Clostridium difficile–Associated Diarrhea (CDAD) : surveillance results 2014–2015

Clostridium difficile–Associated Diarrhea (CDAD)
Surveillance Results: 2014-2015

From April 1, 2014, to March 31, 2015, 95 healthcare facilities participated in the surveillance of Clostridium difficile–associated diarrhea (CDAD), for a combined total of 5,076,655 inpatient days (Table 1). The participating facilities reported 3,453 cases of healthcare-associated (HA) CDAD. The incidence rate of HA CDAD was 6.8 cases per 10,000 patient days. This incidence rate was significantly lower compared to the rate of 2013–2014. The 10-day fatality rate was 9.8% (n = 285) while the 30-day fatality rate was 18.6% (n = 543). In total, 36 (1.2%) colectomies were reported. Data was extracted on May 20th, 2015 and updated on June 1st 2015.  

Updated : March 24, 2016

Table 1 – Participation of Healthcare Facilities in the Surveillance of CDAD, Québec, 2010–2011 to 2014–2015

 

2010-2011

2011-2012

2012-2013

2013-2014

2014-2015

Participating facilities (N)

95

95

95

95

95

Admissions (N)

617,103

630,156

640,103

650,571

654,931

Inpatient days (N)

5,160,240

5,176,519

5,227,730

5,122,540

5,076,655

Healthcare-associated CDAD cases (cat. 1a+ 1b) (N)

3,635

3,778

3,794

3,663

3,453

In 2014–2015, the provincial incidence rate for HA CDAD was 6.8 cases per 10,000 patient days (Table 2). According to number of beds and teaching vocation, incidence rates for CDAD remained significantly higher in facilities with 100 beds or more, whatever the proportion of admitted patient aged 65 years or older and the teaching vocation (Figure 1 and Table 2).

Figure 1 – Healthcare-associated CDAD Incidence Rate, by Healthcare Facility Category, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 1 – Healthcare-associated CDAD Incidence Rate, by Healthcare Facility Category, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

p65 : Proportion of admitted patients aged 65 years or older
95% CI: 95% confidence interval.

In 2014–2015, the types of healthcare facility (Table 2) that reported a CDAD incidence rate higher than that of the reference facilities (facilities ˂ 100 beds and p65 < 35%) were:

  • Facilities ˂ 100 beds and p65 ≥ 35% (univariate rate ratio = 1.6);
  • Non-teaching facilities ≥ 100 beds and p65 < 35% (univariate rate ratio = 2.5);
  • Non-teaching facilities ≥ 100 beds and p65 ≥ 35% (univariate rate ratio = 2.3);
  • Teaching facilities ≥ 100 beds and p65 ˂ 35% (univariate rate ratio = 2.7);
  • Teaching facilities ≥ 100 beds and p65 ≥ 35% (univariate rate ratio = 2.5).

Table 2 – Percentile, Incidence Rate and Univariate Rate Ratio of Healthcare-Associated CDAD by Healthcare Facility Category, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Healthcare Facility Category

Distribution Indicator

Incidence Rate
[95% CI]

Univariate Rate Ratio
[95% CI]

Min.

25%

50%

75%

90%

Max.

 

 

Facilities < 100 beds and p65 < 35% (N = 4)

0.4

1.0

2.6

4.5

5.3

5.3

3.0 [1.9-4.3]

(ref)

Facilities < 100 beds and p65 ≥ 35% (N = 29)

0

2.0

4.0

5.7

10.4

14.9

4.7 [4.1-5.4]

1.6 [1.0-2.4]*

Non-teaching ≥ 100 beds and p65 < 35% (N = 4)

2.0

2.3

6.7

11.2

11.6

11.6

7.6 [6.2-9.1]

2.5 [1.6-3.9]*

Non- teaching  ≥ 100 beds and p65 ≥ 35% (N = 28)

1.1

4.0

6.0

9.6

12.9

15.7

7.0 [6.6-7.4]

2.3 [1.6-3.5]*

Teaching ≥ 100 beds and p65 < 35% (N = 6)

3.0

4.2

8.8

11.7

11.9

11.9

8.1 [7.4-8.8]

2.7 [1.8-4.0]*

Teaching ≥ 100 beds and p65 ≥ 35% (N = 16)

2.4

6.3

7.6

8.3

9.2

12.7

7.5 [7.1-7.9]

2.5 [1.6-3.7]*

Rehabilitation (N = 6)

0.0

1.9

3.5

4.7

6.1

6.1

3.4 [2.7-4.2]

1.1 [0.7-1.8]

Pediatric (N = 2)

2.7

2.7

3.9

5.0

5.0

5.0

3.4 [2.3-4.7]

1.1 [0.7-1.9]

Total (N = 95)

0.0

2.7

5.0

8.0

11.7

15.7

6.8 [6.6-7.0]

 

There are two teaching facilities included in the healthcare facilities with the fewer than 100 beds category.
*Significant statistical difference (p < 0.05) between univariate rate ratio of the heatlcare facility category and reference (ref).
p65 : Proportion of admitted patients aged 65 years or older.

