Publications
MRSA
and VRE in Ontario, Canada - Results of 7 Years of Surveillance and
Control Measures.
K. GREEN1, C. A. FLEMING2, H. RICHARDSON2,
D. E. LOW1, B. WILLEY1, A. MCGEER1;
1TML and Mount Sinai Hospital, Toronto, ON, Canada, 2Quality
Management Program-Laboratory Services (QMP-LS), Toronto, ON, Canada.
Background:
Methicillin-resistant S. aureus (MRSA) and vancomycin-resistant
enterococci (VRE) are causing an increasing proportion of nosocomial
infections worldwide. In Ontario, screening and isolation precautions
have been recommended in acute care facilities (ACF) since 1995.
QMP-LS has conducted annual surveys in order to assess changes in
the incidence of these pathogens in the province.
Methods:
Each year since 1995, QMP-LS mails a questionnaire to all licensed
microbiology labs in Ontario (pop‘n 11M). Labs report the number
of patients identified as colonized or infected with MRSA and VRE,
as well as details of lab protocols , and hospital control programs.
Results:
98-100% of labs respond each year. The proportion of hospitals complying
with recommended screening has increased from 75% in 1998 to 93%
in 2001; 66% of ACF perform additional screening of high risk in-patients
. In 2001 the number of patients colonized or infected with MRSA
decreased (7684 , down 18% from 9345 in 2000). Of the identified
patients in 2001, 32% were infected (stable since 2000, but up from
21% in 1998), and 189 (2.5%) were bacteremic. 76% of patients were
thought to have acquired MRSA in an ACF, 14% in a long-term care
facility (LTCF), and 10% in the community. VRE were first identified
in Ontario in 1993. The number of identified patients increased
until 1998, but has decreased for three consecutive years (685 in
1999, 445 in 2000, 237 in 2001). In 2001, 9 patients were infected
with VRE and 1 was bacteremic (compared to 20 infections and 1 bacteremia
in 2000). 91% of VRE-colonized patients acquired their VRE in an
ACF, 4% in a LTCF, and 5% in the community (up from the <1% reported
in 2000).
Conclusions:
Adherence to province-wide control programs have led to decreased
rates of nosocomial MRSA in Ontario for the first time since 1992
and appear to have been successful in reducing the rate of VRE colonization
and infection in the province.
42nd INTERSCIENCE CONFERENCE ON ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(ICAAC), San Diego, California, USA, September 28, 2002. 8:30am-11:00am
©Copyright 2002 Last Modified
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