Monitoring report

À la demande du ministère de la Santé et des Services sociaux, l’Institut national de santé publique du Québec a réalisé l’Étude clinique sur l’état de santé buccodentaire des élèves québécois du primaire 2012-2013 (ÉCSBQ). Cette étude évalue la condition buccodentaire des élèves québécois de 2e et 6e années du primaire et met en lumière des tendances par rapport à l’évolution de leur santé buccodentaire depuis la fin des années 90.

Pour la première fois au Québec, l’ÉCSBQ 2012-2013 utilise un nouveau système de mesure visuelle qui permet maintenant d’étudier la carie réversible en plus de considérer la carie irréversible comme c’était le cas jusqu’ici. La carie réversible, aussi appelée carie non évidente, est une lésion se limitant aux premiers stades du développement de la maladie et qui peut être renversée par des actions préventives. La carie irréversible se présente, pour sa part, sous trois formes : une lésion non traitée ayant atteint un stade plus avancé de la…

This report discusses the prevalence and the incidence rate of autism spectrum disorder (ASD). It also demonstrates the capability of the Québec Integrated Chronic Disease Surveillance System (QICDSS) to identify the comorbidities associated with ASD and the profile of health services utilization. These estimates were obtained from a longitudinal study covering the period from April 1, 2000, to March 31, 2015, for all persons eligible for health coverage between the ages of 1 and 24 years. To be considered to have ASD, the individual must have had at least one medical visit or hospitalization with a principal diagnosis of ASD.

Ce rapport présente la prévalence et le taux d’incidence du trouble du spectre de l’autisme (TSA). Il démontre également la capacité du Système intégré de surveillance des maladies chroniques du Québec (SISMACQ) à identifier les comorbidités associées au TSA et le profil d’utilisation des services médicaux. Les estimations ont été obtenues à partir d’un suivi longitudinal allant du 1^er avril 2000 au 31 mars 2015 pour toutes personnes admissibles à la couverture du régime de santé âgées de 1 à 24 ans. Pour être considéré comme ayant le TSA, l’individu devra avoir eu au moins une visite médicale ou une hospitalisation avec un diagnostic principal de TSA.

From April 1^st, 2016, to March 31^st, 2017, 48 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 57,570 patient-periods (Table 1). Participating units reported 127 VARBSIs in 120 patients. Patient-periods involving a fistula account for 40.7% of patient-periods. The VARBSI incidence rate is 0.06 cases per 100 patient-periods for patients with an arteriovenous (AV) fistula, 0.10 for patients with a synthetic fistula (graft), 0.32 for patients with a tunneled catheter and 1.24 for patients with a non-tunneled catheter. In 2016–2017, incidence rates for tunneled and non-tunneled catheters have significantly decreased compared to rates for 2012-2016 (p < 0.05) while rates for AV fistulas and grafts have remained stable. Since 2015-2016, three HD units joined the surveillance. Data were extracted on May 5^th, 2017.

From April 1^st, 2016, to March 31^st, 2017, 69 intensive care units (ICUs) took part in surveillance of central line–associated bloodstream infections (CLABSIs), for a combined total of 135,114 catheter days (Table 1). Participating ICUs report 133 CLABSIs in 125 patients. Incidence rates are 0.91 per 1,000 catheter days in coronary ICUs, 0.62 in teaching adult ICUs, 0.46 in non-teaching adult ICUs, 2.16 in pediatric ICUs and 2.78 in neonatal ICUs. The incidence rates in 2016–2017 are lower compared to 2012–2016 in neonatal ICUs while they remain statistically stable in other ICU types. Compared to 2015-2016, one adult non-teaching ICUs with less than 10 beds has stopped participating to surveillance while two coronary ICUs and one adult teaching joined the surveillance. Data were extracted on May 5^th, 2017.

From April 1^st, 2016, to March 31^st, 2017, 89 healthcare facilities took part in the hospital-wide surveillance of bloodstream infections (BSIs), for a combined total of 4,830,348 patient days (Table 1). Participating facilities reported 3,167 BSIs in 2,982 patients. The total incidence rate was 5.43 cases per 10,000 patient days. The incidence rate in 2016–2017 is stable compared with the average rate for 2012–2016. Two non-teaching facilities joined the program in 2016–2017. Data were extracted on May 5^th, 2017.

From April 1^st, 2016 to March 31^st, 2017, 95 healthcare facilities participated in the Clostridium difficile–associated diarrhea (CDAD) surveillance program, for a combined total of 5,022,104 patient days (Table 1). These participating facilities reported 2,330 healthcare-associated CDAD (HA-CDAD), either acquired during a current or previous hospitalization (categories 1a and 1b). The HA-CDAD incidence rate was 4.64 cases per 10,000 patient days. This incidence rate has declined for a third consecutive year and this decline was statistically and significantly lower than the 2015–2016 rate. The 10-day fatality rate was 6.3% (n = 130) while the 30-day fatality rate was 12.4% (n = 258). In total, 14 (0.7%) colectomies were reported. For all results, analyses include facilities that participated a minimum of 11 periods. Data were extracted on June 1^st, 2017. The new healthcare facility categories established in 2015-2016 based on the teaching vocation, the number of beds and the proportion of admitted patients aged 65 years and older of the participating facilities were maintained this year and applied to prior years when used for comparisons.

From April 1^st, 2016, to March 31^st, 2017, 82 healthcare facilities took part in the surveillance of carbapenemase-producing Gram negative bacilli (CPGNB) infections, for a total of 4,448,999 patient days (Table 1). These facilities reported 17 healthcare-associated CPGNB (HA-CPGNB) infections among patients who acquired their strain during a current or previous hospitalization (categories 1a and 1b). The incidence rate of HA-CPGNB infection was 0.04 per 10,000 patient days. The acquisition rate of HA-CPGNB colonization was 0.57 per 10,000 patient days. Eight infections were observed among healthcare facilities that joined the surveillance this year. Two teaching and one non-teaching facilities discontinued their participation this year whereas three teaching and nine non-teaching facilities joined the program. Data were extracted on June 1^st, 2017.

From April 1^st, 2016 to March 31^st, 2017, 89 healthcare facilities took part in the surveillance of vancomycin-resistant enterococci (VRE) infections, for a combined total of 4,827,659 patient days (Table 1). These facilities reported 44 healthcare-associated VRE (HA-VRE) infections, either acquired during a current or previous hospitalization (categories 1a and 1b). The HA-VRE infection rate was 0.09 per 10,000 patient days. This incidence rate was down from 2015-2016. The acquisition rate of HA-VRE colonization (cat. 1a and 1b) in 2016-2017 was 7.43 per 10,000 patient days and was lower compared to 2015-2016. For all results, analyses include facilities that participated for a minimum of 11 periods. Data were extracted on June 1^st, 2017.