Hospital-Wide Healthcare-associated Bloodstream Infections : surveillance results 2014–2015

Hospital-Wide Healthcare-associated Bloodstream Infections
Surveillance results: 2014-2015

From April 1st, 2014, to March 31st, 2015, 88 healthcare facilities took part in the hospital-wide surveillance of bloodstream infections (BSIs), for a combined total of 4,733,772 patient-days (Table 1). Participating facilities reported 3,035 BSIs in 2,832 patients. The total incidence rate was 5.3 cases per 10,000 patient-days. The incidence rate in 2014–2015 was significantly lower compared to the average rate for 2010–2014 in facilities that took part in both surveillance periods. Two teaching and 10 non-teaching facilities joined the program in 2014–2015 and one stopped participating; in addition, four facilities are not counted anymore in the 2013-2014 surveillance results, having provided data for less than 11 periods for this surveillance year. Data was extracted on May 20th, 2015.

Updated : March 29, 2016

Table 1 – Participation of Healthcare Facilities in the Hospital-Wide Surveillance of BSIs, Québec, 2010–2011 to 20142015

 

2010-2011

2011-2012

2012-2013

2013-2014

2014-2015

Participating facilities (N)

56

59

64

73

88

Admissions (N)

389,274

409,435

482,354

520,772

633,155

Patient-days (N)

3,152,924

3,226,042

3,791,482

3,998,173

4,733,772

BSIs (cat. 1a, 1b and 1c, N)

2,338

2,228

2,665

2,459

3,035

Infected patients (N)

2,170

2,129

2,550

2,297

2,832

In 2014–2015, the total incidence rate was 5.3 BSIs per 10,000 patient days. Incidence rates were much higher in intensive care units (ICUs) than in other units (Table 2). Catheter-related bloodstream infections (CRBSIs) were the most common BSIs in ICUs (Table 2 and Figure 2). In other units, the incidence rates varied depending on the type of healthcare facility: non-CRBSI were the most common primary BSIs in teaching facilities, while BSIs secondary to urinary tract infections were the most common in non-teaching facilities (Table 2 and Figure 3). In teaching facilities, in non-intensive care units, the CRBSI incidence rate (1.0 case / 10,000 patient-days) increases to 1.5 case / 10,000 patient-days when CRBSI associated with a mucosal barrier injury (MBI) are also considered.

Figure 1 – BSI Incidence Rate for Each Type of Infection, by Type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Figure 1 – BSI Incidence Rate for Each Type of Infection, by Type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Figure 2 – BSI Incidence Rate in ICUs, For Each Type of Infection, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Figure 2 – BSI Incidence Rate in ICUs, For Each Type of Infection, by Type of Healthcare Facility and Type of ICU, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Figure 3 – BSI Incidence Rate in Non-ICU Units, for Each Type of Infection, by Type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Figure 3 – BSI Incidence Rate in Non-ICU Units, for Each Type of Infection, by Type of Healthcare Facility, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Table 2 – BSI Incidence Rate for Each Type of Infection, by Type of Healthcare Facility, Type of Unit and Type of ICU, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

 

 

Primary BSIs

Secondary BSIs

Total

 

CRBSI-MBI

CRBSI

Non-CRBSI - MBI

Non-CRBSI

Urinary tract

Abdominal

Pulmonary

SSI

Other**

Total hospitalized

0.2
[0.2 ; 0.3]

0.9
[0.8 ; 0.9]

0*

1.1
[1 ; 1.2]

1.3
[1.2 ; 1.4]

0.5
[0.4 ; 0.5]

0.5
[0.5 ; 0.6]

0.5
[0.5 ; 0.6]

0.4
[0.3 ; 0.4]

5.3
[5.1 ; 5.5]

Teaching

0.4
[0.4 ; 0.5]

1.3
[1.2 ; 1.5]

0*

1.4
[1.3 ; 1.6]

1.3
[1.2 ; 1.5]

0.7
[0.6 ; 0.8]

0.6
[0.5 ; 0.7]

0.8
[0.7 ; 0.9]

0.5
[0.4 ; 0.6]

7.2
[6.8 ; 7.5]

Non;teaching

0*

0.4
[0.3 ; 0.5]

0*

0.7
[0.6 ; 0.8]

1.2
[1.1 ; 1.4]

0.3
[0.2 ; 0.3]

0.4
[0.4 ; 0.5]

0.3
[0.2 ; 0.3]

0.3
[0.2 ; 0.3]

3.7
[3.4 ; 3.9]

ICUs

0.1
[0 ; 0.3]

4.5
[3.7 ; 5.3]

0*

2.3
[1.8 ; 2.9]

1.5
[1.1 ; 1.9]

1.4
[1 ; 1.8]

2.8
[2.2 ; 3.5]

