Healthcare-associated infections and antimicrobial resistance in Canadian acute care hospitals, 2020-2024.

BACKGROUND

Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) continue to contribute to excess morbidity and mortality among Canadians.

OBJECTIVE

To describe epidemiologic and laboratory characteristics and trends of HAIs and AMR, 2020-2024, using surveillance and laboratory data submitted by hospitals to the Canadian Nosocomial Infection Surveillance Program (CNISP) and by provincial and territorial laboratories to the National Microbiology Laboratory.

METHODS

Data was collected from 109 Canadian sentinel acute care hospitals between January 1, 2020 and December 31, 2024 for Clostridioides difficile infections (CDI), methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs), vancomycin-resistant Enterococcus (VRE) BSIs (specifically Enterococcus faecalis and Enterococcus faecium), carbapenemase-producing Enterobacterales (CPE) and carbapenemase-producing Acinetobacter baumannii (CPA) infections and colonizations and Candidozyma auris (C. auris; formerly Candida auris) infections. Trend analysis for case counts, incidence rates (rates), outcomes, molecular characterization and AMR profiles are presented.

RESULTS

From 2020 to 2024, rates remained relatively stable for CDI (range: 5.01-5.38 infections per 10,000 patient days) and MRSA BSI (range: 0.99-1.16 infections per 10,000 patient days) and increased significantly for VRE BSIs (from 0.30 to 0.42 infections per 10,000 patient days; p=0.01). During this time, infection rates for CPE remained low compared to other HAIs but increased significantly (rates: 0.05-0.20; p=0.03), CPA counts continue to remain very low (n=22 infections) and C. auris counts remained low compared to other HAIs (n=43 isolates).

CONCLUSION

The incidence of MRSA BSIs and CDI remained stable and VRE BSIs and CPE infections increased in the Canadian acute care hospitals participating in CNISP. An increased number of C. auris isolates were identified. Reporting standardized surveillance data to inform the application of infection prevention and control practices in acute care hospitals is critical to help decrease the burden of HAIs and AMR in Canada.