658 Point Prevalence Surveillance Project for Healthcare-associated Infections within Selected Canadian Health Care Institutions

Saturday, March 20, 2010
Grand Hall (Hyatt Regency Atlanta)
Denise Gravel, MSc , Public Health Agency of Canada, Ottawa, ON, Canada
Geoffrey Taylor, MD , University of Alberta Hospital, Edmonton, AB, Canada
Anne Matlow, MD , Hospital for Sick Children, Toronto, ON, Canada
John Embil, MD , Health Sciences Centre, Winnipeg, MB, Canada
Elizabeth Henderson, PhD , Alberta Health Services, Calgary, AB, Canada
Michael John, MD , London Health Sciences Centre, London, ON, Canada
Nicole Lesaux, MD , Children's Hospital on Eastern Ontario, Ottawa, ON, Canada
B. Lynn Johnston, MD , Dalhousie University, Halifax, NS, CANADA
Kathryn Suh, MD, MSc , The Ottawa Hospital, Ottawa, ON, Canada
Alice Wong, MD , Royal University Hospital, Saskatoon, SK, Canada
Background: Surveillance of healthcare-associated infections (HAI) is an important component of a comprehensive infection prevention and control program and is a primary step toward the prevention of HAI.  The only data available on the overall burden of illness in Canada related to HAI is that from the previous point prevalence survey that was conducted by Canadian Nosocomial Infections Surveillance Programme (CNISP) in 2002.  Objective: To estimate the prevalence of HAI in Canadian acute care hospitals participating in the CNISP and compare to the previous reported survey conducted in 2002.

Methods: A point-prevalence study conducted in February 2009 in 49 hospitals across Canada. Information on HAI, utilization of antimicrobial agents, and isolation precautions was collected. The study design was similar to the 2002 protocol to ensure comparability of the results.

Results: 9953 patients were surveyed; 8599 (86.4%) were adults (≥18 years of age), 662 (6.4%) were 1 to 17 years of age , and 732 (7.4%) were infants under the age of 1 years. 1231 HAI were detected in 1173 patients, for a prevalence of 124 per 1000 patients surveyed, compared with 111 per 1000 in surveyed in 2002.  Adults were 1.7 times more likely to have an HAI compared to children and infants (12.3% vs. 7.2%, p < 0.0001).  The most common HAI was urinary tract infection (UTI), followed by pneumonia, surgical site infections (SSI), bloodstream infections (BSI), and Clostridium difficile disease (CDI) (Table).  3998 (40.2%) patients were on antimicrobial agents compared to 36.6% in 2002 (p < 0.0001) and 1470 (14.8%) were on isolation precautions in 2009 compared to 7.6% in 2002 (p < 0.0001).

Table 1:  Point prevalence: Comparison of 2002 and 2009 survey





P value

# hospitals




Surveyed patients





Per 1000 patients





p < 0.0001

UTI (%)



p < 0.0001

SSI (%)







p < 0.0001




p < 0.0001




p < 0.0001


Conclusions: In this follow-up national point prevalence study in Canada, the prevalence of HAI increased slightly largely attributed to an increased prevalence of UTI and CDI with a decrease in pneumonia and BSI.   There were also a significant increase in antimicrobial use and a doubling of prevalence of patients on isolation, the latter related to CDI and antimicrobial resistant organisms.   These data will also be useful to provide an estimate of the health burden of HAI in Canada