Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infections : surveillance results 2014–2015

From April 1, 2014, to March 31, 2015, 88 healthcare facilities participated in the surveillance of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, for a combined total of 4,689,050 inpatient days (Table 1). Together, these facilities reported 95 cases of healthcare-associated MRSA. The incidence rate was 0.20 / 10,000 patient-days. This incidence rate has declined over the past five years but has stabilized this year. The proportion of methicillin resistance in healthcare-associated S. aureus bloodstream infections was 17.8%. Data was extracted on May 20th, 2015 and updated on June 1st 2015 for complications

Updated : February 24, 2016

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

 2010-20112011-20122012-20132013-20142014-2015
Facilities (N)8788888888
Admissions (N)615,164629,067639,647643,076626,421
Inpatient days (N)4,951,1624,980,8565,005,2894,893,5494,689,050
MRSA bloostream infections     
     Healthcare-associated (cat. 1a et 1b) (N)1681441479695
     Total (cat. 1a, 1b, 1c, 1d, 2, 3 et 4) (N)334300300257238
S. aureus bloodstream infection     
     Healthcare-associated (cat. 1a et 1b) (N)676610660527511
     Total (cat. 1a, 1b, 1c, 1d, 2, 3 et 4) (N)1,7431,7741,9411,8001,700

NB: It is possible that number of MRSA and S. aureus of categories 1d, 2, 3 and 4 are not complete since date entry for periods 12 and 13 in 2014-2015 have been delayed.

In 2014-2015, the incidence rate for healthcare-associated MRSA was 0.20 / 10,000 patient-days (Figure 1 and Table 2). The incidence rate of healthcare-associated MRSA in pediatric facilities was equal to 0.08 in 2014-2015.

Figure 1 – Incidence Rate of Healthcare-associated MRSA (cat. 1a + 1b), by Type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Figure 1 – Incidence Rate of Healthcare-associated MRSA (cat. 1a + 1b), by Type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Table 2 – Percentile Distribution and Incidence Rate of Healthcare-Associated MRSA Bloodstream Infections (cat. 1a + 1b) by type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Type of Healthcare FacilityDistribution IndicatorIncidence Rate
[95% CI]
Min.25%50%75%90%Max.
Non-teaching facilities       
     < 250 beds (N = 55)0000.230.532.070.2 [0.14-0.27]
     ≥ 250 beds (N = 7)0.120.150.190.210.350.350.2 [0.11-0.31]
Teaching facilities       
     < 250 beds (N = 6)000.080.620.810.810.39 [0.20-0.64]
     ≥ 250 beds (N =18)000.150.290.721.260.18 [0.12-0.25]
Pediatric facilities (N =2)000.060.110.110.110.08 [0-0.31]
Total (N = 88)0000.220.542.070.20 [0.16-0.24]

The incidence rate of healthcare-associated MRSA bloodstream infections decreased in the past five years (Figure 2). The incidence rate of healthcare-associated MRSA bloodstream infections was 0.54 per 10,000 patient-days during the first year of mandatory surveillance (2006-2007).

Compared with 2013-2014, the incidence rate of healthcare-associated MRSA bloodstream infections in 2014-2015 was stable (Table 3).

Figure 2 – Incidence Rate of Healthcare-associated MRSA Bloodstream Infections (cat. 1a + 1b) for Participating Healthcare Facilities, Québec, 2006–2007 to 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI]) (N = 82)

Figure 2 – Incidence Rate of Healthcare-associated MRSA Bloodstream Infections (cat. 1a + 1b) for Participating Healthcare Facilities, Québec, 2006–2007 to 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI]) (N = 82)

Note: data analyzed are those from healthcare facilities that participated in the surveillance from 2006-2007 to 2014-2015 and at least 11 periods between 2006-2007 and 2013-2014.

Table 3 – Incidence Rate of Healthcare-associated MRSA Bloodstream Infections (cat. 1a + 1b) by type of Healthcare Facility for Participating Healthcare Facilities, Québec, 2010-2011 to 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI]) (N = 86)

 2010–20112011–20122012–20132013–20142014–2015
Non-teaching facilities     
     < 250 beds (N = 53)0.24 [0.17-0.32]0.23 [0.16-0.31]0.22 [0.16-0.30]0.15 [0.10-0.21]0.20 [0.14-0.27]
     ³ 250 beds (N = 7)0.26 [0.15-0.39]0.27 [0.16-0.40]0.35 [0.23-0.50]0.23 [0.13-0.35]0.20 [0.11-0.31]
Teaching facilities     
     < 250 beds (N = 6)0.41 [0.21-0.68]0.31 [0.14-0.54]0.67 [0.41-1.00]0.24 [0.10-0.45]0.41 [0.21-0.68]
     ³ 250 beds (N =18)0.46 [0.37-0.56]0.36 [0.28-0.45]0.28 [0.21-0.36]0.23 [0.17-0.30]0.18 [0.12-0.25]
Pediatric facilitites (N =2)000.31 [0.08-0.68]00.08 [0-0.31]
Total (N = 86)0.34 [0.29-0.39]0.29 [0.24-0.34]0.29 [0.24-0.34]0.20 [0.16-0.24]0.20 [0.16-0.24]

Note: data analyzed are those from healthcare facilities that participated in the surveillance at least 11 periods between 2010-2011 and 2014-2015.

