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Prevalence of antimicrobial-resistant organisms in smaller Canadian hospitals: Community, Rural, and Northern Acute
Shari Thomas1, Denise Gravel Tropper1, Braden Knight1
1Antimicrobial Resistance Task Force, Public Health Agency of Canada, Ottawa, ON.
Background:
The availability of national data on the prevalence of antimicrobial resistant infections in smaller, community, northern and rural acute care hospitals is limited. The objective of this article is to determine the prevalence of infections caused by selected antimicrobial-resistant organisms (AROs) in these smaller hospitals.
Methods:
A point prevalence survey was conducted by 55 hospitals between February and May 2019 and included representation from all 10 Canadian provinces. Eligible hospitals were those with 350 or fewer beds. Data were collected on hospital characteristics. De-identified patient data were collected on selected infections (pneumonia, urinary tract infections, bloodstream infections, skin/soft tissue infections, surgical site infections, and Clostridioides difficile infections) for selected AROs (methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, extended-spectrum β-lactamase-producing organisms and carbapenemase-producing organisms). Data on antimicrobial prescribing and infection prevention and control precautions were also collected.
Results:
A total of 3,640 patients were included in the survey. Median patient age was 73 years, and 52.8% (n=1,925) were female. Selected infections were reported in 14.4% (n=524) of patients, of which 6.9% (n=36) were associated with an ARO infection. Infection prevention and control additional precautions were in place for 13.7% (n=500) of patients, of which half (51.0%, n=255) were due to an ARO. Approximately one third (35.2%, n=1,281) of patients had at least one antimicrobial prescribed.
Conclusion:
Antimicrobial-resistant organisms remain a serious threat to public health in Canada. The results of this survey warrant further investigation into AROs in smaller Canadian hospitals as a potential reservoir of antimicrobial resistance.
Insights
Antimicrobial-resistant organism infections occurred in 6.9% of patients in smaller Canadian hospitals. Further investigation is needed as these facilities may harbor antimicrobial resistance.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Limited national data exist on antimicrobial-resistant infections in smaller, rural, northern, and community acute care hospitals.
- Antimicrobial resistance (AMR) poses a significant public health threat.
Purpose of the Study:
- To determine the prevalence of infections caused by selected antimicrobial-resistant organisms (AROs) in smaller Canadian acute care hospitals.
- To assess the scope of ARO infections in facilities with 350 or fewer beds.
Main Methods:
- A point prevalence survey was conducted across 55 hospitals in all 10 Canadian provinces.
- Data were collected on patient demographics, specific infection types, AROs, antimicrobial prescribing, and infection control precautions.
- Infections studied included pneumonia, UTI, bloodstream, skin/soft tissue, surgical site, and Clostridioides difficile infections.
Main Results:
- A total of 3,640 patients were surveyed; 14.4% had selected infections.
- 6.9% of patients with infections had an ARO-associated infection.
- Antimicrobial prescribing was noted in 35.2% of patients, and infection control precautions were used for 13.7%.
Conclusions:
- Antimicrobial-resistant organisms are a significant public health concern in Canada.
- Smaller Canadian hospitals may represent a reservoir for antimicrobial resistance, necessitating further research.
- Findings highlight the need for targeted surveillance and control strategies in these settings.
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