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The Canadian Nosocomial Infection Surveillance Program
CNISP Quick Links
Surveillance for Methicillin-resistant Staphylococcus aureus (MRSA) in Patients Hospitalized in Canadian Acute-Care Hospitals Participating in CNISP
2006-2007 Preliminary Results
Introduction
In 2007, 47 sentinel hospitals from nine Canadian provinces participated in the CNISP surveillance for MRSA and submitted data on MRSA cases for hospitalized patients 1 . The MRSA cases included in this surveillance consist of only the MRSA cases that are identified for the first time in one of the CNISP sentinel hospitals. It does not include MRSA cases previously identified at other CNISP sentinel hospitals, cases identified in emergency wards, clinics and outpatient settings or previously identified cases that are re-admitted with MRSA.
The denominator data for the calculation of the MRSA rates includes the number of patient admissions and the number of patient days for each hospital. Of the 47 participating CNISP hospitals, 17 admitted both adults and children, 23 admitted only adult, and 7 admitted only children. The list of participating hospitals is provided in the Appendix.
Results
There was a slight increase (1%) in the total number of cases reported to CNISP in 2007. There were a total of 5955 MRSA cases during the 2007 MRSA surveillance period compared to 5867 in 2006. The number of cases of MRSA acquired in the reporting CNISP hospitals decreased in 2007 by 8%; whereas there was an increase in the number of community-associated MRSA (CA-MRSA) of 6%.
Table 1. Site of MRSA acquisition, 2006-2007
|
2006 |
2007 |
Acquired in the Reporting CNISP Hospital |
3594 (61%) |
3147 (53%) |
Acquired in Another Acute Care Hospital |
475 (8%) |
541 (9%) |
Acquired in a Long-term Care Facility |
454 (8%) |
413 (7%) |
Acquired from Another Healthcare Exposure |
- |
103 (2%) |
Community-associated |
893 (15%) |
1227 (21%) |
Unknown |
411 (7%) |
524 (9%) |
Overall |
5867 |
5955 |
Overall MRSA Results
The overall MRSA results include all “newly identified” MRSA cases which are:
- Healthcare-Associated (formerly Nosocomial):
- Acquired in the reporting CNISP hospital
- Acquired in another acute-care hospital other than the reporting hospital
- Acquired in a long-term care facility
- Acquired from another healthcare exposure
- Community-associated 2
- Cases identified as acquisition unknown.
Table 2. 2006 overall MRSA incidence rate per 1,000 patient admissions and 10,000 patient days by region
|
Rate per 1,000 patient admissions |
Rate per 10,000 patient days |
||||
All |
Infection |
Colonization |
All |
Infection |
Colonization |
|
Western |
6.31 |
3.45 |
2.86 |
9.44 |
5.17 |
4.28 |
Central |
9.36 |
2.05 |
7.30 |
10.90 |
2.39 |
8.51 |
Eastern |
6.52 |
2.50 |
4.01 |
6.86 |
2.63 |
4.22 |
Overall |
7.75 |
2.67 |
5.14 |
9.90 |
3.39 |
6.51 |
Table 3. 2007 overall MRSA incidence rate per 1,000 patient admissions and 10,000 patient days by region
|
Rate per 1,000 patient admissions |
Rate per 10,000 patient days |
||||
All |
Infection |
Colonization |
All |
Infection |
Colonization |
|
Western |
7.30 |
3.56 |
3.63 |
11.74 |
5.72 |
5.85 |
Central |
10.12 |
1.75 |
8.10 |
12.58 |
2.18 |
10.06 |
Eastern |
6.70 |
2.70 |
4.00 |
7.57 |
3.05 |
4.52 |
Overall |
8.62 |
2.57 |
5.87 |
11.63 |
3.47 |
7.92 |
Healthcare-associated (HA-MRSA) to the Reporting CNISP Hospitals MRSA Results
The healthcare-associated to the reporting CNISP hospitals MRSA results includes all “newly identified” MRSA cases that were acquired in the participating CNISP hospitals.