1.1
[0.8 ; 1.6]

0.7
[0.4 ; 1]

14.4
[13.1 ; 15.8]

Adult teaching

0.3
[0.1 ; 0.7]

3.5
[2.6 ; 4.6]

0*

2.4
[1.7 ; 3.4]

1.5
[0.9 ; 2.3]

1.8
[1.2 ; 2.6]

3.5
[2.6 ; 4.6]

1.8
[1.2 ; 2.6]

0.8
[0.4 ; 1.3]

15.9
[13.8 ; 18.1]

Adult non;teaching

0*

3.8
[2.6 ; 5.3]

0*

2
[1.2 ; 3]

2.1
[1.2 ; 3.2]

0.8
[0.3 ; 1.5]

3.8
[2.6 ; 5.3]

1
[0.5 ; 1.8]

0.3
[0.1 ; 0.9]

14
[11.6 ; 16.6]

Pediatric

0*

11.9
[6.6 ; 18.6]

0*

2.4
[0.4 ; 5.8]

0*

0*

0.8
[0 ; 3.1]

0.8
[0 ; 3.1]

0*

15.8
[9.6 ; 23.5]

Neonatal

0*

5.7
[4 ; 7.6]

0*

2.3
[1.3 ; 3.6]

0.9
[0.3 ; 1.7]

1.5
[0.7 ; 2.5]

0.6
[0.2 ; 1.3]

0*

1
[0.4 ; 1.9]

12
[9.5 ; 14.7]

Non;ICU units

0.2 [0.2 ; 0.3]

0.6
[0.5 ; 0.7]

0*

1
[0.9 ; 1.1]

1.3
[1.2 ; 1.4]

0.4
[0.3 ; 0.5]

0.4
[0.3 ; 0.4]

0.5
[0.4 ; 0.6]

0.3
[0.3 ; 0.4]

4.7
[4.5 ; 4.9]

Teaching

0.5
[0.4 ; 0.6]

1
[0.8 ; 1.1]

0*

1.3
[1.2 ; 1.5]

1.3
[1.2 ; 1.5]

0.6
[0.5 ; 0.7]

0.5
[0.4 ; 0.6]

0.8
[0.7 ; 0.9]

0.4
[0.3 ; 0.5]

6.4
[6 ; 6.7]

Non;teaching

0*

0.3
[0.2 ; 0.4]

0*

0.7
[0.6 ; 0.8]

1.2
[1.1 ; 1.3]

0.3
[0.2 ; 0.3]

0.3
[0.2 ; 0.4]

0.2
[0.2 ; 0.3]

0.3
[0.2 ; 0.3]

3.3
[3.1 ; 3.5]

* When the incidence rate is 0, the confidence interval [CI] is not calculated.
** The “Other” column also includes HD-related BSIs and secondary BSIs arising from a skin, soft tissue, bone or joint infection.

The BSI incidence rate in 2014–2015 decreased significantly compared to the 2010–2014 pooled rate (p < 0.01, Table 3). This results from the significant decrease observed in teaching facilities (p < 0.01), while incidence rates remained stable in non-teaching facilities. This downward trend was observed for every BSI type except for non-CRBSIs (Figure 4). Observed variations were significant for CRBSI (p < 0.01), non-CRBSI (p < 0.01), hemodialysis-related BSIs
(p < 0.01) and BSIs secondary to a surgical site infection (SSI) (p < 0.01).

Figure 4 – BSI Incidence Rate, by Type of Infection, in Facilities that Previously participated in Surveillance (N = 75), Québec, 2010–2014 and 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Figure 4 – BSI Incidence Rate, by Type of Infection, in Facilities that Previously participated in Surveillance (N = 75), Québec, 2010–2014 and 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Table 3 – BSI Incidence Rate, by Type of Healthcare Facility, in Facilities that Previously participated in Surveillance (N = 75), Québec, 2010–2014 and 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

 

Number of Facilities

Incidence Rate

2010-2014

2014-2015

Teaching facilities

22

7.8 [7.6 ; 8.0]

7.1 [6.7 ; 7.5]*

Non-teaching facilities

53

3.6 [3.4 ; 3.7]

3.5 [3.3 ; 3.8]

Total

75

5.7 [5.6 ; 5.8]

5.3 [5.1 ; 5.5]*

* Statistically significant difference (p < 0.01). 

Patients who developed a BSI were aged between 0 and 102 years, with a median age of 69 years. Although the incidence rates were higher in ICUs, most BSIs occurred in non-ICU units (69%, Table 4 and Figure 5). CRBSIs were the most commonly encountered BSIs in ICUs, whereas BSIs secondary to urinary tract infections were the most common in non-ICU units. Non-CRBSIs were the most frequent type of BSI in teaching facilities, whereas BSIs originating from a urinary tract infection ranked first among non-teaching facilities (Table 4 and Figure 6). At least one procedure was reported for 38% (257 / 668) of non-CRBSIs.

