Central Line–Associated Bloodstream Infections in Intensive Care Units in Québec surveillance results : 2014–2015

From April 1st, 2014, to March 31st, 2015, 67 intensive care units (ICUs) took part in surveillance of central line–associated bloodstream infections (CLABSIs), for a combined total of 130,776 catheter-days (Table 1). Participating ICUs reported 115 CLABSIs in 112 patients. Incidence rates were 0.34 per 1,000 catheter-days in coronary ICUs, 0.52 in teaching adult ICUs, 0.76 in non-teaching adult ICUs, 2.06 in pediatric ICUs and 2.20 in neonatal ICUs. The incidence rates in 2014–2015 were lower compared to 2010–2014 in teaching adult as well as in neonatal ICUs while non-teaching adult, pediatric and coronary ICUs pooled mean rates remained stable. Compared to 2013-2014, two adult non-teaching ICUs with less than 10 beds and a neonatal ICU are not considered anymore in the results, having provided less than 11 periods of data. Data were extracted on May 20, 2015.

Updated : March 29, 2016

Table 1 – Participation of ICUs in the Surveillance of CLABSIs, Québec, 2010–2011 to 2014–2015

 

2010–2011

2011–2012

2012–2013

2013–2014

2014–2015

Participating ICUs (N)

63

65

66

66

67

Patient-days (N)

277,536

286,673

293,617

295,314

297,308

Catheter-days (N)

121,107

127,269

127,322

129,927

130,776

CLABSIs (cat. 1, N)

192

203

200

169

115

Infected patients (N)

183

193

196

156

112

In 2014–2015, incidence rates were 0.34 per 1,000 catheter-days in coronary ICUs, 0.52 in teaching adult ICUs, 0.76 in non-teaching adult ICUs, 2.06 in pediatric ICUs and 2.20 in neonatal ICUs. The lowest pooled mean rate was found in coronary ICUs (Table 2). The CLABSI incidence rate was highest in neonatal and pediatric ICUs, and these rates were significantly higher than that of adult ICUs (p < 0.01).

Table 2 – CLABSI Incidence Rate and Catheter Utilization Ratio, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days [95% CI])

Type of ICU

ICUs (N)

Incidence Rate

Incidence Rate
(including mucosal barrier injuries)

Utilization Ratio

Coronary

3

0.34 [0.00 ; 1.34]

0.34 [0.00 ; 1.34]

0.23

Adult, teaching

27

0.52 [0.37 ; 0.69]

0.57 [0.41 ; 0.76]

0.61

Adult, non-teaching

27

0.76 [0.47 ; 1.12]

0.76 [0.47 ; 1.12]

0.35

Pediatric

4

2.06 [1.15 ; 3.23]

2.06 [1.15 ; 3.23]

0.59

Neonatal

6

2.20 [1.56 ; 2.94]

2.20 [1.56 ; 2.94]

0.26

95% CI: 95% confidence interval.

In 2014–2015, six neonatal ICUs provided the number of catheter-days by birth weight category showing that incidence rates tend to be higher in the lowest birth weight categories (Table 3).

Table 3 – CLABSI Incidence Rate in Neonatal ICUs, by Birth Weight Category, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days [95% CI])

Birth Weight Category 
(grams)

Number of Cases

Incidence Rate

≤ 750

13

3.69 [1.96 ; 5.98]

751–1,000

8

2.32 [0.99 ; 4.22]

1,001–1,500

6

1.69 [0.61 ; 3.30]

1,501–2,500

2

0.65 [0.06 ; 1.85]

> 2,500

9

2.10 [0.95 ; 3.70]

Total

38

2.12 [1.50 ; 2.85]

In 2014–2015, compared to the previous four years (Figure 1), CLABSI incidence rates declined significantly in adult teaching ICUs (p < 0.01) and neonatal ICUs (p < 0.01), but remained stable in adult non-teaching ICUs (p > 0.05), pediatric ICUs (p > 0.05) and coronary ICUs (p > 0.05).

