have small dialysis units and declared only one or two VARBSIs in 2015-2016. Facilities with an incidence rate of 0 had small dialysis units of 5 to 11 chairs.

Figure 10 – Patient-periods Followed, by Healthcare Facility, Québec, 2015–2016 (%)

Figure 11 – Breakdown of Patient-periods Monitored by Type of Vascular Access and by Healthcare Facility, Québec, 2015–2016 (N)

Figure 12 – VARBSI Incidence Rate per Healthcare Facility (2015–2016) and Incidence Rate Percentile (2011–2012 to 2014–2015), Québec, 2015–2016 (Incidence Rate per 100 Patient-periods)

Table 6 – Number of Patient-periods Monitored and Percentage of Fistulas, by Healthcare Facility, Québec, 2011–2015 and 2015–2016 (N, % [95% CI])

Facility

2011-2015

2015-2016

 

Patient-periods (n)

% with fistula

Patient-periods (n)

% with fistula

Variations
(p < 0.05)

1

HÔPITAL CHARLES LEMOYNE

16,185

41.3 [40.9 ; 41.6]

4,293

34.8 [34.1 ; 35.5]

diminution

3

GLEN - ROYAL VICTORIA

7,374

43.2 [42.7 ; 43.8]

851

32.2 [30.6 ; 33.8]

diminution

4

HÔPITAL NOTRE-DAME DU CHUM

9,377

64.2 [63.8 ; 64.7]

1,893

57.2 [56.1 ; 58.3]

diminution

5

HÔPITAL GÉNÉRAL JUIF

10,209

23.9 [23.4 ; 24.3]

2,783

19.2 [18.5 ; 19.9]

diminution

6

GLEN - ENFANTS

164

31.7 [28.1 ; 35.3]

33

18.2 [11.6 ; 24.8]

 

7

PAVILLON L'HÔTEL-DIEU DE QUÉBEC

14,776

53.9 [53.5 ; 54.3]

3,918

52.1 [51.3 ; 52.8]

diminution

8

PAVILLON MAISONNEUVE/PAVILLON MARCEL-LAMOUREUX

19,273

46.7 [46.4 ; 47.1]

5,065

41.2 [40.5 ; 41.8]

diminution

9

HÔPITAL DU HAUT-RICHELIEU

5,884

44.1 [43.5 ; 44.7]

1,591

42.0 [40.8 ; 43.2]

 

11

HÔPITAL PIERRE-LE GARDEUR

4,256

41.8 [41.1 ; 42.5]

1,299

38.0 [36.6 ; 39.3]

diminution

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE

230

14.3 [12.1 ; 16.6]

43

72.1 [65.4 ; 78.8]

augmentation

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

4,916

25.3 [24.7 ; 26.0]

1,215

23.6 [22.4 ; 24.8]

 

15

HÔPITAL FLEURIMONT

5,198

30.8 [30.2 ; 31.5]

1,088

34.9 [33.5 ; 36.3]

augmentation

16

HÔPITAL RÉGIONAL DE RIMOUSKI

2,658

56.3 [55.4 ; 57.3]

736

60.7 [59.0 ; 62.5]

augmentation

18

HÔTEL-DIEU DE LÉVIS

4,168

46.7 [46.0 ; 47.5]

1,101

47.5 [46.0 ; 49.0]

 

19

HÔPITAL CITÉ DE LA SANTÉ

11,618

66.3 [65.9 ; 66.7]

3,173

62.1 [61.2 ; 62.9]

diminution

20

HÔPITAL DE CHICOUTIMI

3,965

55.9 [55.1 ; 56.7]

892

45.4 [43.8 ; 47.0]

diminution

21

HÔPITAL SAINT-LUC DU CHUM

5,390

61.5 [60.9 ; 62.2]

1,793

54.8 [53.7 ; 56.0]

diminution

23

HÔTEL-DIEU D'ARTHABASKA

1,165

34.5 [33.1 ; 35.9]