Figure 5 – Breakdown of Cases Based on Type of Unit and Type of ICU, Québec, 2014–2015 (%)

Figure 5 – Breakdown of Cases Based on Type of Unit and Type of ICU, Québec, 2014–2015 (%)

Figure 6 – Breakdown of Cases Based on Type of BSI, for Teaching and Non-Teaching Healthcare Facilities, Québec, 2014–2015 (%)

Figure 6 – Breakdown of Cases Based on Type of BSI, for Teaching and Non-Teaching Healthcare Facilities, Québec, 2014–2015 (%)

Table 4 – Number of Cases for Each Type of BSI, by Type of Healthcare Facility, Type of Unit and Type of ICU, Québec, 2014–2015 (N)

 

Primary BSIs

Secondary BSIs

Total

 

CRBSI-MBI

CRBSI

Non-CRBSI - MBI

Non-CRBSI

HD

Urinary tract

Abdominal

Pulmonary

SSI

Other*

Total

102

502

0

668

152

670

231

253

271

186

3,035

Teaching

99

375

0

423

97

326

157

145

195

110

1,927

Non-teaching

3

127

0

245

55

344

74

108

76

76

1,108

Total hospitalized

102

406

0

500

19

600

221

251

254

172

2,525

Teaching

99

301

0

321

16

296

152

145

187

106

1,623

Non-teaching

3

105

0

179

3

304

69

106

67

66

902

ICU

4

133

0

68

2

44

41

84

34

20

430

Adult, teaching

4

46

0

32

2

20

24

46

24

10

208

Adult, non-teaching

0

33

0

17

0

18

7

33

9

3

120

Pediatric

0

15

0

3

0

0

0

1

1

0

20

Neonatal

0

39

0

16

0

6

10

4

0

7

82

Non-ICU hospitalization

98

273

0

432

17

556

180

167

220

152

2,095

Teaching

95

201

0

270

14

270

118

94

162

89

1,313

Non-teaching

3

72

0

162

3

286

62

73

58

63

782

Ambulatory

0

96

0

168

133

70

10

2

17

14

510

Teaching

0

74

0

102

81

30

5

0

8

4

304

Non-teaching

0

22

0

66

52

40

5

2

9

10

206

* The “Other” column also includes BSIs secondary to skin, soft tissue, bone or joint infection.

Overall, 19% of BSI cases resulted in death within 30 days of bacteremia onset (Table 5). Case fatality was highest in patients with a BSI secondary to a pulmonary infection (Table 5 and Figure 7).

Figure 7 – 30-Day Case Fatality for Each Type of Infection, Québec, 2014–2015 (%)

Figure 7 – 30-Day Case Fatality for Each Type of Infection, Québec, 2014–2015 (%)

Table 5 – 10-Day and 30-Day Case Fatality for Each Type of Infection, 2014–2015 (N, %)

 

BSIs (N)

10-day case fatality

30-day case fatality

N

%

N

%

Primary BSIs

         

CRBSI-MBI

102

1

1

7

7

CRBSI

502

35

7

64

13

Non-CRBSI-MBI

0

0

-

0

-

Non-CRBSI

668

137

21

161

24

HD

152

8

5

19

13

Secondary BSIs

         

Urinary tract

670

60

9

102

15

Abdominal

231

45

19

61

26

Pulmonary

253

77

30

101

40

SSI

271

18

7

30

11

Skin and soft tissue

94

17

18

22

23

Bone and joint

25

3

12

6

24

Other

67

5

7

9

13

Total

3,035

406

13

582

19

The two most frequently isolated microorganisms in reported cases and in cases resulting in death within 30 days were Staphylococcus aureus and Escherichia coli (Figure 8 and Table 6). Coagulase-negative staphylococci (CoNS) were the most frequently isolated microorganisms in patients with a CRBSI (Figure 9 and Table 6). S. aureus was the most frequently isolated microorganism in hemodialysis-related BSIs and in BSIs secondary to a pulmonary infection or a SSI.  In patients with a non-CRBSI, CRBSI-MBI or a BSI secondary to a urinary tract or abdominal infection, enterobacteria were the most common microorganisms. A polymicrobial infection occurred in 7% of cases.