In total, 238 cases of MRSA bloodstream infections were reported, of which 142 (59.7%) were healthcare-associated (cat. 1a, 1b, 1c, 1d, 2) and 125 (52.5%) were related to the reporting facility (cat. 1a, 1b, 1c, 1d) (Table 4)

Table 4 – Cases of MRSA and S. aureus Bloodstream Infections by Presumed Origin of Acquisition, Québec, 2014–2015 (N, %)

CategoryOrigin of AcquisitionMRSAS. aureus
N%*N%
1aHealthcare-associated with a current hospitalisation in the reporting facility875.1%45026.5%
1bHealthcare-associated with a previous hospitalisation in the reporting facility80.5%613.6%
1cHealthcare-associated with ambulatory care in the reporting facility251.5%1639.6%
1dHealthcare-associated with long term care unit in the reporting facility50.3%140.8%
2Healthcare-associated with another facility171.0%573.4%
3Community-associated754.4%82148.3%
4Unknown origin of acquisition211.2%1347.9%
 Total23814.0%1700100.0%

*  Percentage of MRSA compared to total S. aureus.
Note : It is possible that number of MRSA and S. aureus of categories 1d, 2, 3 and 4 are not complete since date entry for periods 12 and 13 in 2014-2015 have been delayed.

Non-catheter-related bloodstream infections represented the most frequently reported type of infection (17.5%) as either primary bloodstream infections related to catheter use and related to hemodialysis venous access (44.1%) among 120 healthcare-associated MRSA bloodstream infections (cat. 1a. 1b and 1c) in 2014-2015 (Table 4). This was followed by pulmonary (14.2%), skin and soft tissue (12.5%) surgical site (12.5%) and urinary tract (9.2%) infections (Figure 3 and Table 5).

Non-catheter-related bloodstream infections represented the most frequently reported type of infection (17.5%) as either primary bloodstream infections related to catheter use and related to hemodialysis venous access (44.1%) among 120 healthcare-associated MRSA bloodstream infections (cat. 1a. 1b and 1c) in 2014-2015 (Table 4). This was followed by pulmonary (14.2%), skin and soft tissue (12.5%) surgical site (12.5%) and urinary tract (9.2%) infections (Figure 3 and Table 5).

A total of 34 deaths were observed among the 120 healthcare-associated MRSA bloodstream infections, yealding a 30 days case fatality of 28.3% (Table 6).

Figure 3 – Breackdown of Healthcare-Associated MRSA Bloodstream Infections (cat. 1a. 1b and 1c) by Type of Infection. Québec, 2014-2015 (N = 120)

Figure 3 – Breackdown of Healthcare-Associated MRSA Bloodstream Infections (cat. 1a. 1b and 1c) by Type of Infection. Québec, 2014-2015 (N = 120)

BSI : bloodstream infection
Non-CRBSI : non- catheter-related primary bloodstream infection
HD: hemodialysis

Table 5 – Number of cases Corresponding to Each type of Infection Associated with Healthcare-Associated MRSA Bloodstream Infections (cat. 1a. 1b and 1c) by Type of Facility. Québec, 2014–2015 (N=120)

 

 

Primary BSISecondary BSI
CRBSINon-CRBSIHDUrinaryAbdominalPulmonarySurgical site
Non-teaching facilities       
    < 250 beds4826172
     ³ 250 beds1423141
Teaching facilities       
     < 250 beds4110012
     ³ 250 beds98821510
Pediatric facilities1000000
Total1921131131715
 Secondary BSI
Skin and soft tissusBones and jointsCentral nervous systemothersTotal
Non-teaching facilities     
    < 250 beds710240
     ³ 250 beds200119
Teaching facilities     
     < 250 beds300012
     ³ 250 beds310148
Pediatric facilities00001
Total15204120

BSI : bloodstream infection
CRBSI : catheter-related bloodstream infection
Non-CRBSI : non- catheter-related primary bloodstream infection
HD: hemodialysis

Number of Deaths and 30-days Case Fatality Related to Healthcare-Associated MRSA Bloodstream Infections (cat. 1a. 1b and 1c), Québec, 2013-2014 to 2014-2015

 2013-20142014-2015
Healthcare-associated MRSA bloodstream infections121120
Number of deaths3934
Case fatality32.2%28.3%

The proportion of methicillin resistance in healthcare-associated bloodstream infections due to S. aureus dropped between 2010-2011 and 2013-2014 to 16.8% before exhibiting an increase to 17.8 in 2014-2015 (Figure 4)

Figure 4 – Proportion of Methicillin Resistance in Healthcare-Associated Bloodstream Infections (cat. 1a, 1b and 1c) and all Bloodstream Infections (cat. 1a. 1b. 1c. 1d. 2. 3 and 4), Québec, 2010-2011 to 2014-2015 (N = 86)

Figure 4 – Proportion of Methicillin Resistance in Healthcare-Associated Bloodstream Infections (cat. 1a, 1b and 1c) and all Bloodstream Infections (cat. 1a. 1b. 1c. 1d. 2. 3 and 4), Québec, 2010-2011 to 2014-2015 (N = 86)

Note: data analyzed are those from healthcare facilities that participated in the surveillance in 2014-2015 and at least 11 periods between 2010-2011 and 2013-2014.

The incidence rate of healthcare-associated MRSA bloodstream infections and percentile ranking by type of facility are shown in Figures 5 through 9.

