1377. Characteristics of Patients with New Hospital-Acquired Antibiotic Resistant Organisms and Clostridium difficile Infections in Alberta Health Services and Covenant Health (AHS/CH), Alberta, Canada
Session: Poster Abstract Session: Clostridium difficile
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • SHEA2013_ARO CDI_Population_Sept24_FINAL.pdf (258.8 kB)
  • Background: Surveillance for Antibiotic Resistant Organisms (ARO) such as Methicillin Resistant Staphylococcus aureus (MRSA) and Vancomycin Resistant Enterococcus (VRE) and for Clostridium difficile infections (CDI) is vital for prevention of healthcare-acquired infections in acute care facilities. AHS/CH provides health care for the province of Alberta, Canada and has 8,500 acute care beds in more than 100 hospitals. We describe the population of patients with incident ARO and CDI hospitalized between April 2011 and March 2012.

    Methods: Demographic, facility, and microbiological data were collected on individuals hospitalized in acute care facilities and newly identified with MRSA, VRE and CDI from April 2011 to March 2012. Standardized provincial surveillance definitions were used and incident cases were classified as Hospital Acquired (HA) when detected more than 48 hours after admission for MRSA/VRE or 72 hours for CDI. Patient admissions were tracked throughout the province and incident cases were counted once. Data were analysed using STATA/IC 10.0 (StataCorp, Texas, 2007).

    Results: There were approximately 3 million patient-days from April 2011 to March 2012.  HA-MRSA, VRE and CDI rates were 3.0, 6.4 and 4.2 per 10,000 patient-days, respectively. HA cases occurred primarily among patients aged more than 65 years: HA-MRSA (mean 69.0, SD 20.9 years); HA-VRE (mean 70.1, SD 16.9 years); and HA-CDI (mean 70.2, SD 19.6 years). Gender was equally distributed for MRSA (male n=495, 51.2%) and VRE (male n=956, 50.8%) but predominately female for CDI (female n=659, 55.1%). More than 50% of HA cases occurred in hospitals with > 500 beds: MRSA (n=499, 55.6%); VRE (n=1223, 65.0%); and CDI (n=734, 61.3%).  Colonization accounted for the majority of ARO (MRSA 60.3%, VRE 92.0%) cases.  Culture sites for ARO infections were predominately skin/soft tissue for MRSA (58.0%) and urine for VRE (63%).

    Conclusion: Surveillance for HA-ARO and HA-CDI is essential to control and prevent these infections in acute care facilities. Standardized provincial surveillance definitions for HA-ARO and CDI improve data quality and allow comparisons over time to better understand the epidemiology of ARO and CDI and guide appropriate interventions.

    Kathryn Bush, MSc1, Jenine Leal, MSc1, Andrea Durette2, Elizabeth Henderson, PhD3, Geoffrey Taylor, MD4 and Infection Prevention and Control Program, Alberta Health Services and Covenant Health, (1)Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada, (2)Infection Prevention and Control, Alberta Health Services, Edmonton, AB, Canada, (3)Alberta Health Services, Calgary, AB, Canada, (4)University of Alberta Hospital, Edmonton, AB, Canada


    K. Bush, None

    J. Leal, None

    A. Durette, None

    E. Henderson, None

    G. Taylor, None

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