Figure 8 – Breakdown of Categories of Isolated Microorganisms in All Cases (N = 3,287) and Cases of Fatality Within 30 Days (N = 646), Québec, 2014–2015 (%)

Isolated Microorganisms—All Cases
Figure 8 – Breakdown of Categories of Isolated Microorganisms in All Cases (N = 3,287) and Cases of Fatality Within 30 Days (N = 646), Québec, 2014–2015 (%)

 Isolated Microorganisms—Fatality Within 30 Days

Figure 8 – Breakdown of Categories of Isolated Microorganisms in All Cases (N = 3,287) and Cases of Fatality Within 30 Days (N = 646), Québec, 2014–2015 (%)

Figure 9 – Breakdown of Categories of Isolated Microorganisms, for Each Type of BSI, Québec, 2014–2015 (%)

Figure 9 – Breakdown of Categories of Isolated Microorganisms, for Each Type of BSI, Québec, 2014–2015 (%)

Table 6 – Breakdown of Microorganisms associated with BSIs, for each Type of BSI, for all BSIs and for those associated with a Fatality Within 30 Days, Québec, 2014–2015 (N, %)

Microorganism

Primary BSIs

Secondary BSIs

Overall*

30-Day Case Fatality

CRBSI-MBI

CRBSI

Non-CRBSI - MBI

Non-CRBSI

HD

Urinary tract

Abdominal

Pulmonary

SSI

N

%

Enterobacteria

74

0

0

354

23

489

145

78

72

1,332

229

17.2

  E. coli

36

12

0

189

2

309

77

29

29

705

132

18.7

  Klebsiella sp.

24

20

0

89

7

87

44

27

22

328

51

15.5

  Other enterobacteriaceae

14

29

0

76

14

93

24

22

21

299

46

15.4

S. aureus

0

160

0

94

87

47

9

97

94

676

164

24.3

CNS

0

165

0

28

22

11

3

1

12

248

27

10.9

Enterococcus sp.

12

46

0

81

7

80

42

6

17

306

62

20.3

Candida sp.

3

44

0

26

2

23

10

15

12

135

42

31.1

Anaerobic

5

3

0

14

2

2

24

4

53

111

24

21.6

Pseudomonas sp.

0

16

0

40

5

27

10

18

4

130

28

21.5

Other

16

53

0

97

11

19

28

53

30

349

70

20.1

Total

110

487

0

734

159

698

271

272

294

3,287

646

19.7

* This column includes the sum of the other columns as well as secondary BSIs arising from a skin, soft tissue, bone or joint infection, or another source.

Methicillin-resistant S. aureus (MRSA) accounted for 18% (118 / 672) of S. aureus BSIs in all geographic areas (Table 7 and Figure 10). BSIs associated with carbapenem-resistant enterobacteriaceae continued to be relatively rare in Québec.

Table 7 – Proportion of Strains Tested and Proportion of Resistance to Antibiotics for Selected Isolated Microorganisms, Québec, 2014–2015 (N, %)

Microorganism

Antibiotic

Isolated (N)

Tested

Resistant

N

%

N

%

Staphylococcus aureus

Oxacillin

676

672

99.4

118

17.6

Enterococcus faecium

Vancomycin

97

97

100.0

16

16.5

Enterococcus faecalis

Vancomycin

167

167

100.0

1

0.6

Klebsiella (pneumoniae/oxytoca)

CSE 4

328

259

79.0

18

6.9

Imipenem or meropenem

328

188

57.3

2

1.1

Multiresistant 1

328

290

88.4

14

4.8

Escherichia coli

CSE 4

705

539

76.5

62

11.5

Fluoroquinolones 3

705

643

91.2

167

26.0

Imipenem or meropenem

705

379

53.8

0

-

Multiresistant 1

705

600

85.1

31

5.2

Enterobacter sp.

CSE 4

156

137

87.8

29

21.2

Imipenem or meropenem

156

92

59.0

0

0.0

Multiresistant 1

156

136

87.2

3

2.2

Pseudomonas sp.

Amikacin, gentamicin or tobramycin

130

97

74.6

2

2.1

CSE 2

130

118

90.8

7

5.9

Fluoroquinolones 2

130

120

92.3

9

7.5

Imipenem or meropenem

130

106

81.5

10

9.4

Piperacillin/tazobactam

130

82

63.1

6

7.3

Multiresistant 2

130

123

94.6

7

5.7

Acinetobacter sp.

Imipenem or meropenem

11

10

90.9

0

0.0

Multiresistant 3

11

2

18.2

0

0.0

CSE 4 : cefepime, cefotaxime, ceftazidime or ceftriaxone; CSE 2: cefepime or ceftazidime.
Fluoroquinolones 3 : ciprofloxacin, levofloxacin or moxifloxacin; Fluoroquinolones 2: ciprofloxacin or levofloxacin.
Multiresistant 1 : intermediate or resistant to an agent in three of the following five categories: cephalosporins 4, fluoroquinolones 3, aminoglycosides, carbapenems, piperacillin or piperacillin/tazobactam.
Multiresistant 2 : intermediate or resistant to an agent in three of the following five categories: cephalosporins 2, fluoroquinolones 2, aminoglycosides, carbapenems, piperacillin or piperacillin/tazobactam.
Multiresistant 3 : intermediate or resistant to an agent in three of the following six categories: cephalosporins 2, fluoroquinolones 2, aminoglycosides, carbapenems, piperacillin or piperacillin/tazobactam, ampicillin/sulbactam.

