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...

Vascular Access–Related Bloodstream Infections in Hemodialysis Patients in Québec
Surveillance results: 2014-2015

From April 1st, 2014, to March 31st, 2015, 45 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 55,640 patient-periods (Table 1). Participating units reported 156 VARBSIs in 142 patients. The proportion of patient-periods involving a fistula accounted for 43.4%. The VARBSI incidence rate was 0.09 cases per 100 patient-periods for patients with an arteriovenous (AV)...

Hospital-Wide Healthcare-associated Bloodstream Infections
Surveillance results: 2014-2015

From April 1st, 2014, to March 31st, 2015, 88 healthcare facilities took part in the hospital-wide surveillance of bloodstream infections (BSIs), for a combined total of 4,733,772 patient-days (Table 1). Participating facilities reported 3,035 BSIs in 2,832 patients. The total incidence rate was 5.3 cases per 10,000 patient-days. The incidence rate in 2014–2015 was significantly lower compared to the average rate for 2010–2014 in facilities that took part in both surveillance periods. Two teaching and 10 non-...

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...