Figure 5 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for non-Teaching Healthcare Facilities with Less than 250 Beds, Québec, 2014–2015

Figure 5 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for non-Teaching Healthcare Facilities with Less than 250 Beds, Québec, 2014–2015

NB: Facilities 23, 32, 46, 49, 51, 52, 53, 56, 59, 61, 63, 64, 67, 70, 71, 72, 74, 77, 80, 81, 82, 83, 84, 85, 86, 88, 89, 96, 97, 103, 107, 109, 111, 112, 113 and 130 did not report any cases in 2014-2015.

Figure 6 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for non-Teaching Healthcare Facilities with 250 or more Beds, Québec, 2014–2015

Figure 6 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for non-Teaching Healthcare Facilities with 250 or more Beds, Québec, 2014–2015

Figure 7 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for Teaching Healthcare Facilities with Less than 250 Beds, Québec, 2014–2015

Figure 7 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for Teaching Healthcare Facilities with Less than 250 Beds, Québec, 2014–2015

NB: Facilities 13, 116 and 118 did not report any cases in 2014-2015.

Figure 8 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for Teaching Healthcare Facilities with 250 or more Beds, Québec, 2014–2015

Figure 8 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for Teaching Healthcare Facilities with 250 or more Beds, Québec, 2014–2015

NB: Facilities 1, 18, 24, 27, 31, and 33 did not report any cases in 2014-2015.

Figure 9 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for Pediatric Healthcare Facilities, Québec, 2014–2015

Figure 9 – Incidence Rate and Percentile Ranking of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility for Pediatric Healthcare Facilities, Québec, 2014–2015

NB: Facilities 6 did not report any cases in 2014-2015.

At the local level. in 2014-2015, the incidence rate of healthcare-associated MRSA bloodstream infections ranged from 0 to 1.26 / 10,000 patient-days. The incidence rate for the past five years of surveillance is shown in Table 7. Significant variations compared to 2013-2014 are also indicated.

Overall. 4 facilities (4.5%) exhibited a significant decrease in the incidence rate of healthcare-associated MRSA bloodstream infections per 10,000 patient-days compared to the 2013-2014 surveillance year, whereas 6 facilities (6.8%) exhibited a significant increase in this incidence rate. Furthermore, in 2014-2015, the incidence rate of healthcare-associated MRSA bloodstream infections per 10,000 patient-days in health region of Chaudière-Appalaches significantly decreased as compared to 2013-2014.

Table 8 presents the number of healthcare-associated MRSA bloodstream infections and the proportion of methicillin resistance in healthcare-associated S. aureus bloodstream infections for the past five years.

Table 7 – Incidence rate of Healthcare-associated MRSA Bloodstream Infections (cat. 1a and 1b) by Facility, Québec, 2010–2011 to 2014–2015 (Incidence Rate per 10.000 Patient-Days [95% CI])