The univariate analysis presented on Table 3 reveals that:

  • Facilities with 100 to 249 beds have a higher annual incidence rate of CDAD than facilities with fewer than 100 beds (univariate rate ratio of 1.3);
  • Facilities with 250 beds or more have a higher annual incidence rate of CDAD than facilities with fewer than 100 beds (univariate rate ratio of 1.8);
  • Facilities with a proportion of admitted patients aged 65 years or older equal of greater to 35% have a similar incidence rate than facilities  with a proportion of admitted patients aged 65 years or older lower than 35% (univariate rate ratio of 0.9);
  • Teaching facilities have a higher incidence rate than non-teaching facilities (univariate rate ratio of 1.2);
  • Rehabilitation facilities have a lower incidence rate than non-teaching facilities (univariate rate ratio of 0.5);
  • Pediatric facilities have a lower incidence rate than non-teaching facilities (univariate rate ratio of 0.5).

Table 3 – Healthcare-associated CDAD Incidence Rate and Univariate Rate Ratio Stratified by Number of Beds, Proportion of Admitted Patients Aged 65 Years or Older and Type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Facility Characteristics

Incidence Rate
[95% CI]

Univariate Rate Ratio
[95% CI]

Number of Beds*

 

 

< 100 beds (N = 33)

4.5 [3.9 ; 5.1]

(ref)

100–249 beds (N = 30)

6.0 [5.6 ; 6.3]

1.3 [1.2-1.5]***

≥ 250 beds (N = 26)

8,0 [7.7 ; 8.3]

1.8 [1.6-2.1]***

 

 

 

Proportion of Admitted Patients Aged 65 Years or Older**

p65 < 35% (N = 14)

7.5 [6.9-8.1]

(ref)

p65 ≥ 35% (N = 73)

7.0 [6.7-7.2]

0.9 [0.9-1.0]

 

 

 

Type of Healthcare Facility

Non-teaching (N = 63)

6.6 [6.2-6.9]

(ref)

Teaching (N = 24)

7.6 [7.2-7.9]

1.2 [1.1-1.2]***

Rehabilitation (N = 6)

3.4 [2.7-4.2]

0.5 [0.4-0.7]***

Pediatric (N = 2)

3.4 [2.3-4.6]

0.5 [0.4-0.7]***

* The six rehabilitation facilities are excluded from the analysis.
**The six rehabilitation facilities and two pediatric facilities are excluded from the analysis.
*** Significant statistical difference (p < 0.05) between univariate rate ratio of the heatlcare facility category and reference (ref).
p65 : Proportion of admitted patients aged 65 years or older.

HA CDAD incidence rates in 2014–2015 were lower compared to 2013–2014 (Table 4, Figures 2 and 3).

Figure 2 – Healthcare-associated CDAD Incidence Rate for Participating Healthcare Facilities, Québec, 2004–2005 to 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI]) (N = 95)1

Figure 2 – Healthcare-associated CDAD Incidence Rate for Participating Healthcare Facilities, Québec, 2004–2005 to 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI]) (N = 95)

1 Data are those from facilities that participated in surveillance in 2014-2015 as well as at least height periods in 2004.2005 and at least 11 periods between 2005-2006 and 2013-2014.

Figure 3 – Healthcare-associated CDAD Incidence Rate and 75th percentile Threshold Value (for Participating Facilities, Québec, 2010–2011 to 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI]) (N = 95) 

Figure 3 – Healthcare-associated CDAD Incidence Rate and 75th percentile Threshold Value (for Participating Facilities, Québec, 2010–2011 to 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI]) (N = 95)

Compared to 2013-2014, non-teaching healthcare facilities with 100 or more beds and less than 35% of admitted patients aged 65 years or older (p65 < 35%) demonstrated a significant increase in their CDAD incidence rate from 3.8 to 7.6 healthcare-associated CDAD / 10 000 patient days. In contrast, teaching facilities with 100 or more beds and 35% or more admitted patients aged 65 years or older (p65 ≥ 35%) demonstrated a significant drop for a second consecutive year in their CDAD incidence rate from 8.8 to 7.5 healthcare-associated CDAD / 10 000 patient days (Table 4).

Table 4 – Healthcare-associated CDAD Incidence Rate by Healthcare Facility Category (N = 95)1, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Healthcare Facility Category

2010–2011

2011–2012

2012–2013

2013–2014

2014–2015

Facilities ˂ 100 beds, p65 ˂ 35% (N = 4)

3.1 [2.0-4.4]

5.3 [3.8-7.0]

3.5 [2.3-4.9]

2.9 [1.8-4.2]

3.0 [1.9-4.3]

Facilities ˂ 100 beds, p65 ≥ 35% (N = 29)

6.4 [5.7-7.2]

5.0 [4.4-5.7]

5.4 [4.7-6.1]

5.6 [4.9-6.3]

4.7 [4.1-5.4]

Non-teaching ≥ 100 beds, p65 ˂ 35% (N = 4)

7.6 [6.2-9.1]

6.0 [4.8-7.4]

4.7 [3.6-5.9]

3.8 [2.9-4.9]

7.6 [6.2-9.1]*

Non-teaching ≥ 100 beds, p65 ≥ 35% (N = 28)

6.4 [6.0-6.8]

6.6 [6.2-7.0]

6.0 [5.7-6.4]

7.1 [6.7-7.5]

7.0 [6.6-7.4]

Teaching ≥ 100 beds, p65 ˂ 35% (N = 6)

7.4 [6.7-8.1]

8.0 [7.3-8.7]

8.6 [7.9-9.4]

7.8 [7.1-8.5]

8.1 [7.4-8.8]

Teaching ≥ 100 beds, p65 ≥ 35% (N = 16)

8.7 [8.3-9.1]

9.6 [9.1-10.1]

9.9 [9.4-10.4]

8.8 [8.4-9.3]

7.5 [7.1-7.9]*

Rehabilitation facilities (N = 6)

