1491. The Prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA), Vancomycin-Resistant Enterococcus (VRE), Extended-Spectrum Beta-lactamase-producing Enterobacteriaceae (ESBL), Carbapenem-Resistant Enterobacteriaceae (CRE) and Clostridium difficile Infection (CDI) in Canadian Hospitals. A Comparison of Survey Results in 2010, 2012 and 2016.
Session: Poster Abstract Session: HAI: Surveillance and Public Reporting
Friday, October 28, 2016
Room: Poster Hall
Background: Repeated point-prevalence surveys are useful in identifying changes in the epidemiology of antimicrobial resistance. A point-prevalence survey for MRSA, VRE, ESBLs, CREs and CDI was done in 2010 and in 2012. We wanted to determine if there were any changes in prevalence over time.

Methods: A third follow-up survey of MRSA, VRE, ESBLs, CREs and CDI was done in adult inpatients in Canadian hospitals with ≥ 50 beds in Feb 2016. Data describing the participating hospitals and the patient cases were obtained at each participating site using standard criteria and case definitions.

Results: 159 hospitals with 34 510 inpatients participated in the follow-up survey with representation from 9 provinces. Routine universal or targeted admission screening for VRE decreased from 99% in 2010 to 90% in 2012 and to 77% in 2016. 105 hospitals participated in all 3 surveys; median prevalence rates in these hospitals are summarized in the Table. The prevalence of MRSA, CDI, ESBL and CRE did not significantly change over time. The prevalence of VRE also did not significantly change from 2012 to 2016, even if only centres that screened for VRE at the time of the survey were included in the analysis. The median prevalence of CRE was lower in centres that screened for VRE (p=0.01). Although not statistically significant, centres that did not screen for VRE in 2016 tended to have higher prevalence of MRSA and ESBL. In 2016, CREs were reported from 24 hospitals (15%) compared to 10 hospitals (7%) in 2012.

Median prevalence per 100 inpatients (range)

 

2010

2012

2016

MRSA

4.2 (0-14.8)

4.0 (0-13.9)

4.1 (0-18.5)

VRE

0.5 (0-13.0)

1.3 (0-12.7)

0.8 (0-18.5)

CDI

0.8 (0-4.3)

1.0 (0-5.5)

1.1 (0-4.5)

ESBL

0.5 (0-8.5)

0.3 (0-10.9)

CRE

0 (0-1.3)

0 (0-1.6)

Conclusion: These data provide national prevalence rates for MRSA, VRE, ESBLs, CREs, and CDI among adult inpatients in Canadian hospitals. There was no significant change in the prevalence of any of the organisms from 2012 to 2016. CREs were identified in more hospitals in 2016 than in 2012, but remain infrequently identified in Canadian hospitals. There has been a substantial decrease in the number of hospitals that screen patients for VRE; this change in practice might lead to changes in the prevalence of other antibiotic resistant organisms.

Philippe Martin, MD1, Victoria Williams, BSc, BASc, MPH, CIC2, Kathryn Bush, MSc3, Myrna Dyck, RN, BN, BSc, MSc4, Zahir Hirji, MSc5, Oscar E. Larios, MD6, Allison Mcgeer, MD, MSc7,8, Christine Moore, BSc, MLT9, Karl Weiss, MD, MSc, FRCPC10 and Andrew E. Simor, MD, FRCPC, FACP1, (1)Department of Microbiology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, (2)Sunnybrook Health Sciences Centre, Toronto, ON, Canada, (3)Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada, (4)Infection Prevention and Control, Winnipeg Regional Health Authority, Winnipeg, MB, Canada, (5)The Scarborough Hospital, Toronto, ON, Canada, (6)Division of Infectious Diseases, University of Calgary, Calgary, AB, Canada, (7)Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada, (8)Faculty of Medicine: Lab Medicine & Pathobiology & Public Health, University of Toronto, Toronto, ON, Canada, (9)Mount Sinai Hospital, Toronto, ON, Canada, (10)Department of Infectious Diseases and Microbiology, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada

Disclosures:

P. Martin, None

V. Williams, None

K. Bush, None

M. Dyck, None

Z. Hirji, None

O. E. Larios, None

A. Mcgeer, None

C. Moore, None

K. Weiss, None

A. E. Simor, None

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