Figure 1 – CLABSI Incidence Rate, by Type of Healthcare Facility and Type of ICU, in ICUs that previously participated in SPIN (N = 67), Québec, 2010–2014 and 2014–2015 (Incidence Rate per 1,000 Catheter-days [I.C. 95%])

Figure 1 – CLABSI Incidence Rate, by Type of Healthcare Facility and Type of ICU, in ICUs that previously participated in SPIN (N = 67), Québec, 2010–2014 and 2014–2015 (Incidence Rate per 1,000 Catheter-days [I.C. 95%])

In addition to the marked decrease of CLABSI rates, a significant increase (p < 0.05) of catheter utilization ratios was observed in neonatal ICUs. The catheter utilization ratio decreased significantly in other ICUs (Figure 2).

Figure 2 – Catheter Utilization Ratio, by Type of Healthcare Facility and Type of ICU, in ICUs that previously participated in SPIN (N = 67), Québec, 2010–2014 and 2014–2015

Figure 2 – Catheter Utilization Ratio, by Type of Healthcare Facility and Type of ICU, in ICUs that previously participated in SPIN (N = 67), Québec, 2010–2014 and 2014–2015

Patients who developed a CLABSI were aged between 0 and 87 years, with a median age of 67 years in the adult ICUs, 0.6 years in pediatric ICUs and a little less than one month of age in neonatal ICUs. In adult ICUs, the central lines most frequently associated with bloodstream infections were the 'other' central venous catheters (CVCs) that included central lines previously named 'regular' CVCs, followed by peripherally inserted central catheters (PICCs) (Figure 3). In neonatal ICUs, PICCs were the CVCs most associated with CLABSI, followed by umbilical catheters.

Figure 3 – Type of Central Line Used in CLABSI Cases, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (N)

Figure 3 – Type of Central Line Used in CLABSI Cases, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (N)

NB: More than one central line may be reported in any given case of CLABSI, which explains why the total number of central lines is higher than the total number of CLABSIs presented earlier in this paper.

In 2014–2015, 19% of CLABSI cases died in the 30 days following bacteremia onset (Table 4). Case fatality was 100% in coronary ICUs (Table 4) but the number of cases was very small. The overall case fatality of 19% is not a significant increase compared to the case fatality of 16% observed in 2013–2014 (p > 0.05).

Figure 4 – 30-Day Case Fatality, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (%)

Figure 4 – 30-Day Case Fatality, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (%)

Table 4 – 30-Day Case Fatality, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (N, %)

Type of ICU

CLABSIs
N

Death in 10 Days

 

Death in 30 Days

N

%

 

N

%

Coronary

1

1

100

 

1

100

Adult, teaching

39

8

21

 

12

31

Adult, non-teaching

21

2

10

 

3

14

Pediatric

15

4

27

 

5

33

Neonatal

39

1

3

 

1

3

Total

115

16

14

 

22

19

Figure 5 shows that the microorganisms most frequently isolated in reported CLABSI cases were coagulase-negative staphylococci (CoNS, 38%), followed by Enterococcus sp. (13%) and S. aureus (13 %). However, CoNS and Candida sp. were present in almost two thirds of cases resulting in death (61%).

Figure 5 – Categories of Isolated Microorganisms in All Cases (N = 133) and Cases of Mortality Within 30 Days (N = 26), Québec, 2014–2015 (%)

Isolated Microorganisms – All Cases
Figure 5 – Categories of Isolated Microorganisms in All Cases (N = 133) and Cases of Mortality Within 30 Days (N = 26), Québec, 2014–2015 (%)

Isolated Microorganisms – Mortality Within 30 Days
Figure 5 – Categories of Isolated Microorganisms in All Cases (N = 133) and Cases of Mortality Within 30 Days (N = 26), Québec, 2014–2015 (%)

In 2014–2015, 12% of S. aureus strains were resistant to oxacillin; 26% of Gram-negative bacteria showed resistance to piperacillin/tazobactam. One vancomycin-resistant Enterococcus was reported, for a proportion of resistant enterococci of 6% (Table 5 and Figure 6).

