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Central-Line–Associated Bloodstream Infections in Québec Intensive Care Units: Results from the Provincial Healthcare-Associated Infections Surveillance Program (SPIN)

Published online by Cambridge University Press:  19 July 2016

Lynne Li ,
Elise Fortin ,
Claude Tremblay ,
Muleka Ngenda-Muadi ,
Caroline Quach  and
for SPIN-BACC
Lynne Li
Affiliation:
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal (QC), Canada
Elise Fortin
Affiliation:
Institut National de Santé Publique du Québec, Québec and Montréal (QC), Canada
Claude Tremblay
Affiliation:
Institut National de Santé Publique du Québec, Québec and Montréal (QC), Canada Centre Hospitalier Universitaire de Québec - Pavillon Hôtel-Dieu de Québec, Québec City (QC), Canada
Muleka Ngenda-Muadi
Affiliation:
Institut National de Santé Publique du Québec, Québec and Montréal (QC), Canada
Caroline Quach*
Affiliation:
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal (QC), Canada Institut National de Santé Publique du Québec, Québec and Montréal (QC), Canada Research Institute, McGill University Health Centre, Montreal (QC), Canada Department of Pediatrics, The Montreal Children’s Hospital of the McGill University Health Centre, McGill University, Montreal (QC), Canada
*
Address correspondence to Dr. Caroline Quach - McGill University Health Center, E05-1954 – 1001 Decarie Boulevard, Montreal, QC H4A 3J1, Canada (caroline.quach@mcgill.ca).
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Abstract

BACKGROUND

Following implementation of bundled practices in 2009 in Quebec and Canadian intensive care units (ICUs), we describe CLABSI epidemiology during the last 8 years in the province of Québec (Canada) and compare rates with Canadian and American benchmarks.

METHODS

CLABSI incidence rates (IRs) and central venous catheter utilization ratios (CVCURs) by year and ICU type were calculated using 2007–2014 data from the Surveillance Provinciale des Infections Nosocomiales (SPIN) program. Using American and Canadian surveillance data, we compared SPIN IRs to rates in other jurisdictions using standardized incidence ratios (SIRs).

RESULTS

In total, 1,355 lab-confirmed CLABSIs over 911,205 central venous catheter days (CVC days) were recorded. The overall pooled incidence rate (IR) was 1.49 cases per 1,000 CVC days. IRs for adult teaching ICUs, nonteaching ICUs, neonatal ICUs (NICUs), and pediatric ICUs (PICUs) were 1.04, 0.91, 4.20, and 2.15 cases per 1,000 CVC days, respectively. Using fixed SPIN 2007–2009 benchmarks, CLABSI rates had decreased significantly in all ICUs except for PICUs by 2014. Rates declined by 55% in adult teaching ICUs, 52% in adult nonteaching ICUs, and 38% in NICUs. Using dynamic American and Canadian CLABSI rates as benchmarks, SPIN adult teaching ICU rates were significantly lower and adult nonteaching ICUs had lower or comparable rates, whereas NICU and PICU rates were higher.

CONCLUSION

Québec ICU CLABSI surveillance shows declining CLABSI rates in adult ICUs. The absence of a decrease in CLABSI rate in NICUs and PICUs highlights the need for continued surveillance and analysis of factors contributing to higher rates in these populations.

Infect Control Hosp Epidemiol 2016;1–9

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 10 , October 2016 , pp. 1186 - 1194
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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