3.3 [2.7-4.0]

3.0 [2.4-3.7]

3.3 [2.7-4.0]

2.9 [2.3-3.6]

3.4 [2.7-4.2]

Pediatric facilities (N = 2)

3.2 [2.2-4.4]

2.5 [1.6-3.5]

3.9 [2.8-5.2]

3.2 [2.2-4.4]

3.4 [2.3-4.7]

Total

7.0 [6.8-7.2]

7.3 [7.1-7.5]

7.3 [7.1-7.5]

7.2 [7.0-7.4]

6.8 [6.6-7.0]*

* Significant statistical difference (p < 0.05) between healthcare-associated CDAD of 2013-2014 and 2014-2015.
p65: Proportion of admitted patients aged 65 years or older.
1  Data are those from facilities that participated in surveillance in 2014-2015 as well as at least 11 periods between 2010-2011 and 2013-2014.

In total, 5,004 cases of CDAD were reported of which 3,453 were healthcare-associated (current or previous hospitalisation) (cat. 1a, 1b), and 304 cases which were associated with ambulatory care in the reporting facility (cat. 1c) (Table 5).

Table 5 – Distribution of CDAD Cases by Presumed Origin of Acquisition, Québec, 2014–2015 (N, %)

Category

Origin of Acquisition

N

%

1a

Healthcare-associated with a current hospitalisation in the reporting facility

2,489

49.7

1b

Healthcare-associated with a previous hospitalisation in the reporting facility

964

19.3

1c

Healthcare-associated with ambulatory care in the reporting facility

304

6.1

1d

Healthcare-associated with long term unit in the reporting facility

12

0.2

2

Healthcare-associated with another facility

262

5.2

3

Community

737

14.7

4

Unknown

236

4.7

 

Total

5,004

100

Data related to complications were available in 2,922 of the 3,453 cases of HA CDAD (84.6%). The 10-day case fatality rate (n = 285) was 9.8% whereas the 11- to 30-day case fatality rate (n = 258) was 8.8%. In addition to the 543 deaths that occurred within 30 days (18.6%), 36 colectomies (1.2%), 202 readmissions (6.9%) and 98 transfers to an intensive care unit (ICU) (3.4%) were reported (Table 6). As of 2010-2011, the percentage of deaths within 30 days has remained stable, ranging from 15.1% to 18.6%.

Table 6 – Number of Deaths, Case Fatality Rate and Complications Related to Healthcare-associated CDAD, Québec, 2010–2011 to 2014–2015 [N (%)]

 

2010–2011

2011–2012

2012–2013

2013–2014

2014–2015

     Number and percentage of CDAD cases with documented complications

3,343 (92)

3,550 (94)

3,483 (91.8)

3,525 (96.2)

2,922 (84.6)

     Number of facilities reporting complications

89

91

88

89

82

Deaths

         

     Death within 10 days

318 (9.5)

305 (8.6)

304 (8.7)

322 (9.1)

285 (9.8)

     Death within 30 days*

580 (17.3)

545 (15.4)

561 (16.1)

534 (15.1)

543 (18.6)

Other complications

         

     Colectomy

59 (1.8)

53 (1.5)

33 (0.9)

46 (1.3)

36 (1.2)

     Readmission

170 (5.1)

155 (4.4)

182 (5.2)

223 (6.3)

202 (6.9)

Admission to ICU

94 (2.8)

98 (2.8)

97 (2.8)

110 (3.1)

98 (3.4)

*The number of deaths within 30 days includes the number of deaths within 10 days

A laboratory surveillance of C. difficile strains is performed by the Laboratoire de santé publique du Québec every year. This surveillance took place in 2014-2015 and results will be incorporated into this report shortly. 

The HA CDAD incidence rates by healthcare facility and healthcare facility category are shown in Figures 4 through 11.

Figure 4 – Healthcare-associated CDAD Incidence Rate, Among Facilities with Fewer than 100 Beds and a Proportion of Admitted Patients Aged 65 Years or Older Below 35% , Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 4 – Healthcare-associated CDAD Incidence Rate, Among Facilities with Fewer than 100 Beds and a Proportion of Admitted Patients Aged 65 Years or Older Below 35% , Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 5 – Healthcare-associated CDAD Incidence Rate Among Facilities with Fewer than 100 Beds and a Proportion of Admitted Patients Aged 65 Years or Older of 35% or More, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 5 – Healthcare-associated CDAD Incidence Rate Among Facilities with Fewer than 100 Beds and a Proportion of Admitted Patients Aged 65 Years or Older of 35% or More, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 6 – Healthcare-associated CDAD Incidence Rate Among Non-Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older Below 35%, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 6 – Healthcare-associated CDAD Incidence Rate Among Non-Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older Below 35%, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 7 – Healthcare-associated CDAD Incidence Rate Among Non-Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older of 35% or More, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 7 – Healthcare-associated CDAD Incidence Rate Among Non-Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older of 35% or More, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 8 – Healthcare-associated CDAD Incidence Rate Among Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older Below 35%, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 8 – Healthcare-associated CDAD Incidence Rate Among Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older Below 35%, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 9 – Healthcare-associated CDAD Incidence Rate Among Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older of 35% or More, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 9 – Healthcare-associated CDAD Incidence Rate Among Teaching Facilities with 100 Beds or More and a Proportion of Admitted Patients Aged 65 Years or Older of 35% or More, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 10 – Healthcare-associated CDAD Incidence Rate Among Rehabilitation Facilities, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 10 – Healthcare-associated CDAD Incidence Rate Among Rehabilitation Facilities, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 11 – Healthcare-associated CDAD Incidence Rate Among Pediatric Facilities, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

Figure 11 – Healthcare-associated CDAD Incidence Rate Among Pediatric Facilities, Québec, 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

At the local level, the HA CDAD incidence rate ranged from 0 to 15.7/10,000 patient days in 2014–2015. The incidence rates for the past five years of surveillance are indicated in Table 7. Overall, 17 healthcare facilities (17.9%) saw a significant decrease in their HA CDAD incidence rate compared to 2013–2014, whereas 8 facilities (8.4%) experienced a significant increase. Two regions (Capitale-Nationale and Chaudière-Appalaches) as well as the province have a significant decrease in their HA CDAD as compared to 2013-2014.