302

21.9 [19.5 ; 24.2]

diminution

25

HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL

9,320

29.6 [29.2 ; 30.1]

2,268

32.6 [31.6 ; 33.5]

augmentation

26

HÔPITAL DE VERDUN

6,530

47.0 [46.4 ; 47.6]

1,716

34.7 [33.6 ; 35.9]

diminution

29

HÔPITAL GÉNÉRAL DE MONTRÉAL

5,742

33.3 [32.7 ; 33.9]

1,582

32.2 [31.1 ; 33.4]

 

31

PAVILLON SAINTE-MARIE

8,139

28.7 [28.2 ; 29.2]

2,299

27.1 [26.2 ; 28.0]

 

35

HÔPITAL HONORÉ-MERCIER

4,243

52.8 [52.1 ; 53.6]

1,404

51.4 [50.1 ; 52.7]

 

36

HÔPITAL GÉNÉRAL DU LAKESHORE

5,304

36.9 [36.2 ; 37.5]

1,675

31.4 [30.3 ; 32.5]

diminution

37

HÔTEL-DIEU DE SOREL

2,528

55.7 [54.7 ; 56.6]

724

58.3 [56.5 ; 60.1]

 

40

HÔPITAL DE HULL

9,178

29.4 [28.9 ; 29.9]

2,007

27.0 [26.0 ; 28.0]

diminution

44

HÔPITAL SAINTE-CROIX

1,996

42.3 [41.2 ; 43.4]

505

30.5 [28.5 ; 32.5]

diminution

46

HÔPITAL DE GRANBY

2,509

53.4 [52.4 ; 54.3]

729

53.8 [52.0 ; 55.6]

 

47

HÔPITAL DE ROUYN-NORANDA

687

68.0 [66.2 ; 69.7]

145

89.7 [87.2 ; 92.1]

augmentation

48

CENTRE HOSPITALIER DE ST. MARY

4,243

43.7 [42.9 ; 44.4]

1,272

40.0 [38.7 ; 41.4]

diminution

49

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX MEMPHRÉMAGOG

761

47.2 [45.4 ; 48.9]

195

45.1 [41.6 ; 48.6]

 

51

HÔPITAL DE MANIWAKI

809

36.0 [34.3 ; 37.6]

247

31.2 [28.3 ; 34.1]

 

53

HÔPITAL DE CHANDLER

103

41.7 [37.0 ; 46.5]

133

65.4 [61.4 ; 69.5]

augmentation

58

HÔPITAL DU SUROÎT

4,186

54.7 [53.9 ; 55.4]

1,069

40.4 [38.9 ; 41.9]

diminution

63

HÔPITAL DE SAINT-GEORGES

576

49.7 [47.6 ; 51.7]

286

62.9 [60.1 ; 65.7]

augmentation

65

HÔPITAL ET CLSC DE VAL-D'OR

1,596

47.6 [46.4 ; 48.8]

355

40.3 [37.7 ; 42.8]

diminution

70

CENTRE DE SOINS DE COURTE DURÉE LA SARRE

444

58.3 [56.0 ; 60.6]

111

58.6 [54.0 ; 63.1]

 

72

HÔPITAL ET CENTRE D'HÉBERGEMENT DE SEPT-ÎLES

434

58.1 [55.7 ; 60.4]

141

76.6 [73.1 ; 80.1]

augmentation

74

HÔPITAL DE DOLBEAU-MISTASSINI

251

37.5 [34.5 ; 40.4]

148

35.8 [31.9 ; 39.7]

 

81

HÔPITAL DE MONT-LAURIER

1,595

51.7 [50.4 ; 52.9]

473

48.0 [45.7 ; 50.2]

 

89

HÔPITAL DE MONTMAGNY

144

43.8 [39.7 ; 47.8]

205

39.5 [36.2 ; 42.9]

 

96

CENTRE DE SANTÉ DE CHIBOUGAMAU

967

34.3 [32.8 ; 35.8]