Table 4. 2006 HA-MRSA to the reporting hospital incidence rates per 10,000 patient days
|
Rate per 10,000 patient days |
||
All |
Infection |
Colonization |
|
Western |
5.18 |
2.74 |
2.44 |
Central |
6.98 |
1.51 |
5.47 |
Eastern |
4.61 |
1.74 |
2.87 |
Overall |
6.07 |
1.97 |
4.09 |
Table 5. 2007 HA-MRSA to the reporting hospital incidence rates per 10,000 patient days
|
Rate per 10,000 patient days |
||
All |
Infection |
Colonization |
|
Western |
5.89 |
2.75 |
3.07 |
Central |
6.46 |
1.08 |
5.15 |
Eastern |
5.54 |
2.30 |
3.24 |
Overall |
6.15 |
1.79 |
4.20 |
Members of the Canadian Hospital Epidemiology Committee who participate in the surveillance for methicillin-resistant Staphylococcus aureus and their affiliated hospitals
Dr. Pamela Kibsey, Victoria, British Columbia
- Victoria General Hospital
- Royal Jubilee Hospital
Dr. Elizabeth Bryce, Vancouver, British Columbia
- Vancouver General Hospital
- Richmond General Hospital
- University of British Columbia Hospital
- Lion's Gate Hospital
- Powell River Hospital
- St. Mary's Hospital
- Squamish Hospital
Dr. Eva Thomas, Vancouver, British Columbia
- Children's and Women's Health Center
Dr. Elizabeth Henderson and Dr. John Conly, Calgary, Alberta
- Peter Lougheed Centre
- Rockyview General Hospital
- Foothills Hospital
- Alberta Children's Hospital
Dr. Geoffrey Taylor, Edmonton, Alberta
- University of Alberta Hospital
Dr. Sarah Forgie, Edmonton, Alberta
- Stollery Children's Hospital
Dr. Alice Wong, Saskatoon, Saskatchewan
- Royal University Hospital
Dr. John Embil, Winnipeg, Manitoba
- Health Sciences Centre,
Dr. Joanne Embree, Winnipeg, Manitoba
- University of Manitoba, Pediatric Infectious Diseases
Dr. Michael John, London, Ontario
- St. Joseph's Health Care, London
- Children's Hospital of Western Ontario
- London Health Sciences Centre
Dr. Michael Gardam, Toronto, Ontario
- University Health Network
- Toronto General Hospital
- Toronto Western Hospital
- Princess Margaret Hospital
Dr. Allison McGeer, Toronto, Ontarioo
- Mount Sinai Hospital
Dr. Andrew Simor and Dr. Mary Vearncombe, Toronto, Ontario
- Sunnybrook Health Science Centre
Dr. Anne Matlow, Toronto, Ontario
- The Hospital for Sick Children
Dr Mark Loeb, Hamilton, Ontario
- Hamilton Health Sciences, McMaster Site
- Hamilton Health Sciences, Chedoke Site
- St Joseph's Healthcare, Hamilton
- Hamilton Health Sciences, Henderson Site
- Hamilton Health Sciences, General Site
Dr. Virginia Roth, Ottawa, Ontario
- The Ottawa Hospital, Civic Site
- The Ottawa Hospital, General Site
- The Ottawa Heart Institute
Dr. Kathryn Suh, Ottawa, Ontario
- The Children's Hospital of Eastern Ontario
Dr. Dick Zoutman, Kingston, Ontario
- Kingston General Hospital
Dr. Mark Miller, Montreal, Quebec
- SMBD‑Jewish General Hospital, Montreal
Dr. Dorothy Moore, Montreal, Quebec
- Montreal Children's Hospital, McGill University Health Centre
Dr. Karl Weiss
- Maisonneuve-Rosemont Hospital
Dr. Charles Frenette, Longueuil, Québec
- Hôpital Charles Lemoyne
Dr. Sophie Michaud, Sherbrooke, Québec
- CHUS -Hôpital Fleurimont
- Hôtel-Dieu de Québec du CHUQ
Dr. William Thompson, Moncton, New Brunswick
- South East Regional Health Authority: The Moncton Hospital
Dr. Lynn Johnston, Halifax, Nova Scotia
- QE ll Health Sciences Centre
- Halifax Infirmary
- Victoria General Hospital
- Rehabilitation Centre
- Veterans Memorial Building
Dr. Joanne Langley, Halifax, Nova Scotia
- IWK Health Centre
Dr. Jim Hutchinson, St. John's, Newfoundland
- The General Hospital & Miller Centre Sites
- Janeway Site
- St. Clare Site
- MRSA case definition: Isolate of Staphylococcus aureus from any body site and resistance of the isolate to oxacillin.
- Definition for CA-MRSA: Patients were hospitalized for less than 72 hours AND have no history of an admission in an acute-care hospital or long-term facility in the previous 12 months AND have no indwelling medical devices.