Table 7 – Healthcare-associated CDAD Incidence Rate per Healthcare Facility, Québec, 2010–2011 to 2014–2015 (Incidence Rate per 10,000 Patient Days [95% CI])

HR

Facility

Incidence rate of healthcare-associated CDAD / 10,000 patient days [95% CI]

Number

Name

2010-2011

2011-2012

2012-2013

2013-2014

2014-2015

01

16

HÔPITAL RÉGIONAL DE RIMOUSKI

9.8 [7.4-12.6]

16.0 [12.8-19.6]

7.0 [5.0-9.4]

5.1 [3.3-7.2]

4.5 [2.8-6.5]

 

32

CENTRE HOSPITALIER RÉGIONAL DU GRAND-PORTAGE

4.6 [2.6-7.2]

3.1 [1.5-5.3]

2.6 [1.1-4.7]

2.7 [1.2-4.9]

1.8 [0.6-3.7]

 

61

CENTRE NOTRE-DAME-DE-FATIMA

9.7 [4.4-17.1]

8.2 [3.5-14.9]

9.8 [4.4-17.2]

7.8 [2.8-15.3]

14.9 [7.9-24.1]

 

71

HÔPITAL DE MATANE

3.0 [0.8-6.7]

3.7 [1.2-7.7]

1.6 [0.1-4.6]

3.1 [0.8-6.9]

3.6 [1.1-7.4]

 

77

HÔPITAL D’AMQUI

16.8 [9.6-26]

17.8 [10.2-27.6]

9.7 [4.2-17.6]

6.2 [2.0-12.8]

5.7 [1.8-11.8]

 

84

HÔPITAL DE NOTRE-DAME-DU-LAC

0

7.1 [2.6-13.9]

0

2.4 [0.2-6.9]

8.7 [3.4-16.3]

 

 

BAS-SAINT-LAURENT

7.6 [6.2-9.2]

10.3 [8.6-12.2]

5.3 [4.1-6.7]

4.3 [3.2-5.6]

4.9 [3.7-6.2]

02

20

HÔPITAL DE CHICOUTIMI

3.2 [2.1-4.5]

3.5 [2.4-4.8]

6.4 [4.8-8.2]

8.0 [6.3-9.9]

8.1 [6.3-10.2]

 

67

HÔPITAL ET CENTRE DE RÉADAPTATION DE JONQUIÈRE

3.9 [2.2-6.1]

3.6 [2.0-5.7]

3.0 [1.5-4.9]

10.1 [7.2-13.5]

6.4 [4.1-9.2]

 

74

HÔPITAL DE DOLBEAU-MISTASSINI

3.6 [1.4-6.8]

2.9 [1.0-5.7]

4.7 [2.0-8.5]

3.2 [1.0-6.6]

7.0 [3.5-11.8]

 

88

HÔPITAL. CLSC ET CENTRE D’HÉBERGEMENT DE ROBERVAL

2.3 [0.9-4.3]

1.2 [0.3-2.6]

3.0 [1.4-5.1]

2.0 [0.7-3.9]

5.7 [3.3-8.7]*

 

112

HÔPITAL D’ALMA

14.6 [10.7-19.1]

8.8 [5.8-12.4]

3.2 [1.5-5.5]

8.1 [5.3-11.5]

12.5 [8.8-16.9]

 

 

SAGUENAY–LAC-SAINT-JEAN

5.0 [4.1-6.0]

3.8 [3.0-4.7]

4.6 [3.7-5.6]

7.2 [6.1-8.4]

8.0 [6.8-9.3]

03

2

HÔPITAL DE L’ENFANT-JÉSUS

3.5 [2.6-4.6]

6.9 [5.6-8.4]

6.8 [5.5-8.3]

5.0 [3.9-6.3]

6.1 [4.8-7.5]

 

7

PAVILLON L’HÔTEL-DIEU DE QUÉBEC

13.4 [11.1-15.9]

9.9 [7.9-12.1]

7.7 [5.9-9.7]

13.7 [11.3-16.3]

9.2 [7.3-11.4]*

 

24

HÔPITAL DU SAINT-SACREMENT

4.7 [3.0-6.8]

5.3 [3.6-7.4]

7.9 [5.8-10.4]

5.7 [3.9-7.9]

7.8 [5.6-10.3]

 

27

PAVILLON CENTRE HOSPITALIER DE L’UNIVERSITÉ LAVAL

7.1 [5.6-8.8]

5.0 [3.7-6.5]

3.2 [2.2-4.4]

4.3 [3.1-5.7]

3.0 [2.0-4.2]

 

28

PAVILLON SAINT-FRANÇOIS D’ASSISE

12.8 [10.6-15.2]

