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 – P…

Vancomycin-Resistant Enterococci (VRE) Infections
Surveillance results: 2014-2015

From April 1, 2014, to March 31, 2015, 89 healthcare facilities took part in the surveillance of healthcare-associated vancomycin-resistant enterococci (VRE) infections, for a combined total of 4,839,578 patient days (Table 1). In total, 87 VRE infections were reported among patients who contracted strain during a current or previous hospital stay in the reporting facility (categories 1a + 1b). The incidence rate of healthcare-associated VRE infections (cat. 1a + 1b) was 0.18 / 10,000 patient days. This incidence rate was stable since 2013-2014. The acquisition rate of healthcare-associated VRE colonization (cat. 1a + 1b) was 10.99 / 10,000 patient days. Data was extracted on May 20th, 2015 and updated on June 1, 2015 for complications.

Updat…

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

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Gram-negative bacilli (GNB) are bacteria frequently encountered in clinical settings, both as normal flora and as pathogens in a variety of infections. The use of antibiotics has led to the emergence of various resistance mechanisms and some of these bacteria are now resistant to several classes of antibiotics. This document has been prepared to help healthcare-associated infection prevention and control (IPC) teams recognize the major multidrug-resistant Gram-negative bacilli (MDR-GNB) and to implement IPC measures to avoid their transmission in acute care settings in Québec.

This document is primarily intended to be used as a basic reference for centres that are not dealing with an outbreak. While the measures to be implemented in the case of an outbreak are often mentioned in the literature, very few articles discuss the measures to be taken to avoid transmission outside such a context. The following recommendations are therefore based in large part on the opinion of the…

Clostridium difficile is the leading cause of healthcare-associated infectious diarrhea in adults, affecting 0.3–2% of hospitalized patients. The epidemiology, pathogenesis, clinical manifestations, risk factors, diagnosis and management of cases of Clostridium difficile–associated diarrhea (CDAD) were the subject of a previous publication. The incidence of CDAD varies widely across and within institutions.

In 2003, a marked increase was observed in the incidence, morbidity and mortality of CDAD in Québec. Since 2004, considerable efforts have been made to control this infection. The mobilization of infection prevention and control professionals and the allocation of additional resources have made a difference, with CDAD rates falling to their lowest level in 2009-2010. Despite this significant improvement, CDAD outbreaks occur in most institutions from time to time.

In 2005, the Comité sur les infections nosocomiales du Québec (CINQ) [Québec health…

The ministère de la Santé et des Services sociaux (MSSS) mandated the Institut national de santé publique du Québec (INSPQ) with the provincial surveillance of healthcare-associated infections (HAI), as outlined in the 2003–2012 Programme national de santé publique (Public Health Plan), revised in 2008 as well as in the 2006–2009 and 2010–2015 versions of the Plan d’action sur la prévention et le contrôle des infections nosocomiales (Action Plan for Preventing and Controlling HAIs) aimed at reducing the transmission of HAIs in Québec’s healthcare facilities.

The INSPQ set up a structured surveillance program to support public health administrations and local infection prevention and control teams in general and specialized healthcare facilities. The program includes a set of standardized tools and educational activities focusing on infections categorized as “priorities” by the MSSS and by the INSPQ’s Comité des infections nosocomiales du Québec (CINQ) and the Groupe de trava…

An outbreak of Ebola virus disease has been ongoing in West Africa since March 2014. It is the largest outbreak known to date. Although low, the threat of importing Ebola virus disease cannot be excluded. Ebola Virus Disease has a fatality rate of 50% to 90%.

This fact sheet sets out the recommendations of the Comité sur les infections nosocomiales du Québec (CINQ) for Ebola virus disease prevention and control measures for Québec hospitals. Notwithstanding the transmission of the disease through contact and droplets, the CINQ recommends more important measures to take into account possible airborne transmission, significant environmental contamination by blood, body fluids, secretions or excretions, and high Ebola virus disease fatality.

Hospitals must implement the measures necessary to prevent the transmission of Ebola virus disease. The quantity of material to be provided can differ by a hospital as designated for the management of patients with confirmed Ebola v…

An outbreak of Ebola virus disease has been ongoing in West Africa since March 2014. It is the largest outbreak known to date. Although low, the threat of importing Ebola virus disease cannot be excluded. Ebola virus disease has a fatality rate of 50% to 90%.

This fact sheet sets out the recommendations of the Comité sur les infections nosocomiales du Québec (CINQ) for Ebola virus disease prevention and control measures for Québec hospitals. Notwithstanding the transmission of the disease through contact and droplets, the CINQ recommends stronger measures to take into account possible airborne transmission, significant environmental contamination by blood, body fluids, secretions or excretions, and high Ebola virus disease fatality.

Hospitals must implement the measures necessary to prevent the transmission of Ebola virus disease.

Last, it is important to remind clinicians and prevention and control teams of Québec health institutions that other infectious di…

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

From April 1^st, 2013, to March 31^st, 2014, 44 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 54,878 patient-periods (Table 1). Participating units reported 157 VARBSIs in 149 patients. Patient-periods involving a fistula accounted for 44.9% of patient-periods. The VARBSI incidence rate was 0.10 cases per 100 patient-periods for patients with an arteriovenous (AV) fistula, 0.22 for patients with a synthetic fistula (graft), 0.38 for patients with a permanent catheter and 6.20 for patients with a temporary catheter. In 2013-2014, incidence rates were stable for patients with a graft and for patients…

Central Line–Associated Bloodstream Infections in Intensive Care Units
Surveillance results: 2013-2014

From April 1^st, 2013, to March 31^st, 2014, 70 intensive care units (ICUs) took part in surveillance of central line–associated bloodstream infections (CLABSIs), for a combined total of 132,376 catheter-days (Table 1). Participating ICUs reported 165 CLABSIs in 149 patients. Incidence rates were 0.65 per 1,000 catheter-days in coronary ICUs, 0.71 in teaching adult ICUs, 0.77 in non-teaching adult ICUs, 2.48 in pediatric ICUs and 4.01 in neonatal ICUs. The incidence rates in 2013-2014 were lower compared to 2009-2013 in teaching and non-teaching adult ICUs as well as in neonatal ICUs while pediatric and coronary ICUs pooled mean rates remained statistically stable. Compared to 2012-2013, two adult n…