Table 5 – Percentage of Strains Tested and Percentage of Resistance to Antibiotics for Certain Isolated Microorganisms, Québec, 2014–2015 (N, %)

MicroorganismAntibiotic

Isolated
n

Tested

Resistant

n

%

n

%

Staphylococcus aureusOxacillin

17

17

100.0

2

11.8

Enterococcus faeciumVancomycin

8

8

100.0

1

12.5

Enterococcus faecalisVancomycin

8

8

100.0

0

0.0

Klebsiella (pneumoniae/oxytoca)CSE 4

5

5

100.0

1

20.0

Imipenem or meropenem

5

5

100.0

0

0.0

Multiresistant 1

5

5

100.0

1

20.0

Escherichia coliCSE 4

3

3

100.0

0

0.0

Fluoroquinolones 3

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

Enterobacter sp.CSE 4

6

5

83.3

2

40.0

Imipenem or meropenem

6

5

83.3

0

0.0

Multiresistant 1

6

5

83.3

0

0.0

Pseudomonas sp.Amikacin, gentamicin or tobramycin

2

1

50.0

0

0.0

CSE 2

2

2

100.0

0

0.0

Fluoroquinolones 2

2

2

100.0

0

0.0

Imipenem or meropenem

2

1

50.0

0

0.0

Piperacillin/tazobactam

2

2

100.0

1

50.0

Multiresistant 2

2

2

100.0

0

0.0

Acinetobacter sp.Imipenem or meropenem

0

0

-

0

-

Multiresistant 3

0

0

-

0

-

CSE 4: cefepime, cefotaxime, ceftazidime or ceftriaxone; CSE 2: cefepime or ceftazidime.
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 6 – Antibiotic Resistance in Gram-Positive Bacteria, Gram-Negative Bacteria and Pseudomonas sp., Québec, 2010–2014 to 2014–2015 (%)

Figure 6 – Antibiotic Resistance in Gram-Positive Bacteria, Gram-Negative Bacteria and Pseudomonas sp., Québec, 2010–2014 to 2014–2015 (%)

In 2014–2015, all participating coronary, adult teaching, pediatric and neonatal ICUs remained below the 90th percentile from the 2010–2011 to 2013–2014 rates, which suggests an improvement in CLABSI rates (Figures 7, 8, 10 and 11). Only one adult non-teaching ICU ranked above the 90th percentile in its respective category: less than 10% of ICUs, figure 9. Tables 6 and 7 present the numerical values that correspond to rates displayed in Figures 7 to11. Tables 8 and 9 show the catheter utilization rates for each ICU.

Figure 7 – CLABSI Incidence Rate per ICU (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), Coronary ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 7 – CLABSI Incidence Rate per ICU (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), Coronary ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 8 – CLABSI Incidence Rate per ICU (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), Teaching Adult ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 8 – CLABSI Incidence Rate per ICU (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), Teaching Adult ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 9 – CLABSI Incidence Rate per ICU (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), Non-Teaching Adult ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 9 – CLABSI Incidence Rate per ICU (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), Non-Teaching Adult ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 10 – CLABSI Incidence Rate (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014) per ICU, Pediatric ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 10 – CLABSI Incidence Rate (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014) per ICU, Pediatric ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 11 – CLABSI Incidence Rate (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), per ICU, Neonatal ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Figure 11 – CLABSI Incidence Rate (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014), per ICU, Neonatal ICUs, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Table 6 – CLABSI Incidence Rate per ICU, Distribution of CLABSI rates for 2010–2014 and the Ministry’s Strategic Planning Threshold, by ICU Types, for Teaching Healthcare Facilities, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Facility

Adult, teaching*

Coronary

Pediatric

Neonatal

1

HÔPITAL CHARLES LEMOYNE0.00   

2

HÔPITAL DE L'ENFANT-JÉSUS0.00-B   

2

HÔPITAL DE L'ENFANT-JÉSUS1.85-X   

3

HÔPITAL ROYAL VICTORIA0.44

0.00

 

0.31

4

HÔPITAL NOTRE-DAME DU CHUM0.23   

5

HÔPITAL GÉNÉRAL JUIF0.22  

2.49

6

L'HÔPITAL DE MONTRÉAL POUR ENFANTS  

3.27

2.16

7

PAVILLON L'HÔTEL-DIEU DE QUÉBEC0.36   

8

PAVILLON MAISONNEUVE/PAVILLON MARCEL-LAMOUREUX1.44

0.00

  

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE  

1.30

4.82

13

INSTITUT DE CARDIOLOGIE DE MONTRÉAL0.37   

15

HÔPITAL FLEURIMONT0.47-S 

0.00

0.62

15

HÔPITAL FLEURIMONT0.63-M   

18

HÔTEL-DIEU DE LÉVIS1.78   

20

HÔPITAL DE CHICOUTIMI0.00   

21

HÔPITAL SAINT-LUC DU CHUM0.00   

22

HÔTEL-DIEU DU CHUM1.89-B

0.98

  