Figure 10 – Antibiotic Resistance in Gram-Positive Bacteria, Gram-Negative Bacteria and Pseudomonas sp., Québec, 2010–2014 to 2014–2015 (%)

Figure 10 – Antibiotic Resistance in Gram-Positive Bacteria, Gram-Negative Bacteria and Pseudomonas sp., Québec, 2010–2014 to 2014–2015 (%)

One teaching and 6 non-teaching facilities had an incidence rate above the 90th percentiles of 2010-2014 incidence rates (Figures 11 and 12). Tables 8 and 9 present 2014-2015 rates of CRBSI and of BSIs secondary to urinary tract and pulmonary infections, per healthcare facility.

Figure 11 – BSI Incidence Rate per Facility (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014) for Teaching Healthcare Facilities, Québec, 2014–2015

Figure 11 – BSI Incidence Rate per Facility (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014) for Teaching Healthcare Facilities, Québec, 2014–2015

Figure 12 – BSI Incidence Rate per Facility (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014) for Non-Teaching Healthcare Facilities, Québec, 2014–2015

Figure 12 – BSI Incidence Rate per Facility (2014–2015) and Percentile Ranking (2010–2011 to 2013–2014) for Non-Teaching Healthcare Facilities, Québec, 2014–2015

Table 8 – Incidence Rates of CRBSI and of BSIs Secondary to Urinary Tract and Pulmonary Infections per Facility and Percentile Ranking, for Teaching Healthcare Facilities, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Facility

CRBSI

 

Urinairy

 

Pulmonary

 

 

Cases (n)

Incidence rates

 

Cases (n)

Incidence rates

 

Cases (n)

Incidence rates

1

HÔPITAL CHARLES LEMOYNE

9

0.7

[0.3 ; 1.2]

 

6

0.5

[0.2 ; 0.9]

 

8

0.6

[0.3 ; 1.1]

2

HÔPITAL DE L'ENFANT-JÉSUS

13

1.0

[0.5 ; 1.6]

 

28

2.1

[1.4 ; 3.0]

 

4

0.3

[0.1 ; 0.7]

3

HÔPITAL ROYAL VICTORIA

26

2.4

[1.5 ; 3.4]

 

21

1.9

[1.2 ; 2.8]

 

11

1.0

[0.5 ; 1.7]

4

HÔPITAL NOTRE-DAME DU CHUM

20

1.8

[1.1 ; 2.7]

 

22

2.0

[1.2 ; 2.9]

 

17

1.5

[0.9 ; 2.3]

6

L'HÔPITAL DE MONTRÉAL POUR ENFANTS

24

6.5

[4.2 ; 9.4]

 

0

0.0

-

 

0

0.0

-

7

PAVILLON L'HÔTEL-DIEU DE QUÉBEC

13

1.5

[0.8 ; 2.5]

 

23

2.7

[1.7 ; 4.0]

 

11

1.3

[0.7 ; 2.2]

8

PAVILLON MAISONNEUVE/PAVILLON MARCEL-LAMOUREUX

25

1.4

[0.9 ; 1.9]

 

20

1.1

[0.7 ; 1.6]

 

10

0.5

[0.3 ; 0.9]

12

CENTRE HOSPITALIER UNIVERSITAIRE SAINTE-JUSTINE

47

5.1

[3.8 ; 6.7]

 

6

0.7

[0.2 ; 1.3]

 

3

0.3

[0.1 ; 0.8]

13

INSTITUT DE CARDIOLOGIE DE MONTRÉAL

3

0.7

[0.1 ; 1.7]

 

4

0.9

[0.2 ; 2.1]

 

3

0.7

[0.1 ; 1.7]

15

HÔPITAL FLEURIMONT

7

0.6

[0.3 ; 1.2]

 

21

1.9

[1.2 ; 2.9]

 

11

1.0

[0.5 ; 1.7]

18

HÔTEL-DIEU DE LÉVIS

10

1.3

[0.6 ; 2.3]

 

15

2.0

[1.1 ; 3.1]

 

6

0.8

[0.3 ; 1.6]

20

HÔPITAL DE CHICOUTIMI

4

0.5

[0.1 ; 1.1]

 

9

1.1

[0.5 ; 1.9]

 

4

0.5

[0.1 ; 1.1]

21

HÔPITAL SAINT-LUC DU CHUM

9

0.9

[0.4 ; 1.6]

 

16

1.6

[0.9 ; 2.4]

 