11.3 [9.2-13.6]

16.1 [13.6-18.8]

14.3 [11.9-16.9]

11.7 [9.6-14.0]

 

33

INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC

6.2 [4.7-7.9]

8.7 [6.9-10.7]

6.1 [4.7-7.7]

5.2 [3.9-6.7]

2.4 [1.5-3.5]*

 

59

HÔPITAL DE BAIE-SAINT-PAUL

1.1 [0-4.3]

5.5 [1.4-12.2]

1.4 [0-5.5]

1.2 [0-4.7]

0

 

86

HÔPITAL DE LA MALBAIE

21.5 [14.2-30.4]

14.4 [8.2-22.3]

4.3 [1.1-9.5]

8.0 [3.2-15.0]

5.0 [1.6-10.3]

 

 

CAPITALE-NATIONALE

7.9 [7.2-8.6]

7.9 [7.2-8.6]

7.6 [6.9-8.3]

7.7 [7.0-8.4]

6.3 [5.7-7.0]*

04

23

HÔTEL-DIEU D’ARTHABASKA

4.1 [2.6-6.0]

6.9 [4.9-9.3]

6.4 [4.5-8.7]

3.4 [2.0-5.2]

2.7 [1.5-4.3]

 

31

PAVILLON SAINT-JOSEPH

10.6 [8.8-12.5]

11.9 [10.0-13.9]

14.9 [12.9-17.1]

8.8 [7.2-10.5]

8.3 [6.8-10.0]

 

41

HÔPITAL DU CENTRE-DE-LA-MAURICIE

5.4 [3.5-7.7]

4.0 [2.4-6.0]

3.0 [1.6-4.8]

4.1 [2.5-6.1]

4.8 [3.0-7.0]

 

44

HÔPITAL SAINTE-CROIX

11.3 [8.8-14.2]

10.6 [8.1-13.4]

4.4 [2.9-6.3]

4.3 [2.8-6.1]

3.9 [2.4-5.7]

 

85

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

6.4 [2.0-13.2]

4.0 [0.8-9.8]

8.5 [3.1-16.7]

4.3 [0.8-10.5]

3.2 [0.3-9.2]

 

 

MAURICIE ET CENTRE-DU-QUÉBEC

8.6 [7.6-9.7]

9.2 [8.1-10.3]

9.2 [8.1-10.3]

6.1 [5.2-7.0]

5.7 [4.9-6.6]

05

15

HÔPITAL FLEURIMONT

3.1 [2.2-4.2]

2.4 [1.6-3.4]

2.5 [1.7-3.5]

3.3 [2.3-4.5]

4.2 [3.0-5.6]

 

30

HÔTEL-DIEU DE SHERBROOKE

4.2 [2.8-5.9]

3.7 [2.4-5.3]

3.0 [1.8-4.4]

4.5 [3.0-6.3]

3.8 [2.5-5.4]

 

49

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX MEMPHRÉMAGOG

4.3 [1.3-8.9]

4.4 [1.4-9.1]

6.1 [2.4-11.5]

2.8 [0.7-6.3]

0.7 [0-2.7]

 

75

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU GRANIT

4.7 [1.2-10.4]

0

3.1 [0.8-6.9]

1.0 [0-4.0]

1.6 [0.1-4.6]

 

 

ESTRIE

3.6 [2.8-4.5]

2.9 [2.2-3.7]

2.9 [2.2-3.7]

3.6 [2.8-4.5]

3.7 [2.9-4.6]

06

3

HÔPITAL ROYAL VICTORIA

10.4 [8.6-12.4]

14.6 [12.5-16.9]

13.9 [11.8-16.2]

10.9 [9.0-13.0]

11.3 [9.4-13.4]

 

4

HÔPITAL NOTRE-DAME DU CHUM

5.7 [4.4-7.2]

6.4 [5.0-7.9]

6.7 [5.3-8.3]

9.8 [8.1-11.7]

7.3 [5.8-9.0]*

 

5

HÔPITAL GÉNÉRAL JUIF

12.4 [10.8-14.1]

15.7 [13.9-17.6]

16.4 [14.5-18.4]

8.3 [7.0-9.8]

6.8 [5.6-8.1]

 

6

HÔPITAL DE MONTRÉAL POUR ENFANTS

5.1 [2.9-8.0]

3.3 [1.6-5.6]

3.2 [1.4-5.6]

5.9 [3.4-9.2]

5.0 [2.7-7.9]

 

8

PAV. MAISONNEUVE / PAV. MARCEL-LAMOUREUX

12.2 [10.6-13.9]

11.3 [9.8-12.9]

10.7 [9.2-12.3]

10.8 [9.3-12.4]

8.0 [6.7-9.4]*

 

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE

2.5 [1.5-3.8]

2.1 [1.2-3.3]

4.2 [2.8-5.8]

2.2 [1.2-3.4]

2.7 [1.6-4.1]

 

13

INSTITUT DE CARDIOLOGIE DE MONTRÉAL

6.5 [4.3-9.2]

7.2 [4.9-10.0]

7.2 [4.9-10.0]

6.3 [4.1-8.9]

2.8 [1.4-4.6]*

 

21

HÔPITAL SAINT-LUC DU CHUM

6.5 [5.0-8.2]

9.8 [7.9-11.9]

8.5 [6.8-10.4]

9.2 [7.4-11.2]

11.9 [9.9-14.1]

 

22

HÔTEL-DIEU DU CHUM

9.5 [7.4-11.8]

15.4 [12.8-18.3]

