Background: The availability of national data on the prevalence of antimicrobial resistant infections in smaller, community, northern and rural acute care hospitals is limited. The objective of this article is to determine the prevalence of infections caused by selected antimicrobial-resistant organisms (AROs) in these smaller hospitals.
Methods: A point prevalence survey was conducted by 55 hospitals between February and May 2019 and included representation from all 10 Canadian provinces. Eligible hospitals were those with 350 or fewer beds. Data were collected on hospital characteristics. De-identified patient data were collected on selected infections (pneumonia, urinary tract infections, bloodstream infections, skin/soft tissue infections, surgical site infections, and Clostridioides difficile infections) for selected AROs (methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci, extended-spectrum β-lactamase-producing organisms and carbapenemase-producing organisms). Data on antimicrobial prescribing and infection prevention and control precautions were also collected.
Results: A total of 3,640 patients were included in the survey. Median patient age was 73 years, and 52.8% (n=1,925) were female. Selected infections were reported in 14.4% (n=524) of patients, of which 6.9% (n=36) were associated with an ARO infection. Infection prevention and control additional precautions were in place for 13.7% (n=500) of patients, of which half (51.0%, n=255) were due to an ARO. Approximately one third (35.2%, n=1,281) of patients had at least one antimicrobial prescribed.
Conclusion: Antimicrobial-resistant organisms remain a serious threat to public health in Canada. The results of this survey warrant further investigation into AROs in smaller Canadian hospitals as a potential reservoir of antimicrobial resistance.
Keywords: Clostridioides difficile infection; Escherichia coli; antimicrobial resistance; antimicrobial resistant organisms; carbapenemase-producing Enterobacterales; methicillin-resistant Staphylococcus aureus; nosocomial infections; point prevalence study; vancomycin-resistant Enterococci.