2

0.2

[0.0 ; 0.6]

22

HÔTEL-DIEU DU CHUM

14

1.9

[1.0 ; 3.0]

 

13

1.8

[0.9 ; 2.8]

 

8

1.1

[0.5 ; 2.0]

24

HÔPITAL DU SAINT-SACREMENT

0

0.0

-

 

7

1.3

[0.5 ; 2.4]

 

0

0.0

-

25

HÔPITAL DU SACRÉ-COEUR DE MONTRÉAL

37

2.5

[1.8 ; 3.4]

 

33

2.3

[1.6 ; 3.1]

 

13

0.9

[0.5 ; 1.4]

27

PAVILLON CENTRE HOSPITALIER DE L'UNIVERSITÉ LAVAL

10

0.8

[0.4 ; 1.4]

 

7

0.6

[0.2 ; 1.1]

 

1

0.1

[0.0 ; 0.3]

28

PAVILLON SAINT-FRANCOIS D'ASSISE

3

0.3

[0.1 ; 0.8]

 

7

0.8

[0.3 ; 1.5]

 

4

0.4

[0.1 ; 1.0]

29

HÔPITAL GÉNÉRAL DE MONTRÉAL

10

1.2

[0.6 ; 2.0]

 

13

1.5

[0.8 ; 2.5]

 

18

2.1

[1.3 ; 3.2]

30

HÔTEL-DIEU DE SHERBROOKE

2

0.3

[0.0 ; 0.8]

 

2

0.3

[0.0 ; 0.8]

 

3

0.4

[0.1 ; 1.1]

31

PAVILLON SAINT-JOSEPH

1

0.1

[0.0 ; 0.3]

 

12

0.9

[0.5 ; 1.6]

 

3

0.2

[0.0 ; 0.6]

33

INSTITUT UNIVERSITAIRE DE CARDIOLOGIE ET DE PNEUMOLOGIE DE QUÉBEC

5

0.5

[0.2 ; 1.1]

 

3

0.3

[0.1 ; 0.8]

 

0

0.0

-

48

CENTRE HOSPITALIER DE ST. MARY

5

0.6

[0.2 ; 1.3]

 

6

0.7

[0.3 ; 1.5]

 

2

0.2

[0.0 ; 0.7]

116

INSTITUT THORACIQUE DE MONTRÉAL

2

1.3

[0.1 ; 3.8]

 

0

0.0

-

 

0

0.0

-

118

HÔPITAL NEUROLOGIQUE DE MONTRÉAL

2

0.8

[0.1 ; 2.3]

 

2

0.8

[0.1 ; 2.3]

 

3

1.2

[0.2 ; 3.0]

Table 9 – Incidence Rates of CRBSI and of BSIs Secondary to Urinary Tract and Pulmonary Infections per Facility and Percentile Ranking, for Non-Teaching Healthcare Facilities, Québec, 2014–2015 (Incidence Rate per 10,000 Patient-Days [95% CI])

Facility

CRBSI

Urinary Tract

Pulmonary

 

 

Cases (n)

Incidence rates

Cases (n)

Incidence rates

Cases (n)

Incidence rates

9

HÔPITAL DU HAUT-RICHELIEU

5

0.6

[0.2 ; 1.2]

7

0.8

[0.3 ; 1.5]

5

0.6

[0.2 ; 1.2]

10

HÔPITAL PIERRE-BOUCHER

8

0.7

[0.3 ; 1.3]

16

1.5

[0.8 ; 2.3]

2

0.2

[0.0 ; 0.5]

11

HÔPITAL PIERRE-LE GARDEUR

4

0.4

[0.1 ; 0.8]

21

1.9

[1.2 ; 2.8]

7

0.6

[0.3 ; 1.2]

14

CENTRE HOSPITALIER RÉGIONAL DE LANAUDIÈRE

3

0.3

[0.1 ; 0.8]

12

1.3

[0.6 ; 2.1]

6

0.6

[0.2 ; 1.2]

16

HÔPITAL RÉGIONAL DE RIMOUSKI

4

0.8

[0.2 ; 1.7]

7

1.3

[0.5 ; 2.5]

0

0.0

-

19

HÔPITAL CITÉ DE LA SANTÉ

15

0.9

[0.5 ; 1.4]

25

1.4

[0.9 ; 2.1]

6

0.3

[0.1 ; 0.7]

23

HÔTEL-DIEU D'ARTHABASKA

1

0.2

[0.0 ; 0.8]

0

0.0

-

3

0.6

[0.1 ; 1.4]

26

HÔPITAL DE VERDUN

10

1.4

[0.7 ; 2.4]

14

1.9

[1.1 ; 3.1]

5

0.7

[0.2 ; 1.4]