11.2 [9.0-13.6]

14.0 [11.5-16.7]

8.3 [6.4-10.5]*

 

25

HÔPITAL DU SACRÉ-CœUR DE MONTRÉAL

7.2 [5.9-8.6]

8.7 [7.3-10.2]

9.0 [7.6-10.6]

7.7 [6.4-9.2]

12.7 [10.9-14.6]*

 

26

HÔPITAL DE VERDUN

9.0 [7.0-11.3]

8.1 [6.2-10.2]

8.9 [6.9-11.2]

6.6 [4.9-8.6]

7.7 [5.8-9.9]

 

29

HÔPITAL GÉNÉRAL DE MONTRÉAL

14.4 [12.3-16.7]

14.8 [12.6-17.2]

12.5 [10.4-14.7]

11.9 [9.7-14.3]

9.1 [7.2-11.2]

 

34

HÔPITAL SANTA CABRINI

5.1 [3.8-6.6]

9.1 [7.3-11.0]

7.7 [6.1-9.5]

9.5 [7.7-11.4]

14.7 [12.5-17.1]*

 

36

HÔPITAL GÉNÉRAL DU LAKESHORE

10.1 [7.8-12.7]

5.8 [4.1-7.8]

8.4 [6.4-10.7]

10.2 [7.9-12.7]

11.1 [8.7-13.7]

 

38

HÔPITAL JEAN-TALON

8.8 [6.5-11.4]

7.5 [5.4-9.9]

5.3 [3.5-7.4]

7.9 [5.7-10.5]

3.2 [1.9-4.9]*

 

48

CENTRE HOSPITALIER DE ST. MARY

4.8 [3.4-6.4]

4.4 [3.1-6.0]

8.2 [6.3-10.3]

4.7 [3.3-6.3]

6.2 [4.6-8.0]

 

76

HÔPITAL DE LACHINE

4.9 [2.4-8.2]

8.4 [5.0-12.7]

8.8 [5.3-13.2]

9.8 [5.9-14.7]

4.0 [1.6-7.5]*

 

80

HÔPITAL FLEURY

4.7 [2.8-7.1]

7.4 [5.1-10.2]

5.5 [3.5-7.9]

13.3 [10.1-16.9]

12.9 [9.9-16.3]

 

83

HÔPITAL DE LASALLE

7.6 [4.6-11.3]

12.0 [8.0-16.8]

7.9 [4.7-11.9]

9.4 [5.9-13.7]

11.6 [7.6-16.4]

 

114

VILLA MÉDICA

4.8 [3.0-7.0]

3.1 [1.7-4.9]

5.8 [3.7-8.3]

3.5 [2.0-5.4]

4.6 [2.8-6.8]

 

116

INSTITUT THORACIQUE DE MONTRÉAL

5.7 [3.0-9.2]

4.9 [2.4-8.2]

8.5 [5.1-12.8]

8.9 [5.3-13.5]

4.6 [1.8-8.7]

 

118

HÔPITAL NEUROLOGIQUE DE MONTRÉAL

1.2 [0.2-3.0]

4.0 [1.9-6.9]

4.7 [2.4-7.7]

3.6 [1.6-6.3]

5.3 [2.8-8.6]

 

120

HÔPITAL RICHARDSON

0

0

0

0

0

 

121

HÔPITAL CATHERINE BOOTH DE L’ARMÉE DU SALUT

12.0 [8.4-16.2]

7.4 [4.6-10.8]

5.9 [3.5-9.0]

1.7 [0.5-3.5]

6.1 [3.5-9.5]*

 

122

HÔPITAL MARIE-CLARAC

2.4 [1.4-3.7]

2.9 [1.8-4.3]

3.4 [2.1-4.9]

2.6 [1.5-4.0]

2.4 [1.4-3.7]

 

137

INSTITUT DE RÉADAPTATION DE MONTRÉAL

1.3 [0.6-2.3]

2.4 [1.3-3.8]

3.8 [2.4-5.6]

4.6 [3.0-6.6]

4.7 [3.0-6.7]

 

 

MONTRÉAL

7.9 [7.5-8.3]

9.0 [8.6-9.4]

8.9 [8.5-9.3]

8.2 [7.8-8.6]

8.2 [7.8-8.6]

07

39

HÔPITAL DE GATINEAU

6.2 [4.4-8.4]

4.8 [3.2-6.7]

5.6 [3.9-7.6]

3.2 [2.0-4.7]

10.8 [8.3-13.6]*

 

40

HÔPITAL DE HULL

3.8 [2.5-5.4]

2.1 [1.2-3.3]

11.1 [8.8-13.7]

10.2 [7.9-12.8]

8.0 [6.0-10.3]

 

51

HÔPITAL DE MANIWAKI

17.6 [11.3-25.4]

4.1 [1.5-8.0]

7.4 [3.7-12.4]

5.3 [2.3-9.6]

0.6 [0-2.4]*

 

95

CENTRE HOSPITALIER DU PONTIAC

2.1 [0.4-5.1]

1.5 [0.2-4.2]

10.1 [5.5-16.1]

5.2 [2.1-9.8]

5.7 [2.3-10.7]

 

111

HÔPITAL DE PAPINEAU

4.5 [2.0-7.9]

3.1 [1.1-6.1]

1.0 [0.1-2.9]

2.5 [0.8-5.1]

3.1 [1.1-6.1]

 

 

OUTAOUAIS

5.6 [4.6-6.7]

3.2 [2.4-4.1]

