1087. Is the Prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA), Vancomycin-Resistant Enterococcus (VRE), Extended-Spectrum -lactamase-producing Enterobacteriaceae (ESBL), Carbapenem-Resistant Enterobacteriaceae (CRE) and Clostridium difficile Infection (CDI) Changing in Canadian Hospitals? A Comparison of Survey Results in 2010 and 2012
Session: Poster Abstract Session: Surveillance of HAIs: Implementation and National Perspectives
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Background: Repeated point-prevalence surveys are useful for identifying changes in the epidemiology of antimicrobial resistance.  A point-prevalence survey for MRSA, VRE, and CDI was done in 176 Canadian hospitals in 2010.  We wanted to determine if there were any changes in prevalence over time.   

Methods: A follow-up survey of MRSA, VRE, ESBLs, CREs, and CDI prevalence was done in adult inpatients in Canadian hospitals with > 49 beds in Nov. 2012.  Data describing the participating hospitals and the patient cases were obtained at each participating site using standard criteria and case definitions. 

Results:

143 (58% of eligible) hospitals with 29,042 inpatients participated in the follow-up survey with representation from all 10 provinces.  79 (55%) hospitals had 50-200 beds, 58 (41%) had 201-500 beds, and 6 (4%) had > 500 beds.  Most (90%) hospitals did routine screening for MRSA and VRE.  132 hospitals participated in both 2010 and 2012; median prevalence rates are summarized in the Table.  MRSA prevalence did not vary across the country, but hospitals in eastern provinces had lower rates of VRE, whereas CDI rates were highest in central Canada.  The prevalence of MRSA and CDI did not change over time, but there was an increase in VRE prevalence (median prevalence 0.5/100 inpatients in 2010, 1.25 in 2012; p=0.04).  MRSA, VRE, and CDI were all predominantly healthcare-associated, but MRSA was more often community-associated (30%) than was VRE (6%) or CDI (23%) (p<0.001).  ESBLs and CREs were reported from 71 (57%) and 10 (8%) hospitals respectively. 

 

 

Median prevalence per 100 inpatients (range)

Organism

2010

2012

MRSA

 

 

Colonization/infection

4.3 (0-22.1)

3.9 (0-26.8)

Infection

0.3 (0-5.9)

0.3 (0-4.9)

VRE

 

 

Colonization/infection

0.5 (0-13.0)

1.3 (0-18.0)

Infection

0 (0-0.8)

0 (0-1.5)

 

 

 

ESBL

-

0.7 (0-13.5)

CRE

-

0 (0-3.0)

CDI

0.8 (0-8.6)

0.9 (0-5.5)

Conclusion: These data provide national prevalence rates for MRSA, VRE, ESBLs, CREs, and CDI among adult inpatients in Canadian hospitals.  A significant increase in VRE rates was observed from 2010 to 2012.  MRSA and VRE were most often healthcare-associated, and from colonized patients identified by screening high-risk patients or high-risk inpatient units.  CREs are currently infrequently identified in Canadian hospitals.

Andrew E. Simor, MD, FRCPC, FACP1, Victoria Williams, BSc, BASc, MPH, CIC2, Allison McGeer, MD, FRCPC3, Guanhong Han, PhD4, Zahir Hirji, MSc5, Oscar E. Larios, MD6, Christine Moore, BSc, MLT7, Karl Weiss, MD, MSc, FRCPC8 and Community and Hospital Infection Control Association - Canada, (1)Department of Microbiology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, (2)Sunnybrook Health Sciences Centre, Toronto, ON, Canada, (3)Public Health Sciences & Pathobiology, University of Toronto, Toronto, ON, Canada, (4)Provincial Infection Control Network of British Columbia, Vancouver, BC, Canada, (5)Bridgepoint Health, Toronto, ON, Canada, (6)Division of Infectious Diseases, University of Calgary, Calgary, AB, Canada, (7)Mount Sinai Hospital, Toronto, ON, Canada, (8)Dept of Infectious Diseases and Microbiology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada

Disclosures:

A. E. Simor, Pfizer canada Inc: Investigator and Scientific Advisor, Research grant and Speaker honorarium

V. Williams, None

A. McGeer, None

G. Han, None

Z. Hirji, None

O. E. Larios, None

C. Moore, None

K. Weiss, None

Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.