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Vancomycin-resistant enterococci (VRE) are major nosocomial pathogens that have been observed worldwide (2,2). VRE were identified in Canada in 1993 (3), but rates of colonization and infection have remained relatively [...]

Background: Tracking healthcare-associated infections (HAIs) is crucial for reducing and preventing transmission. This study aimed to evaluate the validity and reliability of the Canadian Nosocomial Infection Surveillance Program (CNISP) COVID-19 surveillance data by assessing key metrics, including case definition, case classification, and outcomes. Methods: In December 2022, a survey containing 12 COVID-19 case study questions was administered to staff from 81 eligible hospitals across 32 hospital networks. These staff members were responsible for submitting data using a standardized protocol and case definitions. Results: Fifty-four (67%) of the 81 CNISP hospital sites completed the survey. The mean survey score was 79% with a median of 83%, and a range of 58-91%. Scores varied by question theme, from 70% for reasons for admission, to 93% for multiple positives. Conclusion: The study findings indicate that CNISP case definitions and classifications were consistently and accurately applied across most case study questions. These results underscore the robust quality of COVID-19 data gathered through the national surveillance platform. [ABSTRACT FROM AUTHOR]

Background: There is an ongoing need to track and prevent infections acquired within healthcare facilities. The goal of this study was to evaluate the validity and reliability of Canadian Nosocomial Infection Surveillance Program (CNISP) healthcare-associated (HA) bloodstream infection (BSI) surveillance data by assessing the application of case definitions. Methods: In September 2019, a survey with nine BSI case studies and 19 associated questions was provided to staff from 78 eligible hospitals, representing 40 hospital networks. Results: A total of 723 responses were received from 58% of CNISP sites. Correct responses were reported as a proportion of all responses, with a mean survey score of 87.6% (Median, 89.5%, Range, 52.6%-100%). Scores were similar across all question types: case definition, case classification, and source of infection (88.5%, 84.5% and 88.2% respectively). Conclusion: CNISP case definitions, case classifications and criteria for source of infection were correctly and consistently applied in most case scenarios, highlighting the high quality of BSI surveillance data collected through CNISP. Ongoing data quality reviews to check inter-rater interpretation are important to ensure the validity and reliability of national surveillance of healthcare-acquired infections. [ABSTRACT FROM AUTHOR]

To identify the prevalence of C. auris in Canadian patients who are potentially at risk for colonization, we screened 488 patients who were either hospitalized abroad, had a carbapenemase-producing organism (CPO), or were in units with high antifungal use. Two patients were colonized with C. auris; both had received healthcare in India and had a CPO. Among 35 patients who had recently received healthcare in the Indian subcontinent and were CPO colonized or infected, the prevalence of C. auris was 5.7%. [ABSTRACT FROM AUTHOR]

Objectives: Globally there is an increased prevalence of carbapenem-resistant Acinetobacter spp. (CRAs) and carbapenemase-producing Acinetobacter spp. (CPAs) in the hospital setting. This increase prompted the Canadian Nosocomial Infection Surveillance Program (CNISP) to conduct surveillance of CRA colonizations and infections identified from patients in CNISP-participating hospitals between 2010 and 2016.Methods: Participating acute care facilities across Canada submitted CRAs from 1 January 2010 to 31 December 2016. Patient data were collected from medical records using a standardized questionnaire. WGS was conducted on all CRAs and data underwent single nucleotide variant analysis, resistance gene detection and MLST.Results: The 7 year incidence rate of CRA was 0.02 per 10 000 patient days and 0.015 per 1000 admissions, with no significant increase observed over the surveillance period (P > 0.73). Ninety-four CRA isolates were collected from 58 hospitals, of which 93 (98.9%) were CPA. Carbapenemase OXA-235 group (48.4%) was the most common due to two separate clusters, followed by the OXA-23 group (41.9%). Patients with a travel history were associated with 38.8% of CRA cases. The all-cause 30 day mortality rate for infected cases was 24.4 per 100 CRA cases. Colistin was the most active antimicrobial agent (95.8% susceptibility).Conclusions: CRA remains uncommon in Canadian hospitals and the incidence did not increase from 2010 to 2016. Almost half of the cases were from two clusters harbouring OXA-235-group enzymes. Previous medical treatment during travel outside of Canada was common. [ABSTRACT FROM AUTHOR]

Background The Canadian Nosocomial Infection Surveillance Program (CNISP) has conducted surveillance for vancomycin-resistant enterococci (VRE) in sentinel hospitals since 1999. In 2010, a reliability audit of the 2008 data was conducted. Methods Stratified random sampling was used to obtain a proportional sample of VRE case forms submitted in 2008 from 36 CNISP hospitals. The original VRE data were compared to re-abstracted data for congruence on 16 pre-selected variables. Any discrepancy between the original and re-abstracted data was identified as a discordant response. Results Re-abstracted data were received from 35 out of 36 hospitals, providing 98% (n=428) of the 437 case forms requested. Of these, 37% (n=157) had zero discordant responses, 29% (n=126) had one discordant response, 16% (n=70) had two discordant responses and two forms (0.5%) had eleven discordant responses. Among the 35 hospitals, one hospital (3%) submitted forms with no discordant responses. Overall, the percentage of discordant and missing responses was 5%, ranging from 1% (n=29) for type of infection to 22% (n=93) for previous hospitalization. Conclusions Overall case forms were complete. However, discordant responses were more likely for variables that require interpretation and judgment or using historical data. Clearly defining variables and providing applicable response options may improve data quality. As well, the implementation of electronic health records may also improve the reporting of historical data. [ABSTRACT FROM AUTHOR]

Background The Canadian Nosocomial Infection Surveillance Program (CNISP) conducts surveillance of healthcare-associated infections (HAI) in 54 Canadian acute care hospitals to establish national benchmark rates. This evaluation assessed the CNISP's representativeness based on hospital size, complexity of care provided, and geographic location of sentinel sites. Methods Using data from the Canadian Healthcare Association database, CNISP and non-CNISP general acute care hospitals were compared by number of acute care beds and presence of intensive care beds. Using census data and geospatial mapping, the proportion of Canada's 2006 population living within 100 km of a CNISP hospital was estimated. Results Significantly more (73%) non-CNISP hospitals have fewer than 100 beds compared to CNISP hospitals (13%). Almost all (96%) CNISP hospitals have intensive care beds, compared to only 25% of non-CNISP sites (p<0.001). Most (78%) of the Canadian population lives within a 100 km radius of a CNISP site. However, there are no CNISP hospitals in Nunavut, Northwest Territories or Yukon. Discussion Overall, the CNISP provides important information on HAI from a national perspective, information that is not available from any other source. However, important considerations exist when interpreting the data. HAI data from small hospitals and those in rural and northern areas are underrepresented and thus CNISP data may not be an appropriate benchmark for all Canadian acute care hospitals. [ABSTRACT FROM AUTHOR]