773. Prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA), Vancomycin-Resistant Enterococcus (VRE), and Clostridium difficile Infection (CDI) in Canadian Hospitals
Session: Oral Abstract Session: Staph aureus: Screening and Prevention
Friday, October 21, 2011: 3:15 PM
Room: 157ABC

Background:  Antibiotic-resistant organisms continue to add to the burden of disease in hospitalized patients.  The primary objective of this study was to determine the prevalence of MRSA, VRE, and CDI among adults hospitalized in Canadian hospitals.

Methods:  A 1-day national point-prevalence survey of MRSA, VRE, and CDI in adult inpatients in Canadian acute-care hospitals with at least 50 beds was done in Nov. 2010 (on any week-day, Nov. 8-19).  Data describing the participating hospitals and the prevalent cases identified were obtained by experienced infection control practitioners at each participating site, using standard criteria and case definitions. 

Results:   A total of 173 hospitals (representing 62% of those eligible) with 38,353 inpatients participated in the survey, with representation from every province.  90 (52%) hospitals had 50-200 beds, 72 (42%) had 201-500 beds, and 11 (6%) had > 500 beds.  Almost all (99%) hospitals did routine surveillance for MRSA and VRE.  The national prevalence rates of MRSA, VRE, and CDI are summarized in the Table.  Regional differences in prevalence rates were observed: the prevalence of MRSA was highest in Atlantic provinces; VRE and CDI were most prevalent in British Columbia, Ontario, and Quebec.  MRSA, VRE, and CDI were thought to have been healthcare-associated in 79%, 96%, and 84% of cases respectively.  44% with MRSA, and 56% of those with VRE were first identified with these organisms during the current hospital admission.  CDI patients were older (mean age 76 yrs) than were those with MRSA (70 yrs) or VRE (71 yrs) (p<0.001). 

 

Organism

No. patients

Prevalence per 100 inpatients (range)

MRSA

Colonization or infection

Infection

 

1,893

   246

 

  4.9 (0-20.8)

0.6 (0-5.9)

VRE

Colonization or infection

Infection

 

   772

    24

 

   2.0 (0-13.1)

   0.06 (0-1.8)

CDI (80% primary; 20% recurrent)

  478

1.2 (0-8.6)

 

Conclusion:  These data provide the first national prevalence rates for MRSA, VRE, and CDI in Canadian adult acute-care hospitals.  In most cases, the organisms were nosocomial or healthcare-associated.  MRSA and VRE were most often from colonized patients identified during hospital screening of targeted high-risk patients or high-risk inpatient units. 

 


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Andrew Simor, MD, FRCPC, FIDSA1, Victoria Williams, BSc, BASc, CIC1, Oscar E. Larios, MD2, Karl Weiss, MD3, Felicia Laing, BSc, MSc4, Zahir Hirji, MSc5, Denise Gravel, BScN, MSc6 and Allison McGeer, MD7, (1)Sunnybrook Health Sciences Centre, Toronto, ON, Canada, (2)Division of Infectious Diseases, University of Saskatchewan, Saskatoon, SK, Canada, (3)Hop. Maisonneuve-Rosemont, Montreal, QC, Canada, (4)Fraser Health Authority, Surrey, BC, Canada, (5)Bridgepoint Health, Toronto, ON, Canada, (6)Public Health Agency of Canada, Ottawa, ON, Canada, (7)Department of Microbiology, University of Toronto, Toronto, ON, Canada

Disclosures:

A. Simor, None

V. Williams, None

O. E. Larios, None

K. Weiss, None

F. Laing, None

Z. Hirji, None

D. Gravel, None

A. McGeer, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.