Can Commun Dis Rep. 2020 Nov 5;46(1112):387-397. doi: 10.14745/ccdr.v46i1112a05.
Healthcare-associated infections (HAIs) pose a serious risk to patient safety and quality of care. The Canadian Nosocomial Infection Surveillance Program (CNISP) conducts national surveillance of HAIs at sentinel acute-care hospitals across Canada. This report provides an overview of 10 years of Canadian data on the epidemiology of select device-associated HAIs.
Over 40 hospitals submitted data between 2009 and 2018 for hip and knee surgical site infections (SSIs), cerebrospinal fluid shunt SSIs, paediatric cardiac SSIs and/or central line-associated bloodstream infections (CLABSIs). Counts, rates, patient and hospital characteristics, as well as pathogen distributions and antimicrobial susceptibilities are presented.
A total of 4,300 device-associated infections were reported. Central line-associated bloodstream infections were the most common device-associated HAI reported (n=2,973, 69%) and hip and knee arthroplasty infections were the most common SSIs reported (66% of SSIs). Our findings show decreasing CLABSI rates in neonatal intensive care units (4.2 to 1.9 per 1,000 line-days, <0.0001) and decreasing knee SSI rates (0.69 to 0.30 infections per 100 surgeries, =0.007). Rates of device-associated HAIs have remained relatively consistent over the 10-year surveillance period. Overall, 4,599 pathogens were identified from device-associated HAI; 70% of these were related to CLABSIs. Coagulase-negative staphylococci (29%) and (14%) were the most frequently reported pathogens. Gram-positive pathogens represented 68% of identified pathogens, gram-negative pathogens represented 22% and fungi represented 9%.
Understanding the national burden of device-associated HAIs is essential for developing and maintaining benchmark rates for informing infection and prevention control and antimicrobial stewardship policies and programs.
医疗保健相关感染（HAIs）对患者安全和医疗质量构成严重风险。加拿大医院感染监测计划（CNISP）在加拿大各地的定点急症护理医院开展全国性HAIs监测。本报告概述了加拿大10年来特定器械相关HAIs的流行病学数据。
2009年至2018年期间，40多家医院提交了髋膝关节手术部位感染（SSIs）、脑脊液分流SSIs、儿科心脏SSIs和/或中心静脉导管相关血流感染（CLABSIs）的数据。报告了感染例数、发生率、患者和医院特征，以及病原体分布和抗菌药物敏感性。
共报告了4300例器械相关感染。中心静脉导管相关血流感染是报告的最常见的器械相关HAI（n = 2973，69%），髋膝关节置换感染是报告的最常见的SSI（占SSI的66%）。我们的研究结果显示，新生儿重症监护病房的CLABSI发生率下降（从每1000导管日4.2例降至1.9例，P<0.0001），膝关节SSI发生率下降（从每100例手术0.69例感染降至0.30例，P = 0.007）。在10年的监测期内，器械相关HAIs的发生率保持相对稳定。总体而言，从器械相关HAI中鉴定出4599种病原体；其中70%与CLABSIs有关。凝固酶阴性葡萄球菌（29%）和大肠杆菌（14%）是报告最频繁的病原体。革兰氏阳性病原体占已鉴定病原体的68%，革兰氏阴性病原体占22%，真菌占9%。
了解器械相关HAIs的全国负担对于制定和维持基准发生率至关重要，可为感染预防控制和抗菌药物管理政策及计划提供参考。
