Surveillance for Health Care-Associated Infections, Antimicrobial Resistant Organisms and Antimicrobial use in Canadian Long-Term Care Homes: A Cross-Sectional Survey.

BACKGROUND

Our understanding of health care-associated infection (HAI), antimicrobial resistant organism (ARO), and antimicrobial use (AMU) surveillance activities across Canadian long-term care homes (LTCHs) is limited, in part because nationwide surveillance in this setting has yet to be established.

METHODS

To address this knowledge gap, the Canadian Nosocomial Infection Surveillance Program administered a 12-item cross-sectional survey to LTCHs across all provinces and territories in English and French. LTCHs were defined as government-licensed homes for individuals with medical needs who require 24-hour onsite access to registered nurse care and/or treatment.

RESULTS

Between June 1 and November 28, 2023, 770 of an estimated 2,076 LTCHs responded to the survey (37%). Of the respondents, 41% (318/770) were publicly funded, 67% (504/758) had between 51 and 200 long-term care beds, and 92% (694/758) reported having a designated person who leads infection prevention and control. The majority of LTCHs reported conducting outbreak surveillance (680/713, 95%) and surveillance for at least one type of HAI (672/740, 91%). The most common HAIs under surveillance were urinary tract infection (576/725, 79%), infection (546/725, 75%), and gastroenteritis (545/725, 75%). Half of the LTCHs reported testing new residents for AROs via pre-admission or admission cultures (368/713, 52%). Almost two-thirds (441/703, 63%) reported monitoring systemic antibiotic use.

CONCLUSIONS

Despite differences in the scope of surveillance activities, mechanisms to measure the burden of HAIs and AROs in this setting exist and may provide the foundation for future national surveillance activities. Generalizability to all Canadian LTCHs is uncertain due to possible sampling, non-response, and social desirability biases.