235

32.8 [29.8 ; 35.8]

 

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

9,281

44.4 [43.9 ; 44.9]

2,335

42.1 [41.1 ; 43.1]

diminution

111

HÔPITAL DE PAPINEAU

235

33.6 [30.6 ; 36.6]

233

39.5 [36.3 ; 42.6]

 

113

HÔPITAL DE THETFORD MINES

599

59.3 [57.3 ; 61.2]

184

58.7 [55.1 ; 62.3]

 

 

Québec

209,206

44.4 [44.3 ; 44.6]

54,745

41.0 [40.8 ; 41.2]

 

Table 7 – Number of VARBSI Cases and Incidence Rate by Healthcare Facility, and Percentile Ranking, Québec, 2011–2015 and 2015–2016 (Incidence Rate per 100 Patient-periods [95% CI])

Facility

2011-2015

2015-2016

Number of cases

Mean number of cases

per year

Rate/100 pp

Number of cases

Rate/100 pp

1

HÔPITAL CHARLES LEMOYNE

40

10

0.25 [0.18 ; 0.33]

9

0.21 [0.10 ; 0.37]

3

GLEN - ROYAL VICTORIA

42

10.5

0.57 [0.41 ; 0.76]

5

0.59 [0.19 ; 1.22]

4

HÔPITAL NOTRE-DAME DU CHUM

46

11.5

0.49 [0.36 ; 0.64]

9

0.48 [0.22 ; 0.84]

5

HÔPITAL GÉNÉRAL JUIF

17

4.3

0.17 [0.10 ; 0.26]

7

0.25 [0.10 ; 0.47]

6

GLEN - ENFANTS

0

0

0

0

0

7

PAVILLON L'HÔTEL-DIEU DE QUÉBEC

50

12.5

0.34 [0.25 ; 0.44]

12

0.31 [0.16 ; 0.51]

8

PAVILLON MAISONNEUVE/PAVILLON MARCEL-LAMOUREUX

74

18.5

0.38 [0.30 ; 0.47]

13

0.26 [0.14 ; 0.42]

9

HÔPITAL DU HAUT-RICHELIEU

18

4.5

0.31 [0.18 ; 0.47]

5

0.31 [0.10 ; 0.64]

11

HÔPITAL PIERRE-LE GARDEUR

24

6

0.56 [0.36 ; 0.81]

2

0.15 [0.01 ; 0.43]

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE

11

2.8

4.78 [2.37 ; 8.02]

0

0

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

14

3.5

0.28 [0.15 ; 0.45]

2

0.16 [0.01 ; 0.46]

15

HÔPITAL FLEURIMONT

24

6

0.46 [0.29 ; 0.66]

3

0.28 [0.05 ; 0.68]

16

HÔPITAL RÉGIONAL DE RIMOUSKI

6

1.5

0.23 [0.08 ; 0.45]

1

0.14 [0 ; 0.54]

18

HÔTEL-DIEU DE LÉVIS

7

1.8

0.17 [0.07 ; 0.32]

3

0.27 [0.05 ; 0.66]

19

HÔPITAL CITÉ DE LA SANTÉ

28

7

0.24 [0.16 ; 0.34]

4

0.13 [0.03 ; 0.29]

20

HÔPITAL DE CHICOUTIMI

10

2.5

0.25 [0.12 ; 0.43]

3

0.34 [0.07 ; 0.83]

21

HÔPITAL SAINT-LUC DU CHUM

25

8.3

0.46 [0.30 ; 0.66]

3

0.17 [0.03 ; 0.41]

23

HÔTEL-DIEU D'ARTHABASKA

2

0.5

0.17 [0.02 ; 0.49]

1

0.33 [0 ; 1.30]

25

HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL

50

12.5

0.54 [0.40 ; 0.70]

5

0.22 [0.07 ; 0.46]

26

HÔPITAL DE VERDUN

21

5.3

0.32 [0.20 ; 0.47]