32

CENTRE HOSPITALIER RÉGIONAL DU GRAND-PORTAGE

0

0.0

-

2

0.7

[0.1 ; 2.0]

0

0.0

-

34

HÔPITAL SANTA CABRINI

1

0.1

[0.0 ; 0.4]

11

1.1

[0.5 ; 1.8]

8

0.8

[0.3 ; 1.4]

35

HÔPITAL HONORÉ-MERCIER

4

0.6

[0.2 ; 1.3]

8

1.2

[0.5 ; 2.1]

3

0.4

[0.1 ; 1.1]

36

HÔPITAL GÉNÉRAL DU LAKESHORE

6

0.9

[0.3 ; 1.7]

17

2.5

[1.4 ; 3.8]

10

1.5

[0.7 ; 2.5]

37

HÔTEL-DIEU DE SOREL

5

1.0

[0.3 ; 2.1]

7

1.4

[0.6 ; 2.7]

1

0.2

[0.0 ; 0.8]

38

HÔPITAL JEAN-TALON

0

0.0

-

18

3.4

[2.0 ; 5.2]

2

0.4

[0.0 ; 1.1]

39

HÔPITAL DE GATINEAU

0

0.0

-

9

1.5

[0.7 ; 2.6]

4

0.7

[0.2 ; 1.5]

40

HÔPITAL DE HULL

3

0.5

[0.1 ; 1.1]

8

1.2

[0.5 ; 2.2]

9

1.4

[0.6 ; 2.4]

41

HÔPITAL DU CENTRE-DE-LA-MAURICIE

0

0.0

-

2

0.5

[0.0 ; 1.3]

1

0.2

[0.0 ; 0.9]

42

CENTRE HOSPITALIER ANNA-LABERGE

1

0.1

[0.0 ; 0.5]

9

1.2

[0.5 ; 2.1]

1

0.1

[0.0 ; 0.5]

44

HÔPITAL SAINTE-CROIX

2

0.4

[0.0 – 1.0]

3

0.5

[0.1 ; 1.3]

1

0.2

[0.0 ; 0.7]

45

HÔPITAL DE SAINT-EUSTACHE

2

0.2

[0.0 ; 0.6]

8

0.9

[0.4 ; 1.6]

5

0.6

[0.2 ; 1.1]

46

HÔPITAL DE GRANBY

1

0.2

[0.0 ; 0.8]

4

0.9

[0.2 ; 1.9]

3

0.6

[0.1 ; 1.6]

47

HÔPITAL DE ROUYN-NORANDA

0

0.0

-

2

0.8

[0.1 ; 2.3]

1

0.4

[0.0 ; 1.6]

49

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX MEMPHRÉMAGOG

0

0.0

-

1

0.7

[0.0 ; 2.6]

0

0.0

-

51

HÔPITAL DE MANIWAKI

0

0.0

-

0

0.0

-

0

0.0

-

52

HÔPITAL D'AMOS

0

0.0

-

3

1.3

[0.3 ; 3.3]

0

0.0

-

53

HÔPITAL DE CHANDLER

0

0.0

-

1

0.7

[0.0 ; 2.7]

1

0.7

[0.0 ; 2.7]

56

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX D'ARGENTEUIL

1

0.7

[0.0 ; 2.8]

1

0.7

[0.0 ; 2.8]

0

0.0

-

58

HÔPITAL DU SUROÎT

3

0.5

[0.1 ; 1.3]

18

3.2

[1.9 ; 4.9]

4

0.7

[0.2 ; 1.6]

59

HÔPITAL DE BAIE-SAINT-PAUL

0

0.0

-

0

0.0

-

0

0.0

-

61

HÔPITAL NOTRE-DAME-DE-FATIMA

0

0.0

-

0

0.0

-

0

0.0

-

63

HÔPITAL DE SAINT-GEORGES

0

0.0

-

2

0.5

[0.0 ; 1.4]

1

0.2

[0.0 ; 1.0]

64

HÔPITAL LE ROYER

0

0.0

-

3

1.2

[0.2 ; 2.9]

1

0.4

[0.0 ; 1.5]

65

HÔPITAL ET CLSC DE VAL-D'OR

0

0.0

-

4

1.4

[0.4 ; 3.1]

1

0.4

[0.0 ; 1.4]

67

HÔPITAL ET CENTRE DE RÉADAPTATION DE JONQUIÈRE

0

0.0

-

9

2.3

[1.0 ; 4.1]

0

0.0

-

70

CENTRE DE SOINS DE COURTE DURÉE LA SARRE

0

0.0

-

0

0.0

-

0

0.0

-

71

HÔPITAL DE MATANE

0

0.0

-

0

0.0

-

0

0.0

-

72

HÔPITAL ET CENTRE D'HÉBERGEMENT DE SEPT-ÎLES

0

0.0

-

0

0.0

-

2

0.8

[0.1 ; 2.3]