22

HÔTEL-DIEU DU CHUM0.41-X   

25

HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL1.01   

27

PAVILLON CENTRE HOSPITALIER DE L'UNIVERSITÉ LAVAL0.00 

2.53

0.83

28

PAVILLON SAINT-FRANCOIS D'ASSISE0.80   

29

HÔPITAL GÉNÉRAL DE MONTRÉAL0.98   

30

HÔTEL-DIEU DE SHERBROOKE0.84   

31

PAVILLON SAINT-JOSEPH0.00   

33

INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC0.00-S   

33

INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC0.00-X   

48

CENTRE HOSPITALIER DE ST. MARY0.00   

116

INSTITUT THORACIQUE DE MONTRÉAL1.01   

118

HÔPITAL NEUROLOGIQUE DE MONTRÉAL0.00   

2010–2014 percentile ranking

10th0.00

0.00

0.00

0.00

25th0.00

0.00

0.00

1.67

50th0.80

1.09

2.19

3.17

75th1.50

1.29

3.22

6.36

90th1.90

2.99

4.64

6.73

Strategic planning threshold*

 3.15

-

3.32

6.62

* In healthcare facilities with more than one type of adult ICU: S = surgical, M = medical, X = mixed and B = burn trauma..
** This threshold represents the 90th percentile for 2007–2009 rates

Table 7 – CLABSI Incidence Rate per ICU, Distribution of CLABSI rates for 2010–2014 and the Ministry’s Strategic Planning Threshold, by ICU Types, for Non-teaching Healthcare Facilities, Québec, 2014–2015 (Incidence Rate per 1,000 Catheter-days)

Facility

Adult, Non-teaching

9

HÔPITAL DU HAUT-RICHELIEU

0.00

10

HÔPITAL PIERRE-BOUCHER

0.96

11

HÔPITAL PIERRE-LE GARDEUR

0.00

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

0.00

16

HÔPITAL RÉGIONAL DE RIMOUSKI

0.00

19

HÔPITAL CITÉ DE LA SANTÉ

1.21

23

HÔTEL-DIEU D'ARTHABASKA

0.00

26

HÔPITAL DE VERDUN

1.13

32

CENTRE HOSPITALIER RÉGIONAL DU GRAND-PORTAGE

0.00

34

HÔPITAL SANTA CABRINI

0.00

35

HÔPITAL HONORÉ-MERCIER

0.96

36

HÔPITAL GÉNÉRAL DU LAKESHORE

1.16

38

HÔPITAL JEAN-TALON

0.00

40

HÔPITAL DE HULL

0.37

41

HÔPITAL DU CENTRE-DE-LA-MAURICIE

0.00

42

CENTRE HOSPITALIER ANNA-LABERGE

0.00

44

HÔPITAL SAINTE-CROIX

0.00

45

HÔPITAL DE SAINT-EUSTACHE

0.00

46

HÔPITAL DE GRANBY

0.00

47

HÔPITAL DE ROUYN-NORANDA

0.00

58

HÔPITAL DU SUROÎT

1.57

63

HÔPITAL DE SAINT-GEORGES

0.00

64

HÔPITAL LE ROYER

0.00

67

HÔPITAL ET CENTRE DE RÉADAPTATION DE JONQUIÈRE

0.00

80

HÔPITAL FLEURY

0.00

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

2.63

103

HÔPITAL LAURENTIEN

5.75

2010–2014 percentile ranking

10th

0.00

25th

0.00

50th

0.00

75th

1.29

90th

3.57

Strategic planning threshold*

 

3.30

*This threshold represents the 90th percentile for 2007–2009 rates.

Table 8 – Catheter Utilization Ratio per ICU, Distribution of Ratios for 2010–2014, by ICU Types, for Teaching Healthcare Facilities, Québec, 2014–2015

Facility

Adult, teaching*

Coronary

Pediatric

Neonatal

1

HÔPITAL CHARLES LEMOYNE0.55   

2

HÔPITAL DE L'ENFANT-JÉSUS0.19-B   

2

HÔPITAL DE L'ENFANT-JÉSUS0.45-X   

3

HÔPITAL ROYAL VICTORIA0.91

0.15

 