4

0.23 [0.06 ; 0.51]

29

HÔPITAL GÉNÉRAL DE MONTRÉAL

26

6.5

0.45 [0.29 ; 0.64]

4

0.25 [0.06 ; 0.56]

31

PAVILLON SAINTE-MARIE

26

6.5

0.32 [0.21 ; 0.45]

4

0.17 [0.04 ; 0.38]

35

HÔPITAL HONORÉ-MERCIER

16

4

0.38 [0.22 ; 0.59]

5

0.36 [0.11 ; 0.74]

36

HÔPITAL GÉNÉRAL DU LAKESHORE

10

2.5

0.19 [0.09 ; 0.33]

5

0.30 [0.10 ; 0.62]

37

HÔTEL-DIEU DE SOREL

18

4.5

0.71 [0.42 ; 1.08]

1

0.14 [0 ; 0.55]

40

HÔPITAL DE HULL

27

6.8

0.29 [0.19 ; 0.41]

6

0.30 [0.11 ; 0.59]

44

HÔPITAL SAINTE-CROIX

7

1.8

0.35 [0.14 ; 0.66]

1

0.20 [0 ; 0.78]

46

HÔPITAL DE GRANBY

6

1.5

0.24 [0.09 ; 0.47]

2

0.27 [0.02 ; 0.78]

47

HÔPITAL DE ROUYN-NORANDA

1

0.3

0.15 [0 ; 0.58]

0

0

48

CENTRE HOSPITALIER DE ST. MARY

8

2

0.19 [0.08 ; 0.34]

2

0.16 [0.02 ; 0.46]

49

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX MEMPHRÉMAGOG

1

0.3

0.13 [0 ; 0.51]

0

0

51

HÔPITAL DE MANIWAKI

3

0.8

0.37 [0.07 ; 0.91]

0

0

53

HÔPITAL DE CHANDLER

0

0

0

0

0

58

HÔPITAL DU SUROÎT

8

2

0.19 [0.08 ; 0.34]

2

0.19 [0.02 ; 0.54]

63

HÔPITAL DE SAINT-GEORGES

1

0.3

0.17 [0 ; 0.67]

0

0

65

HÔPITAL ET CLSC DE VAL-D'OR

9

2.3

0.56 [0.25 ; 0.99]

0

0

70

CENTRE DE SOINS DE COURTE DURÉE LA SARRE

0

0

0

0

0

72

HÔPITAL ET CENTRE D'HÉBERGEMENT DE SEPT-ÎLES

1

0.3

0.23 [0 ; 0.90]

1

0.71 [0 ; 2.78]

74

HÔPITAL DE DOLBEAU-MISTASSINI

1

0.5

0.40 [0 ; 1.57]

1

0.68 [0 ; 2.66]

81

HÔPITAL DE MONT-LAURIER

2

0.5

0.13 [0.01 ; 0.37]

3

0.63 [0.12 ; 1.55]

89

HÔPITAL DE MONTMAGNY

0

0

0

2

0.98 [0.09 ; 2.80]

96

CENTRE DE SANTÉ DE CHIBOUGAMAU

0

0

0

0

0

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

52

13

0.56 [0.42 ; 0.72]

6

0.26 [0.09 ; 0.51]

111

HÔPITAL DE PAPINEAU

2

2

0.85 [0.08 ; 2.44]

0

0

113

HÔPITAL DE THETFORD MINES

3

1

0.50 [0.09 ; 1.23]

0

0

 

Québec

737

188.9

0.35 [0.33 ; 0.38]

136

0.25 [0.21 ; 0.29]

 

Percentiles

         
 

10th percentile

   

0.17

 

0.15

 

25th percentile

   

0.21

 

0.19

 

50th percentile

   

0.32

 

0.26

 

75th percentile

   

0.48

 

0.33

 

90th percentile

 

 

0.57

 

0.63

* 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 

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

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

Danielle Moisan, Centre hospitalier régional du Grand-Portage

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

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

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