74

HÔPITAL DE DOLBEAU-MISTASSINI

1

0.6

[0.0 ; 2.5]

0

0.0

-

0

0.0

-

Facility

CRBSI

Urinary Tract

Pulmonary

 

 

Cases (n)

Incidence rates

Cases (n)

Incidence rates

Cases (n)

Incidence rates

75

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU GRANIT

0

0.0

-

1

0.8

[0.0 ; 3.2]

0

0.0

-

76

HÔPITAL DE LACHINE

2

1.1

[0.1 ; 3.3]

9

5.1

[2.3 ; 9.0]

2

1.1

[0.1 ; 3.3]

77

HÔPITAL D'AMQUI

0

0.0

-

0

0.0

-

0

0.0

-

80

HÔPITAL FLEURY

1

0.2

[0.0 ; 0.8]

11

2.3

[1.2 ; 3.9]

2

0.4

[0.0 ; 1.2]

81

HÔPITAL DE MONT-LAURIER

1

0.6

[0.0 ; 2.2]

1

0.6

[0.0 ; 2.2]

0

0.0

-

82

PAVILLON SAINTE-FAMILLE

0

0.0

-

0

0.0

-

0

0.0

-

83

HÔPITAL DE LASALLE

0

0.0

-

0

0.0

-

0

0.0

-

84

HÔPITAL DE NOTRE-DAME-DU-LAC

0

0.0

-

0

0.0

-

0

0.0

-

85

CENTRE DE SANTÉ ET DE SERVICES SOCIAUX DU HAUT-SAINT-MAURICE

0

0.0

-

0

0.0

-

0

0.0

-

86

HÔPITAL DE LA MALBAIE

0

0.0

-

0

0.0

-

0

0.0

-

88

HÔPITAL, CLSC ET CENTRE D'HÉBERGEMENT DE ROBERVAL

1

0.3

[0.0 ; 1.3]

1

0.3

[0.0 ; 1.3]

0

0.0

-

89

HÔPITAL DE MONTMAGNY

0

0.0

-

0

0.0

-

1

0.5

[0.0 ; 2.1]

91

HÔPITAL HÔTEL-DIEU DE GASPÉ

1

1.0

[0.0 ; 3.9]

0

0.0

-

0

0.0

-

95

HÔPITAL DU PONTIAC

0

0.0

-

0

0.0

-

0

0.0

-

96

CENTRE DE SANTÉ DE CHIBOUGAMAU

0

0.0

-

0

0.0

-

0

0.0

-

97

HÔPITAL DE MARIA

0

0.0

-

3

1.5

[0.3 ; 3.7]

0

0.0

-

99

HÔPITAL BROME-MISSISQUOI-PERKINS

0

0.0

-

1

0.4

[0.0 ; 1.4]

3

1.1

[0.2 ; 2.6]

100

HÔPITAL DE LA BAIE

0

0,0

-

0

0,0

-

0

0,0

-

101

HÔPITAL RÉGIONAL DE SAINT-JÉRÔME

16

1.4

[0.8 ; 2.2]

19

1.7

[1.0 ; 2.5]

1

0.1

[0.0 ; 0.3]

103

HÔPITAL LAURENTIEN

1

0.4

[0.0 ; 1.4]

0

0.0

-

0

0.0

-

107

HÔPITAL DE L'ARCHIPEL

0

0.0

-

1

1.3

[0.0 ; 5.2]

0

0.0

-

109

HÔPITAL DE SAINTE-ANNE-DES-MONTS

0

0.0

-

0

0.0

-

0

0.0

-

111

HÔPITAL DE PAPINEAU

1

0.5

[0.0 ; 2.0]

0

0.0

-

1

0.5

[0.0 ; 2.0]

112

HÔPITAL D'ALMA

1

0.3

[0.0 ; 1.3]

1

0.3

[0.0 ; 1.3]

2

0.7

[0.1 ; 1.9]

113

HÔPITAL DE THETFORD MINES

0

0.0

-

4

1.5

[0.4 ; 3.4]

1

0.4

[0.0 ; 1.5]

95% CI: 95% confidence interval
BSI: bloodstream infection
CoNS: coagulase-negative Staphylococcus
CRBSI: catheter-related bloodstream infection
HD: hemodialysis
ICU: intensive care unit
MBI: mucosal barrier injury
Non-CRBSI: non-catheter-related primary bloodstream infection
SSI: surgical site infection

Comité de surveillance provinciale des infections nosocomiales (SPIN) – bactériémies panhospitalières

Editorial Committee 

Alex Carignan, Centre hospitalier universitaire de Sherbrooke

Élise Fortin, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec

Muleka Ngenda-Muadi, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec

Mélissa Trudeau, Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec