• Robyn Mitchell, Geoffrey Taylor, Wallis Rudnick, Stephanie Alexandre, Kathryn Bush, Leslie Forrester, Charles Frenette, Bonny Granfield, Denise Gravel-Tropper, Jennifer Happe, Michael John, Christian Lavallee, Allison McGeer, Dominik Mertz, Linda Pelude, Michelle Science, Andrew Simor, Stephanie Smith, Kathryn N Suh, Joseph Vayalumkal, Alice Wong, Kanchana Amaratunga, and Canadian Nosocomial Infection Surveillance Program.
• Public Health Agency of Canada (Mitchell, Rudnick, Alexandre, Gravel-Tropper, Pelude, Amaratunga), Ottawa, Ont.; University of Alberta Hospital (Taylor, Granfield, Smith), Edmonton, Alta.; Alberta Health Services (Bush), Calgary, Alta.; Vancouver Coastal Health (Forrester), Vancouver, BC; McGill University Health Centre (Frenette), Montréal, Que.; Infection Prevention and Control Canada (Happe), Edmonton, Alta.; London Health Sciences Centre (John), London, Ont.; Hopital Maisonneuve-Rosemont (Lavallee), Montréal, Que.; Mount Sinai Hospital (McGeer), Toronto, Ont.; Department of Medicine, McMaster University and Hamilton Health Sciences (Mertz), Hamilton, Ont.; Hospital for Sick Children (Science); Sunnybrook Health Sciences Centre (Simor), Toronto, Ont.; The Ottawa Hospital (Suh, Amaratunga), Ottawa, Ont.; Alberta Children's Hospital (Vayalumkal), Calgary, Alta.; Royal University Hospital (Wong), Saskatoon, Sask.
• CMAJ. 2019 Sep 9; 191 (36): E981-E988.

BackgroundHealth care-associated infections are a common cause of patient morbidity and mortality. We sought to describe the trends in these infections in acute care hospitals, using data from 3 national point-prevalence surveys.MethodsThe Canadian Nosocomial Infection Surveillance Program (CNISP) conducted descriptive point-prevalence surveys to assess the burden of health care-associated infections on a single day in February of 2002, 2009 and 2017. Surveyed infections included urinary tract infection, pneumonia, Clostridioides difficile infection, infection at surgical sites and bloodstream infections. We compared the prevalence of infection across the survey years and considered the contribution of antimicrobial-resistant organisms as a cause of these infections.ResultsWe surveyed 28 of 33 (response rate 84.8%) CNISP hospitals (6747 patients) in 2002, 39 of 55 (response rate 71.0%) hospitals (8902 patients) in 2009 and 47 of 66 (response rate 71.2%) hospitals (9929 patients) in 2017. The prevalence of patients with at least 1 health care-associated infection increased from 9.9% in 2002 (95% confidence interval [CI] 8.4%-11.5%) to 11.3% in 2009 (95% CI 9.4%-13.5%), and then declined to 7.9% in 2017 (95% CI 6.8%-9.0%). In 2017, device-associated infections accounted for 35.6% of all health care-associated infections. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 3.9% of all organisms identified from 2002 to 2017; other antibiotic-resistant organisms were uncommon causes of infection for all survey years.InterpretationIn CNISP hospitals, there was a decline in the prevalence of health care-associated infection in 2017 compared with previous surveys. However, strategies to prevent infections associated with medical devices should be developed. Apart from MRSA, few infections were caused by antibiotic-resistant organisms.© 2019 Joule Inc. or its licensors.

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