HRFacilityIncidence rate of healthcare-associated MRSA bloodstream infections
 / 10.000 patient-days [95% CI]
NumberName2010-20112011-20122012-20132013-20142014-2015
0116HÔPITAL RÉGIONAL DE RIMOUSKI0.18 [0-0.70]0.19 [0-0.74]000.19 [0-0.75]
 32CENTRE HOSPITALIER RÉGIONAL DU GRAND-PORTAGE00.31 [0-1.22]0.32 [0-1.25]00
 61CENTRE NOTRE-DAME-DE-FATIMA1.07 [0-4.20]1.02 [0-4.01]000
 71HÔPITAL DE MATANE00000
 77HÔPITAL D’AMQUI00000
 84HÔPITAL DE NOTRE-DAME-DU-LAC00000
  BAS-SAINT-LAURENT0.15 [0.01-0.43]0.24 [0.05-0.59]0.08 [0-0.31]00.08 [0-0.32]
0220HÔPITAL DE CHICOUTIMI000.22 [0.02-0.63]00.12 [0-0.47]
 67HÔPITAL ET CENTRE DE RÉADAPTATION DE JONQUIÈRE0.25 [0-0.97]00.25 [0-0.98]00
 74HÔPITAL DE DOLBEAU-MISTASSINI0.51 [0-2.01]0000
 88HÔPITAL. CLSC ET CENTRE D’HÉBERGEMENT DE ROBERVAL00000
 112HÔPITAL D’ALMA0.31 [0-1.21]0000
  SAGUENAY–LAC-SAINT-JEAN0.14 [0.03-0.34]00.14 [0.03-0.34]00.05 [0-0.20]
032HÔPITAL DE L’ENFANT-JÉSUS0.07 [0-0.28]0.36 [0.11-0.75]0.07 [0-0.28]0.44 [0.16-0.86]0.08 [0-0.31]*
 7PAVILLON L’HÔTEL-DIEU DE QUÉBEC0.34 [0.06-0.84]0.12 [0-0.47]0.47 [0.12-1.04]0.23 [0.02-0.66]0.72 [0.26-1.41]
 24HÔPITAL DU SAINT-SACREMENT000.17 [0-0.68]00
 27PAVILLON CENTRE HOSPITALIER DE L’UNIVERSITÉ LAVAL00.17 [0.02-0.48]000
 28PAVILLON SAINT-FRANÇOIS D’ASSISE0.33 [0.06-0.81]0.11 [0-0.43]0.67 [0.24-1.31]0.22 [0.02-0.63]0.11 [0-0.43]
 33INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC0.21 [0.02-0.60]0.31 [0.06-0.76]0.20 [0.02-0.58]00
 59HÖPITAL DE BAIE-SAINT PAUL00000
 86HÔPITAL DE LA MALBAIE00000
  CAPITALE-NATIONALE0.15 [0.07-0.26]0.20 [0.10-0.33]0.23 [0.12-0.37]0.17 [0.08-0.29]0.13 [0.05-0.24]
0423HÔTEL-DIEU D’ARTHABASKA000.18 [0-0.71]00
 31PAVILLON SAINT-JOSEPH0.25 [0.05-0.61]0.08 [0-0.32]0.16 [0.02-0.45]00
 41HÔPITAL DU CENTRE-DE-LA-MAURICIE00000.23 [0-0.89]
 44HÔPITAL SAINTE-CROIX00.17 [0-0.66]0.34 [0.03-0.97]0.34 [0.03-0.98]0.28 [0-1.10]
 85CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU HAUT-SAINT-MAURICE00000
  MAURICIE ET CENTRE-DU-QUÉBEC0.10 [0.02-0.25]0.07 [0.01-0.20]0.17 [0.05-0.35]0.07 [0.01-0.20]0.08 [0.01-0.22]
0515HÔPITAL FLEURIMONT0.08 [0-0.32]0.08 [0-0.32]0.17 [0.02-0.49]0.18 [0.02-0.52]0.19 [0.02-0.54]
 30HÔTEL-DIEU DE SHERBROOKE00.14 [0-0.56]0.14 [0-0.56]0.15 [0-0.59]0.15 [0-0.58]
 49CENTRE DE SANTÉ ET DE SERVICES SOCIAUX MEMPHRÉMAGOG00000
 75CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU GRANIT00002.07 [0.20-5.93]*
  ESTRIE0.05 [0-0.19]0.10 [0.01-0.28]0.14 [0.03-0.35]0.15 [0.03-0.37]0.25 [0.08-0.52]
063HÔPITAL ROYAL VICTORIA0.74 [0.34-1.30]0.24 [0.04-0.59]0.34 [0.09-0.75]0.53 [0.19-1.04]0.18 [0.02-0.52]
 4HÔPITAL NOTRE-DAME DU CHUM0.85 [0.40-1.46]1.01 [0.52-1.66]0.43 [0.14-0.89]0.50 [0.18-0.98]0.18 [0.02-0.51]