7.7 [6.5-9.0]

5.9 [4.8-7.1]

7.6 [6.4-9.0]

08

47

HÔPITAL DE ROUYN-NORANDA

6.4 [3.5-10.2]

3.4 [1.5-6.1]

2.0 [0.6-4.1]

3.9 [1.8-6.8]

2.0 [0.6-4.1]

 

52

CENTRE HOSPITALIER HÔTEL-DIEU D’AMOS

3.1 [1.3-5.6]

8.8 [5.5-12.9]

2.9 [1.1-5.5]

3.3 [1.3-6.2]

0.4 [0-1.7]*

 

65

HÔPITAL ET CLSC DE VAL-D’OR

11 [7.6-15.1]

5.3 [3.0-8.3]

2.5 [1.0-4.7]

0.7 [0.1-2.0]

2.5 [1.0-4.7]

 

70

CENTRE DE SOINS DE COURTE DURÉE LA SARRE

1.0 [0-3.9]

4.7 [1.5-9.7]

1.9 [0.2-5.5]

6.1 [2.4-11.4]

2.0 [0.2-5.7]

 

82

PAVILLON SAINTE-FAMILLE

3.2 [0.6-7.9]

0

1.3 [0-5.2]

2.8 [0.3-8.0]

0*

 

 

ABITIBI-TÉMISCAMINGUE

6.1 [4.6-7.8]

5.2 [3.9-6.7]

2.3 [1.4-3.4]

2.9 [1.9-4.1]

1.6 [0.9-2.5]

09

64

HÔPITAL LE ROYER

2.3 [0.9-4.3]

2.8 [1.2-5.1]

4.0 [2.0-6.7]

3.5 [1.6-6.1]

2.3 [0.8-4.5]

 

72

HÔPITAL ET CENTRE D’HÉBERGEMENT DE SEPT-ÎLES

5.3 [2.7-8.7]

4.6 [2.2-7.9]

3.7 [1.6-6.7]

1.6 [0.4-3.6]

3.6 [1.6-6.3]

 

 

CÔTE-NORD

3.6 [2.2-5.4]

3.5 [2.1-5.3]

3.8 [2.3-5.7]

2.6 [1.4-4.2]

2.9 [1.6-4.6]

10

96

CENTRE DE SANTÉ DE CHIBOUGAMAU

2.6 [0.2-7.5]

0

0

3.1 [0.3-8.9]

1.5 [0-5.8]

 

 

NORD-DU-QUÉBEC

2.6 [0.2-7.5]

0

0

3.1 [0.3-8.9]

1.5 [0-5.8]

11

53

HÔPITAL DE CHANDLER

2.5 [0.7-5.5]

2.7 [0.7-6.0]

0.7 [0-2.8]

3.6 [1.1-7.4]

10.4 [5.8-16.3]*

 

91

HÔPITAL HÔTEL-DIEU DE GASPÉ

11.3 [6.2-18.0]

4.1 [1.3-8.5]

7.7 [3.3-14.0]

3.8 [1.0-8.5]

6.0 [2.2-11.8]

 

97

HÔPITAL DE MARIA

2.5 [0.8-5.2]

1.5 [0.3-3.7]

7.6 [4.3-11.8]

10.0 [5.9-15.2]

5.0 [2.4-8.6]

 

107

HÔPITAL DE L’ARCHIPEL

5.7 [1.8-11.8]

3.8 [0.7-9.3]

1.5 [0-5.8]

4.3 [0.8-10.5]

4.0 [0.8-9.8]

 

109

HÔPITAL DE SAINTE-ANNE-DES-MONTS

6.7 [2.4-13.1]

2.4 [0.2-6.9]

2.8 [0.3-8.0]

1.2 [0-4.8]

2.5 [0.2-7.2]

 

 

GASPÉSIE–ÎLES-DE-LA-MADELEINE

5.1 [3.5-7.0]

2.7 [1.6-4.1]

4.7 [3.1-6.6]

5.4 [3.7-7.5]

6.0 [4.2-8.1]

12

18

HÔTEL-DIEU DE LÉVIS

12.7 [10.3-15.3]

8.7 [6.8-10.9]

13.1 [10.7-15.7]

10.9 [8.7-13.3]

6.4 [4.7-8.3]*

 

63

HÔPITAL DE SAINT-GEORGES

5.7 [3.7-8.1]

8.5 [6.1-11.3]

5.4 [3.4-7.8]

12.3 [9.1-16.0]

12.4 [9.2-16.1]

 

89

HÔPITAL DE MONTMAGNY

16.2 [11.3-21.9]

7.4 [4.3-11.3]

9.9 [6.1-14.6]

11.4 [7.1-16.8]

4.3 [1.8-7.8]*

 

113

HÔPITAL DE THETFORD MINES

4.9 [2.6-7.9]

4.9 [2.6-7.9]

5.1 [2.8-8.1]

8.0 [4.9-11.9]

10.6 [7.0-14.9]

 

 

CHAUDIÈRE-APPALACHES

10.1 [8.6-11.7]

7.9 [6.6-9.3]

9.5 [8.1-11.0]

10.9 [9.3-12.6]

8.3 [7.0-9.8]*

13

19

HÔPITAL CITÉ DE LA SANTÉ

5.3 [4.2-6.5]

6.8 [5.6-8.1]

5.7 [4.6-6.9]

4.1 [3.2-5.1]

4.7 [3.7-5.8]

 

131

HÔPITAL JUIF DE RÉADAPTATION

2.0 [0.9-3.5]

