Can Commun Dis Rep. 2023 May 1;49(5):221-234. doi: 10.14745/ccdr.v49i05a08.
Healthcare-associated infections (HAIs) are a significant healthcare burden in Canada. National surveillance of HAIs at sentinel acute care hospitals is conducted by the Canadian Nosocomial Infection Surveillance Program. This article describes device and surgical procedure-related HAI epidemiology in Canada from 2017 to 2021.
Data were collected from over 60 Canadian sentinel acute care hospitals between January 1, 2017, and December 31, 2021, for central line-associated bloodstream infections (CLABSIs), hip and knee surgical site infections (SSIs), cerebrospinal fluid shunt SSIs and paediatric cardiac SSIs. Case counts, rates, patient and hospital characteristics, pathogen distributions and antimicrobial resistance data are presented.
Between 2017 and 2021, 2,898 device and surgical procedure-related infections were reported, with CLABSIs in intensive care units representing 69% (n=2,002) of all reported infections under surveillance. Significant rate increases were observed in adult mixed intensive care unit CLABSIs (1.08-2.11 infections per 1,000 line days, =0.014) while decreases were observed in SSIs following knee arthroplasty (0.34-0.27 infections per 100 surgeries, =0.05). No changes in trends were observed in the other reported HAIs. Of the 3,089 pathogens identified, the majority were gram-positive (66%), followed by gram negative (23%) and fungi (11%). Coagulase-negative staphylococci (22%) and (17%) were the most frequently isolated pathogens.
Epidemiological and microbiological trends among select device and surgical procedure-related HAIs are essential for benchmarking infection rates nationally and internationally, identifying any changes in infection rates or antimicrobial resistance patterns and helping inform hospital infection prevention and control and antimicrobial stewardship policies and programs.
医疗保健相关感染（HAIs）是加拿大医疗保健领域的一项重大负担。加拿大医院感染监测项目对定点急性护理医院的HAIs进行全国性监测。本文描述了2017年至2021年加拿大与器械和手术操作相关的HAIs流行病学情况。
收集了2017年1月1日至2021年12月31日期间加拿大60多家定点急性护理医院的以下数据：中心静脉导管相关血流感染（CLABSIs）、髋膝关节手术部位感染（SSIs）、脑脊液分流术SSIs和儿科心脏手术SSIs。呈现了病例数、发生率、患者和医院特征、病原体分布以及抗菌药物耐药性数据。
2017年至2021年期间，共报告了2898例与器械和手术操作相关的感染，其中重症监护病房的CLABSIs占所有报告的受监测感染的69%（n = 2002）。成人混合重症监护病房的CLABSIs发生率显著上升（每1000导管日1.08 - 2.11例感染，P = 0.014），而膝关节置换术后的SSIs发生率下降（每100例手术0.34 - 0.27例感染，P = 0.05）。其他报告的HAIs未观察到趋势变化。在鉴定出的3089种病原体中，大多数为革兰氏阳性菌（66%），其次是革兰氏阴性菌（23%）和真菌（11%）。凝固酶阴性葡萄球菌（22%）和金黄色葡萄球菌（17%）是最常分离出的病原体。
特定器械和手术操作相关HAIs的流行病学和微生物学趋势对于在国内和国际上设定感染率基准、识别感染率或抗菌药物耐药模式的任何变化以及为医院感染预防与控制和抗菌药物管理政策及项目提供信息至关重要。