 5HÔPITAL GÉNÉRAL JUIF0.61 [0.30-1.02]0.39 [0.15-0.73]0.29 [0.09-0.60]0.23 [0.06-0.51]0.38 [0.14-0.75]
 6HÔPITAL DE MONTRÉAL POUR ENFANTS001.10 [0.29-2.44]00
 8PAV. MAISONNEUVE / PAV. MARCEL-LAMOUREUX0.55 [0.26-0.94]0.22 [0.06-0.49]0.11 [0.01-0.31]0.11 [0.01-0.31]1.26 [0.33-2.80]*
 12CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE00000.11 [0-0.43]
 13INSTITUT DE CARDIOLOGIE DE MONTRÉAL0.24 [0-0.94]00.24 [0-0.94]0.23 [0-0.91]0
 21HÔPITAL SAINT-LUC DU CHUM0.83 [0.36-1.50]0.52 [0.17-1.07]0.50 [0.16-1.03]0.18 [0.0-0.70]0.29 [0.05-0.72]
 22HÔTEL-DIEU DU CHUM0.13 [0-0.51]0.76 [0.27-1.49]1.12 [0.51-1.97]0.64 [0.20-1.32]0.81 [0.29-1.59]
 25HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL1.06 [0.62-1.62]0.76 [0.39-1.25]0.52 [0.22-0.94]0.20 [0.04-0.49]0.21 [0.04-0.51]
 26HÔPITAL DE VERDUN0.54 [0.14-1.20]0.79 [0.29-1.55]0.27 [0.03-0.77]0.28 [0.03-0.80]0.14 [0-0.54]
 29HÔPITAL GÉNÉRAL DE MONTRÉAL1.16 [0.61-1.88]0.73 [0.31-1.32]0.77 [0.33-1.40]0.90 [0.39-1.63]0.35 [0.07-0.86]
 34HÔPITAL SANTA CABRINI0.21 [0.02-0.60]0.30 [0.06-0.73]0.66 [0.26-1.24]0.19 [0.02-0.54]0.19 [0.02-0.55]
 36HÔPITAL GÉNÉRAL DU LAKESHORE0.30 [0.03-0.86]0.61 [0.16-1.35]0.72 [0.23-1.49]0.29 [0.03-0.84]0.29 [0.03-0.83]
 38HÔPITAL JEAN-TALON0.53 [0.10-1.30]0.18 [0-0.70]0.57 [0.11-1.39]0.39 [0.04-1.11]0.19 [0-0.75]
 48CENTRE HOSPITALIER DE ST. MARY1.01 [0.43-1.83]0.25 [0.02-0.72]1.12 [0.51-1.97]00.62 [0.19-1.29]*
 76HÔPITAL DE LACHINE2.22 [0.70-4.59]000.52 [0-2.03]0*
 80HÔPITAL FLEURY0.50 [0.05-1.43]0.46 [0.04-1.32]0.23 [0-0.90]0.46 [0.04-1.32]0*
 83HÔPITAL DE LASALLE0.38 [0-1.49]0.83 [0.08-2.38]0.83 [0.08-2.38]00
 116INSTITUT THORACIQUE DE MONTRÉAL0.43 [0-1.69]0.45 [0-1.76]0.45 [0-1.76]00
 118HÔPITAL NEUROLOGIQUE DE MONTRÉAL0.83 [0.08-2.37]0000
  MONTRÉAL0.64 [0.53-0.76]0.45 [0.36-0.56]0.47 [0.37-0.58]0.29 [0.21-0.38]0.28 [0.2-0.37]
0739HÔPITAL DE GATINEAU0.17 [0-0.66]0000.33 [0.03-0.95]*
 40HÔPITAL DE HULL0.28 [0.03-0.80]000.16 [0-0.62]0.15 [0-0.60]
 51HÔPITAL DE MANIWAKI00.68 [0-2.67]000
 95CENTRE HOSPITALIER DU PONTIAC000.72 [0-2.82]00.81 [0-3.18]
 111HÔPITAL DE PAPINEAU00000
  OUTAOUAIS0.17 [0.03-0.41]0.05 [0-0.20]0.05 [0-0.21]0.06 [0-0.23]0.23 [0.06-0.51]
0847HÔPITAL DE ROUYN-NORANDA0.92 [0.09-2.63]001.29 [0.24-3.16]0.40 [0-1.56]
 52CENTRE HOSPITALIER HÔTEL-DIEU D’AMOS00.40 [0-1.57]000
 65HÔPITAL ET CLSC DE VAL-D’OR0.33 [0-1.30]000.34 [0-1.33]0.35 [0-1.38]
 70CENTRE DE SOINS DE COURTE DURÉE LA SARRE00000
 82PAVILLON SAINTE-FAMILLE002.69 [0.25-7.71]00
  ABITIBI-TÉMISCAMINGUE0.31 [0.06-0.76]0.10 [0-0.40]0.21 [0.02-0.60]0.43 [0.11-0.96]0.21 [0.02-0.61]
0964HÔPITAL LE ROYER000.72 [0.07-2.06]00
 72HÔPITAL ET CENTRE D’HÉBERGEMENT DE SEPT-ÎLES0000.41 [0-1.61]0