2.5 [1.2-4.2]

1.5 [0.8-2.5]

2.9 [1.4-4.9]

1.9 [0.7-3.7]

 

 

LAVAL

4.6 [3.7-5.6]

5.9 [4.9-7.0]

4.4 [3.6-5.3]

3.8 [3.0-4.7]

4.3 [3.5-5.2]

14

11

HÔPITAL PIERRE-LE GARDEUR

3.4 [2.4-4.6]

1.7 [1.0-2.6]

0.8 [0.3-1.4]

2.0 [1.2-2.9]

1.1 [0.6-1.8]

 

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

13.9 [11.5-16.5]

10.5 [8.5-12.8]

7.6 [5.9-9.5]

16.1 [13.6-18.9]

15.7 [13.3-18.3]

 

 

LANAUDIÈRE

8.3 [7.0-9.7]

5.8 [4.8-6.9]

4.0 [3.1-5.0]

8.4 [7.2-9.7]

7.8 [6.6-9.1]

15

45

HÔPITAL DE SAINT-EUSTACHE

6.6 [4.8-8.7]

7.3 [5.5-9.4]

4.8 [3.4-6.4]

5.7 [4.2-7.4]

5.4 [4.0-7.0]

 

56

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX D’ARGENTEUIL

14.3 [8.8-21.1]

13.8 [8.5-20.3]

16.5 [10.6-23.8]

14.2 [8.7-21.1]

5.0 [2.0-9.4]*

 

81

HÔPITAL DE MONT-LAURIER

8.2 [4.5-13.1]

5.7 [2.7-9.8]

3.9 [1.6-7.3]

3.5 [1.2-6.9]

0.6 [0-2.3]*

 

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

10.5 [8.6-12.6]

12.0 [9.9-14.2]

8.3 [6.6-10.1]

8.9 [7.2-10.8]

8.5 [6.9-10.3]

 

103

HÔPITAL LAURENTIEN

8.1 [5.2-11.7]

4.9 [2.7-7.8]

3.2 [1.5-5.6]

3.7 [1.8-6.3]

2.5 [1.0-4.7]

 

 

LAURENTIDES

9.2 [8.0-10.5]

9.3 [8.1-10.6]

6.7 [5.7-7.8]

7.1 [6.1-8.2]

6.1 [5.2-7.1]

16

1

HÔPITAL CHARLES-LEMOYNE

7.3 [5.9-8.8]

7.0 [5.6-8.5]

10.4 [8.7-12.2]

8.3 [6.8-10.0]

7.0 [5.6-8.5]

 

9

HÔPITAL DU HAUT-RICHELIEU

6.5 [4.9-8.4]

6.9 [5.2-8.8]

10.7 [8.7-12.9]

17.1 [14.5-19.9]

6.5 [4.9-8.3]*

 

10

HÔPITAL PIERRE-BOUCHER

2.3 [1.5-3.3]

5.3 [4.0-6.8]

3.7 [2.6-5.0]

4.4 [3.2-5.8]

6.2 [4.8-7.8]

 

35

HÔPITAL HONORÉ-MERCIER

4.2 [2.8-5.9]

4.5 [3.0-6.3]

6.0 [4.3-8.0]

2.7 [1.6-4.1]

3.6 [2.3-5.2]

 

37

HÔTEL-DIEU DE SOREL

6.3 [4.3-8.7]

4.1 [2.5-6.1]

3.0 [1.7-4.7]

1.6 [0.7-2.9]

2.7 [1.4-4.4]

 

42

HÔPITAL ANNA-LABERGE

2.8 [1.7-4.2]

2.8 [1.7-4.2]

2.1 [1.2-3.3]

7.5 [5.7-9.5]

8.0 [6.1-10.2]

 

46

HÔPITAL DE GRANBY

3.9 [2.3-6.0]

3.7 [2.1-5.7]

11.5 [8.5-15.0]

6.8 [4.6-9.5]

4.3 [2.6-6.4]

 

58

HÔPITAL DU SUROÎT

4.0 [2.5-5.8]

2.1 [1.1-3.4]

4.3 [2.8-6.1]

3.0 [1.8-4.5]

6.9 [4.9-9.2]*

 

99

HÔPITAL BROME-MISSISQUOI-PERKINS

1.5 [0.4-3.3]

6.3 [3.7-9.6]

5.6 [3.2-8.7]

2.8 [1.2-5.1]

13.9 [9.9-18.6]*

 

130

HÔPITAL BARRIE MEMORIAL

5.5 [2.0-10.8]

8.8 [4.2-15.1]

7.7 [3.7-13.2]

7.1 [3.2-12.5]

1.4 [0.1-4.1]*

 

 

MONTÉRÉGIE

4.7 [4.2-5.2]

5.1 [4.6-5.7]

6.7 [6.1-7.3]

6.9 [6.3-7.5]

6.2 [5.6-6.8]

 

 

Total

7.0 [6.8-7.2]

7.3 [7.1-7.5]

7.3 [7.1-7.5]

7.2 [7.0-7.4]

6.8 [6.6-7.0]*

* Significant statistical difference (p < 0.05) between incidence rates for Periods 1 through 13. 2013–2014 and 2014–2015.
When the incidence rate is 0. the confidence interval [CI] is not calculated.

Comité de surveillance provinciale des infections nosocomiales (SPIN)

Editorial Committee 

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

Yves Longtin, Hôpital général juif Sir Mortimer B. Davis

Muleka Ngenda-Muadi, 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