Healthcare-Associated Infections Provincial Surveillance Program: Clostridium difficile–Associated Diarrhea (CDAD)
Surveillance results: 2013-2014

From April 1, 2013, to March 31, 2014, 95 healthcare facilities participated in the surveillance of Clostridium difficile–associated diarrhea (CDAD), for a combined total of 5,121,300 inpatient days (Table 1). The participating facilities reported 3,661 cases of healthcare-associated (HA) CDAD. The incidence rate of HA CDAD was 7.1 cases per 10,000 patient days. This incidence rate was stable compared to the rate of 2012–2013. The 10-day fatality rate was 9.1% (n = 322) while the 30-day rate was 15.1% (n = 534). In total, 46 (1.3%) colectomies were reported. Data was extracted on May 15th, 2014.  

Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infections
Surveillance Results: 2013–2014

From April 1, 2013, to March 31, 2014, 88 healthcare facilities participated in the surveillance of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, for a combined total of 4,939,160 inpatient days (Table 1). Together, these facilities reported 97 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. The proportion of methicillin resistance in healthcare-associated S. aureus bloodstream infections was 16.9%. Data was extracted from Si-SPIN on May 23th, 2014 and updated on June 3st 2014 for complications.

…

A more recent publication based on new studies has just been issued by the Ministère de la Santé et des Services sociaux. This update is titled «L'effet du traitement des personnes vivant avec le VIH sur le risque de transmission sexuelle de l'infection» (The impact of treating people living with HIV on the risk of sexual transmission of the infection) can be found here: http://publications.msss.gouv.qc.ca/msss/document-002173/ (french only).

The CITSS working group was mandated to assess the effect of undetectable viral load on HIV transmission risk in order to support updating the Estimation du risque associé aux activités sexuelles , a resource designed to help guide risk-reduction counselling and to support the assessment of STBBI reports according to section 95 of Québec's Public Health…

From April 1, 2012, to March 31, 2013, 89 healthcare facilities took part in the surveillance of healthcare-associated vancomycin-resistant enterococci (HA-VRE) infections, for a combined total of 5,017,791 patient days. In total, 41 cases of VRE infection were reported among patients who contracted the strain during a current or previous hospital stay in the reporting facility (categories 1a + 1b). The incidence rate of HA-VRE infection (cat. 1a + 1b) was 0.08/10,000 patient days. This incidence rate is similar to the one observed in 2011–2012. The acquisition rate of HA-VRE colonization (cat. 1a + 1b) was 8.26/10,000 patient days.

From April 1, 2012, to March 31, 2013, 88 healthcare facilities took part in the surveillance of methicillinresistant Staphylococcus aureus (MRSA) bloodstream infections, for a combined total of 5,011,231 patient days. Together, these facilities reported 147 cases of healthcare-associated MRSA bloodstream infections. The incidence rate was 0.29/10,000 patient days. This incidence rate has declined over the past five years. The proportion of methicillin resistance in healthcare-associated S. aureus bloodstream infections was 20%.

From April 1, 2012, to March 31, 2013, 95 healthcare facilities participated in the surveillance of Clostridium difficile–associated diarrhea (CDAD), for a combined total of 5,233,966 inpatient days. The participating facilities reported 3,797 cases of healthcare-associated (HA) CDAD. The total incidence rate of HA-CDAD was 7.3 cases per 10,000 patient days. This incidence rate was stable compared to the rate of 2011–2012. The 10-day case fatality was 8.7% (n=304) while the 30-day one was 16.1% (n=560). In total, 32 (0.9%) colectomies were reported.

Entre le 1^er avril 2012 et le 31 mars 2013, 64 installations de santé ont participé sur une base volontaire à la surveillance des bactériémies panhospitalières, pour un cumul de 3 797 385 joursprésence (tableau 1). Ces installations ont rapporté 2 797 bactériémies, survenues chez 2 674 patients. Le taux d'incidence total était de 6,1 cas par 10  000 joursprésence. Le taux d'incidence en 2012-2013 a diminué significativement par rapport au taux moyen de 2008-2012, dans les installations ayant participé à la surveillance pendant les deux périodes. Par rapport à 2011-2012, quatre installations universitaires se sont ajoutées à la surveillance et aucune n'a cessé sa participation.

From April 1, 2012, to March 31, 2013, 67 intensive care units (ICUs) took part in the surveillance of central line–associated bloodstream infections (CLABSIs), for a combined total of 128,207 centralline days. Participating ICUs reported 201 CLABSIs in 197 patients. Incidence rates were 1.13 per 1,000 central-line days in coronary ICUs, 0.84 in teaching adult ICUs, 1.22 in non-teaching adult ICUs, 2.83 in pediatric ICUs and 5.36 in neonatal ICUs. Incidence rates in 2012–2013 were stable compared to 2008–2012 (in ICUs that took part in both surveillance periods), except in adult teaching ICUs, where the pooled mean rate decreased significantly. Two adult non-teaching ICUs with less than 10 beds that did not take part in the 2011–2012 study joined the program in 2012–2013 (one in period 6 and the other in period 9). All participating ICUs in 2011–2012 continued participation in 2012–2013.

From April 1, 2012, to March 31, 2013, 42 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 51,697 patient periods. The participating units reported 218 VARBSIs in 209 patients. Patient periods involving a fistula accounted for 44.9% of cases. The VARBSI incidence rate was 0.19 cases per 100 patient periods for patients with an arteriovenous (AV) fistula, 0.26 for patients with a synthetic fistula (graft), 0.55 for patients with a permanent catheter and 5.06 for patients with a temporary catheter. Incidence rates in 2012–2013 by type of vascular access were stable compared to 2008–2012 despite an increasing proportion of catheter use. The incidence rates for patients with a catheter of either type decreased significantly. The program has been compulsory since 2011–2012, which means the number of participating units has remained unc…

In Nunavik, the battle against bacterial sexually transmissible and blood-borne infections (STBBIs) has become increasingly urgent. In the wake of mass interventions in the 1990s, and despite more recent efforts, the region has been unable to lower its incidence curves, particularly for gonococcal infection, which has reached epidemic proportions since fall 2007. In this context, and spurred by the renewed interest of medical teams on the ground, the Direction de santé publique (department of public health: DSP) of the Régie régionale de la santé et des services sociaux du Nunavik / Nunavik Regional Board of Health and Social Services (NRBHSS) has asked the Institut national de santé publique (Québec's national public health institute: INSPQ) to support a group of experts in an attempt to optimize the regional program for clinical prevention of STBBIs. Accordingly, a meeting was held on October 2010. In attendance were representatives of the two CSSS organizations (physicians, a con…