  CÔTE-NORD000.40 [0.04-1.15]0.20 [0-0.78]0
1096CENTRE DE SANTÉ DE CHIBOUGAMAU00000
  NORD-DU-QUÉBEC00000
1153HÔPITAL DE CHANDLER00.67 [0-2.63]000
 91HÔPITAL HÔTEL-DIEU DE GASPÉ0.81 [0-3.17]00.97 [0-3.80]0.96 [0-3.77]1.00 [0-3.93]
 97HÔPITAL DE MARIA00000
 107HÔPITAL DE L’ARCHIPELa00000
 109HÔPITAL DE SAINTE-ANNE-DES-MONTS00000
  GASPÉSIE–ÎLES-DE-LA-MADELEINE0.17 [0-0.67]0.16 [0-0.62]0.17 [0-0.66]0.17 [0-0.67]0.17 [0-0.66]
1218HÔTEL-DIEU DE LÉVIS0.39 [0.07-0.95]0.37 [0.07-0.91]0.13 [0-0.50]0.13 [0-0.51]0
 63HÔPITAL DE SAINT-GEORGES00.21 [0-0.83]000
 89HÔPITAL DE MONTMAGNY00.87 [0.08-2.49]0.47 [0-1.85]0.54 [0-2.12]0
 113HÔPITAL DE THETFORD MINES1.12 [0.21-2.75]0.75 [0.07-2.15]1.09 [0.2-2.67]0.40 [0-1.56]0
  CHAUDIÈRE-APPALACHES0.35 [0.13-0.69]0.45 [0.19-0.82]0.29 [0.09-0.60]0.19 [0.04-0.46]0*
1319HÔPITAL CITÉ DE LA SANTÉ0.32 [0.1-0.66]0.06 [0-0.24]0.52 [0.24-0.92]0.35 [0.13-0.69]0.17 [0.03-0.42]
  LAVAL0.32 [0.1-0.66]0.06 [0-0.24]0.52 [0.24-0.92]0.35 [0.13-0.69]0.17 [0.03-0.42]
1411HÔPITAL PIERRE-LE GARDEUR0.10 [0-0.39]0.20 [0.02-0.58]00.19 [0.02-0.54]0.18 [0.02-0.52]
 14CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE00.23 [0.02-0.66]0.34 [0.06-0.84]0.23 [0.02-0.66]0.21 [0.02-0.60]
  LANAUDIÈRE0.05 [0-0.20]0.21 [0.05-0.47]0.16 [0.03-0.39]0.21 [0.06-0.46]0.19 [0.05-0.43]
1545HÔPITAL DE SAINT-EUSTACHE0.15 [0-0.60]00.12 [0-0.47]00.33 [0.06-0.81]*
 56CENTRE DE SANTÉ ET DE SERVICES SOCIAUX D’ARGENTEUIL01.32 [0.13-3.78]00.71 [0-2.79]0
 81HÔPITAL DE MONT-LAURIER0.59 [0-2.31]0000
 101HÔPITAL RÉGIONAL DE SAINT-JÉRÔME0.59 [0.21-1.16]1.00 [0.48-1.72]0.29 [0.06-0.71]0.19 [0.02-0.54]0.35 [0.09-0.78]
 103HÔPITAL LAURENTIEN0.34 [0-1.33]0000
  LAURENTIDES0.40 [0.18-0.70]0.51 [0.26-0.84]0.16 [0.04-0.36]0.12 [0.02-0.29]0.27 [0.11-0.51]
161HÔPITAL CHARLES-LEMOYNE0.15 [0.01-0.44]0.56 [0.22-1.05]00.24 [0.05-0.59]0*
 9HÔPITAL DU HAUT-RICHELIEU0.12 [0-0.48]0.12 [0-0.47]0.43 [0.11-0.96]0.22 [0.02-0.63]0.12 [0-0.46]
 10HÔPITAL PIERRE-BOUCHER0.19 [0.02-0.54]0.20 [0.02-0.57]00.19 [0.02-0.55]0.19 [0.02-0.54]
 35HÔPITAL HONORÉ-MERCIER00.15 [0-0.59]0.44 [0.08-1.08]00.58 [0.15-1.29]*
 37HÔTEL-DIEU DE SOREL0.20 [0-0.78]0.39 [0.04-1.12]0.20 [0-0.78]00.21 [0-0.82]
 42HÔPITAL ANNA-LABERGE0.42 [0.08-1.03]0.28 [0.03-0.80]0.13 [0-0.51]0.39 [0.07-0.95]0.54 [0.14-1.20]
 46HÔPITAL DE GRANBY00.46 [0.04-1.32]0.94 [0.24-2.09]00
 58HÔPITAL DU SUROÎT0.34 [0.03-0.98]0.34 [0.03-0.98]00.16 [0-0.62]0.53 [0.10-1.30]
 99HÔPITAL BROME-MISSISQUOI-PERKINS00000.36 [0-1.41]
 130HÔPITAL BARRIE MEMORIAL0.92 [0-3.60]0000
  MONTÉRÉGIE0.19 [0.10-0.31]0.30 [0.18-0.45]0.19 [0.10-0.31]0.17 [0.09-0.28]0.24 [0.14-0.37]
  Total0.34 [0.29-0.39]0.29 [0.24-0.34]0.29 [0.24-0.34]0.20 [0.16-0.24]0.20 [0.16-0.24]