0.55

4

HÔPITAL NOTRE-DAME DU CHUM0.91   

5

HÔPITAL GÉNÉRAL JUIF0.83  

0.21

6

L'HÔPITAL DE MONTRÉAL POUR ENFANTS  

0.59

0.49

7

PAVILLON L'HÔTEL-DIEU DE QUÉBEC0.65   

8

PAVILLON MAISONNEUVE/PAVILLON MARCEL-LAMOUREUX0.67

0.27

  

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE  

0.72

0.20

13

INSTITUT DE CARDIOLOGIE DE MONTRÉAL0.99   

15

HÔPITAL FLEURIMONT0.53-S 

0.18

0.26

15

HÔPITAL FLEURIMONT0.36-M   

18

HÔTEL-DIEU DE LÉVIS0.26   

20

HÔPITAL DE CHICOUTIMI0.73   

21

HÔPITAL SAINT-LUC DU CHUM0.84   

22

HÔTEL-DIEU DU CHUM0.52-B

0.37

  

22

HÔTEL-DIEU DU CHUM0.98-X   

25

HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL0.48   

27

PAVILLON CENTRE HOSPITALIER DE L'UNIVERSITÉ LAVAL0.19 

0.44

0.14

28

PAVILLON SAINT-FRANCOIS D'ASSISE0.33   

29

HÔPITAL GÉNÉRAL DE MONTRÉAL0.71   

30

HÔTEL-DIEU DE SHERBROOKE0.30   

31

PAVILLON SAINT-JOSEPH0.53   

33

INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC0.96-S   

33

INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC0.37-X   

48

CENTRE HOSPITALIER DE ST. MARY0.50   

116

INSTITUT THORACIQUE DE MONTRÉAL0.51   

118

HÔPITAL NEUROLOGIQUE DE MONTRÉAL0.15   

2010–2014 percentile ranking*

10th0.28

0.17

0.04

0.01

25th0.41

0.19

0.18

0.12

50th0.58

0.25

0.40

0.22

75th0.82

0.38

0.59

0.27

90th0.96

0.41

0.74

0.41

* In healthcare facilities with more than one type of adult ICU: S = surgical, M = medical, X = mixed and B = burn trauma.

Table 9 – Catheter Utilization Ratio per ICU, Breakdown for 2010–2014, by ICU Types, for Non-teaching Healthcare Facilities, Québec, 2014–2015

Facility

Adult, non-teaching

9

HÔPITAL DU HAUT-RICHELIEU

0.31

10

HÔPITAL PIERRE-BOUCHER

0.30

11

HÔPITAL PIERRE-LE GARDEUR

0.59

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

0.21

16

HÔPITAL RÉGIONAL DE RIMOUSKI

0.25

19

HÔPITAL CITÉ DE LA SANTÉ

0.44

23

HÔTEL-DIEU D'ARTHABASKA

0.08

26

HÔPITAL DE VERDUN

0.59

32

CENTRE HOSPITALIER RÉGIONAL DU GRAND-PORTAGE

0.29

34

HÔPITAL SANTA CABRINI

0.26

35

HÔPITAL HONORÉ-MERCIER

0.31

36

HÔPITAL GÉNÉRAL DU LAKESHORE

0.70

38

HÔPITAL JEAN-TALON

0.47

40

HÔPITAL DE HULL

0.67

41

HÔPITAL DU CENTRE-DE-LA-MAURICIE

0.11

42

CENTRE HOSPITALIER ANNA-LABERGE

0.42

44

HÔPITAL SAINTE-CROIX

0.14

45

HÔPITAL DE SAINT-EUSTACHE

0.27

46

HÔPITAL DE GRANBY

0.18

47

HÔPITAL DE ROUYN-NORANDA

0.14

58

HÔPITAL DU SUROÎT

0.45

63

HÔPITAL DE SAINT-GEORGES

0.10

64

HÔPITAL LE ROYER

0.20

67

HÔPITAL ET CENTRE DE RÉADAPTATION DE JONQUIÈRE

0.19

80

HÔPITAL FLEURY

0.29

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

0.37

103

HÔPITAL LAURENTIEN

0.14

2010–2014 percentile ranking

10th

0.12

25th

0.16

50th

0.32

75th

0.42

90th

0.60

Comité de surveillance provinciale des infections nosocomiales (SPIN) – bactériémies sur cathéters centraux aux soins intensifs

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

Caroline Quach, Centre universitaire de santé McGill, Hôpital de Montréal pour enfants

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