HR: Heath region.
* Significant statistical difference (p < 0.05) between healthcare-associated MRSA bloodstream infections of 2013-2014 and 2014-2015.
When the incidence rate is 0, the confidence interval [CI] is not calculated.
aFacility participating in the surveillance of bloodstream infections due to S. aureus as of Period 1 of 2011–2012.

Table 8 – Number of Healthcare-associated MRSA Bloodstream Infections and Proportion of Resistance to Methicillin by Healthcare-Associated S. aureus Bloodstream Infection (cat. 1a and 1b) by Facility, Québec, 2010–2011 to 2014–2015 (Number, [%])

HRFacilityNumber of healthcare-associated MRSA infections and proportion of resistance to methicillin by healthcare-associated S. aureus bloodstream infections (N [%])
NumberName2010-20112011-20122012-20132013-20142014-2015
0116HÔPITAL RÉGIONAL DE RIMOUSKI1 (16.7%)1 (16.7%)001 (25,0%)
 32CENTRE HOSPITALIER RÉGIONAL DU GRAND-PORTAGE01 (16.7%)1 (50.0%)00
 61CENTRE NOTRE-DAME-DE-FATIMA1 (100.0%)1 (100.0%)000
 71HÔPITAL DE MATANE00000
 77HÔPITAL D’AMQUI00000
 84HÔPITAL DE NOTRE-DAME-DU-LAC00000
  BAS-SAINT-LAURENT2 (25.0%)3 (23.1%)1 (12.5%)01 (20.0%)
0220HÔPITAL DE CHICOUTIMI1 (10.0%)1 (25.0%)2 (11.1%)01 (8.3%)
 67HÔPITAL ET CENTRE DE RÉADAPTATION DE JONQUIÈRE1 (25.0%)01 (100.0%)00
 74HÔPITAL DE DOLBEAU-MISTASSINI1 (50.0%)0001 (50.0%)
 88HÔPITAL. CLSC ET CENTRE D’HÉBERGEMENT DE ROBERVAL00001 (33.3%)
 112HÔPITAL D’ALMA1 (25.0%)0000
  SAGUENAY–LAC-SAINT-JEAN4 (18.2%)1 (5.9%)3 (13.6%)1 (4.3%)3 (14.3%)
032HÔPITAL DE L’ENFANT-JÉSUS1 (4.2%)5 (17.2%)1 (3.2%)6 (26.1%)1 (5.9%)
 7PAVILLON L’HÔTEL-DIEU DE QUÉBEC3 (14.3%)2 (7.4%)4 (13.8%)3 (13.6%)6 (30.0%)
 24HÔPITAL DU SAINT-SACREMENT001 (25.0%)00
 27PAVILLON CENTRE HOSPITALIER DE L’UNIVERSITÉ LAVAL02 (22.2%)000
 28PAVILLON SAINT-FRANÇOIS D’ASSISE4 (40.0%)1 (20.0%)6 (66.7%)2 (14.3%)2 (20.0%)
 33INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC2 (11.1%)3 (33.3%)2 (25.0%)00
 59HÖPITAL DE BAIE SAINT-PAUL00000
 86HÔPITAL DE LA MALBAIE00000
  CAPITALE-NATIONALE10 (11.5%)13 (16.3%)14 (16.1%)11 (13.6%)9 (14.3%)
0423HÔTEL-DIEU D’ARTHABASKA001 (50.0%)00
 31PAVILLON SAINT-JOSEPH3 (37.5%)1 (6.3%)2 (15.4%)01 (6.7%)
 41HÔPITAL DU CENTRE-DE-LA-MAURICIE00001 (20.0%)
 44HÔPITAL SAINTE-CROIX01 (16.7%)2 (40.0%)2 (40.0%)1 (33.3%)
 85CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU HAUT-SAINT-MAURICE00000
  MAURICIE ET CENTRE-DU-QUÉBEC3 (14.3%)2 (6.5%)5 (23.8%)2 (7.4%)3 (12.0%)
0515HÔPITAL FLEURIMONT1 (4.2%)1 (7.7%)2 (10.0%)3 (13.0%)2 (6.9%)
 30HÔTEL-DIEU DE SHERBROOKE01 (33.3%)1 (14.3%)2 (33.3%)1 (16.7%)
 49CENTRE DE SANTÉ ET DE SERVICES SOCIAUX MEMPHRÉMAGOG00000
 75CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU GRANIT00002 (100.0%)
  ESTRIE1 (2.9%)2 (12.5%)3 (10.3%)5 (16.7%)5 (13.2%)
063HÔPITAL ROYAL VICTORIA9 (26.5%)5 (20.0%)8 (22.2%)8 (23.5%)3 (14.3%)
 4HÔPITAL NOTRE-DAME DU CHUM11 (31.4%)14 (35.9%)6 (25.0%)7 (20.6%)2 (7.1%)
 5HÔPITAL GÉNÉRAL JUIF13 (32.5%)8 (30.8%)5 (17.2%)7 (23.3%)8 (25.0%)
 6HÔPITAL DE MONTRÉAL POUR ENFANTS01 (10.0%)4 (36.4%)00
 8PAV. MAISONNEUVE / PAV. MARCEL-LAMOUREUX10 (21.7%)8 (21.6%)2 (5.6%)3 (12.5%)4 (57.1%)
 12CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE00001 (12.5%)
 13INSTITUT DE CARDIOLOGIE DE MONTRÉAL1 (20.0%)01 (25.0%)1 (12.5%)0
 21HÔPITAL SAINT-LUC DU CHUM8 (27.6%)5 (15.2%)6 (23.1%)2 (18.2%)3 (23.1%)
 22HÔTEL-DIEU DU CHUM1 (7.1%)6 (40.0%)9 (33.3%)5 (19.2%)6 (25.0%)
 25HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL19 (30.6%)16 (30.8%)10 (16.7%)4 (15.4%)5 (12.2%)
 26HÔPITAL DE VERDUN6 (26.1%)6 (42.9%)4 (33.3%)2 (20.0%)1 (10.0%)
 29HÔPITAL GÉNÉRAL DE MONTRÉAL19 (54.3%)11 (36.7%)10 (27.8%)9 (32.1%)8 (21.1%)
 34HÔPITAL SANTA CABRINI2 (20.0%)3 (17.6%)8 (47.1%)3 (50.0%)2 (40.0%)
 36HÔPITAL GÉNÉRAL DU LAKESHORE3 (21.4%)5 (33.3%)7 (63.6%)2 (33.3%)2 (28.6%)
 38HÔPITAL JEAN-TALON3 (50.0%)1 (9.1%)3 (50.0%)2 (28.6%)1 (16.7%)
 48CENTRE HOSPITALIER DE ST. MARY8 (50.0%)2 (18.2%)10 (35.7%)05 (23.8%)
 76HÔPITAL DE LACHINE5 (83.3%)1 (50.0%)01 (100.0%)0
 80HÔPITAL FLEURY2 (28.6%)2 (18.2%)1 (25.0%)2 (33.3%)0
 83HÔPITAL DE LASALLE1 (33.3%)3 (60.0%)2 (40.0%)00
 116INSTITUT THORACIQUE DE MONTRÉAL1 (50.0%)1 (100.0%)1 (100.0%)00
 118HÔPITAL NEUROLOGIQUE DE MONTRÉAL2 (66.7%)0000
  MONTRÉAL124 (30.3%)98 (26.3%)97 (24.9%)58 (20.3%)51 (18.3%)
0739HÔPITAL DE GATINEAU1 (20.0%)0002 (40.0%)
 40HÔPITAL DE HULL2 (28.6%)001 (10.0%)1 (6.3%)
 51HÔPITAL DE MANIWAKI01 (33.3%)001 (50.0%)
 95CENTRE HOSPITALIER DU PONTIAC001 (100.0%)1 (100.0%)1 (100.0%)
 111HÔPITAL DE PAPINEAU1 (100.0%)0000
  OUTAOUAIS4 (30.8%)1 (5.0%)1 (10.0%)2 (12.5%)5 (20.0%)
0847HÔPITAL DE ROUYN-NORANDA2 (50.0%)003 (50.0%)1 (33.3%)
 52CENTRE HOSPITALIER HÔTEL-DIEU D’AMOS01 (100.0%)000
 65HÔPITAL ET CLSC DE VAL-D’OR2 (40.0%)01 (11.1%)1 (50.0%)2 (50.0%)
 70CENTRE DE SOINS DE COURTE DURÉE LA SARRE00000
 82PAVILLON SAINTE-FAMILLE002 (66.7%)00
  ABITIBI-TÉMISCAMINGUE4 (33.3%)1 (12.5%)3 (23.1%)4 (50.0%)3 (37.5%)
        
0964HÔPITAL LE ROYER002 (66.7%)01 (50.0%)
 72HÔPITAL ET CENTRE D’HÉBERGEMENT DE SEPT-ÎLES0001 (100.0%)0
  CÔTE-NORD002 (33.3%)1 (25.0%)1 (33.3%)
1096CENTRE DE SANTÉ DE CHIBOUGAMAU00000
  NORD-DU-QUÉBEC00000
1153HÔPITAL DE CHANDLER01 (50.0%)000
 91HÔPITAL HÔTEL-DIEU DE GASPÉ1 (50.0%)01 (50.0%)1 (50.%)1 (100.0%)
 97HÔPITAL DE MARIA00000
 107HÔPITAL DE L’ARCHIPELa00000
 109HÔPITAL DE SAINTE-ANNE-DES-MONTS00000
  GASPÉSIE–ÎLES-DE-LA-MADELEINE1 (20.0%)1 (33.3%)1 (33.3%)1 (11.1%)1 (50.0%)
1218HÔTEL-DIEU DE LÉVIS4 (30.8%)3 (16.7%)3 (14.3%)2 (12.5%)0
 63HÔPITAL DE SAINT-GEORGES1 (50.0%)1 (33.3%)000
 89HÔPITAL DE MONTMAGNY02 (66.7%)1 (33.3%)1 (50.0%)0
 113HÔPITAL DE THETFORD MINES3 (75%)2 (40.0%)3 (27.3%)1 (20.0%)0
  CHAUDIÈRE-APPALACHES8 (40.0%)8 (27.6%)7 (18.4%)4 (13.8%)0
1319HÔPITAL CITÉ DE LA SANTÉ6 (13.6%)3 (9.7%)11 (19.3%)7 (17.1%)5 (15.6%)
  LAVAL6 (13.6%)3 (9.7%)11 (19.3%)7 (17.1%)5 (15.6%)
1411HÔPITAL PIERRE-LE GARDEUR3 (33.3%)5 (35.7%)1 (7.7%)3 (15.0%)2 (15.4%)
 14CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE02 (18.2%)5 (26.3%)3 (17.6%)2 (10.5%)
  LANAUDIÈRE3 (21.4%)7 (28.0%)6 (18.8%)6 (16.2%)4 (12.5%)
1545HÔPITAL DE SAINT-EUSTACHE1 (12.5%)01 (16.7%)03 (25.0%)
 56CENTRE DE SANTÉ ET DE SERVICES SOCIAUX D’ARGENTEUIL02 (33.3%)02 (100.0%)0
 81HÔPITAL DE MONT-LAURIER1 (50.0%)0000
 101HÔPITAL RÉGIONAL DE SAINT-JÉRÔME6 (20.0%)10 (29.4%)3 (8.6%)3 (17.6%)5 (21.7%)
 103HÔPITAL LAURENTIEN1 (33.3%)0000
  LAURENTIDES9 (20.9%)12 (26.7%)4 (9.1%)5 (16.7%)8 (21.6%)
161HÔPITAL CHARLES-LEMOYNE2 (7.1%)8 (27.6%)05 (17.2%)2 (6.7%)
 9HÔPITAL DU HAUT-RICHELIEU1 (5.9%)1 (5.9%)4 (18.2%)2 (18.2%)2 (18.2%)
 10HÔPITAL PIERRE-BOUCHER3 (27.3%)3 (25.0%)02 (28.6%)2 (16.7%)
 35HÔPITAL HONORÉ-MERCIER01 (16.7%)3 (23.1%)04 (57.1%)
 37HÔTEL-DIEU DE SOREL1 (9.1%)2 (18.2%)1 (9.1%)1 (10.0%)1 (11.1%)
 42HÔPITAL ANNA-LABERGE3 (37.5%)2 (25.0%)2 (20.0%)4 (27.3%)4 (50.0%)
 46HÔPITAL DE GRANBY03 (50.0%)4 (33.3%)00
 58HÔPITAL DU SUROÎT4 (57.1%)2 (25.0%)1 (12.5%)1 (25.0%)4 (40.0%)
 99HÔPITAL BROME-MISSISQUOI-PERKINS00002 (50.0%)
 130HÔPITAL BARRIE MEMORIAL1 (20.0%)0000
  MONTÉRÉGIE15 (13.4%)22 (21.8%)15 (14.2%)14 (16.3%)21 (22.3%)
  Total194 (22.9%)174 (21.9%)173 (20.0%)120 (16.8%)120 (17.8%)

HR: Heath region
When the number of healthcare-associated MRSA bloodstream infection  is  0, no percentage is calculated.
a Facility participating in the surveillance of bloodstream infections due to S. aureus as of Period 1 of 2011–2012.

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

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

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