A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: Pre- and post-severe acute respiratory syndrome
Identifieur interne : 000D71 ( Pmc/Curation ); précédent : 000D70; suivant : 000D72A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: Pre- and post-severe acute respiratory syndrome
Auteurs : Dick E. Zoutman ; B. Douglas FordSource :
- American Journal of Infection Control [ 0196-6553 ] ; 2008.
Abstract
The Resources for Infection Control in Hospitals (RICH) project assessed infection control programs and rates of antibiotic-resistant organisms (AROs) in Canadian acute care hospitals in 1999. In the meantime, the severe acute respiratory syndrome (SARS) outbreak and the concern over pandemic influenza have stimulated considerable government and health care institutional efforts to improve infection control systems in Canada.
In 2006, a version of the RICH survey similar to the original RICH instrument was mailed to infection control programs in all Canadian acute care hospitals with 80 or more beds. We used χ2, analysis of variance, and analysis of covariance analyses to test for differences between the 1999 and 2005 samples for infection control program components and ARO rates.
72.3% of Canadian acute care hospitals completed the RICH survey for 1999 and 60.1% for 2005. Hospital size was controlled for in analyses involving AROs and surveillance and control intensity levels. Methicillin-resistant
Canadian infection control programs in 2005 continued to fall short of expert recommendations for human resources and surveillance and control activities. Meanwhile, nosocomial MRSA rates more than doubled between 1999 and 2005, and hospitals reporting new nosocomial VRE cases increased 77% over the same period. Although investments have been made toward infection control programs in Canadian acute care hospitals, the rapid rise in ICP positions has not yet translated into marked improvements in surveillance and control activities. In the face of substantial increases in ARO rates in Canada, continued efforts to train ICPs and support hospital infection control programs are necessary.
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DOI: 10.1016/j.ajic.2008.02.008
PubMed: 18834747
PubMed Central: 7132731
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: Pre- and post-severe acute respiratory syndrome</title><author><name sortKey="Zoutman, Dick E" sort="Zoutman, Dick E" uniqKey="Zoutman D" first="Dick E." last="Zoutman">Dick E. Zoutman</name></author><author><name sortKey="Ford, B Douglas" sort="Ford, B Douglas" uniqKey="Ford B" first="B. Douglas" last="Ford">B. Douglas Ford</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18834747</idno><idno type="pmc">7132731</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132731</idno><idno type="RBID">PMC:7132731</idno><idno type="doi">10.1016/j.ajic.2008.02.008</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000D71</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D71</idno><idno type="wicri:Area/Pmc/Curation">000D71</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D71</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: Pre- and post-severe acute respiratory syndrome</title><author><name sortKey="Zoutman, Dick E" sort="Zoutman, Dick E" uniqKey="Zoutman D" first="Dick E." last="Zoutman">Dick E. Zoutman</name></author><author><name sortKey="Ford, B Douglas" sort="Ford, B Douglas" uniqKey="Ford B" first="B. Douglas" last="Ford">B. Douglas Ford</name></author></analytic><series><title level="j">American Journal of Infection Control</title><idno type="ISSN">0196-6553</idno><idno type="eISSN">1527-3296</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The Resources for Infection Control in Hospitals (RICH) project assessed infection control programs and rates of antibiotic-resistant organisms (AROs) in Canadian acute care hospitals in 1999. In the meantime, the severe acute respiratory syndrome (SARS) outbreak and the concern over pandemic influenza have stimulated considerable government and health care institutional efforts to improve infection control systems in Canada.</p></sec><sec><title>Methods</title><p>In 2006, a version of the RICH survey similar to the original RICH instrument was mailed to infection control programs in all Canadian acute care hospitals with 80 or more beds. We used χ<sup>2</sup>, analysis of variance, and analysis of covariance analyses to test for differences between the 1999 and 2005 samples for infection control program components and ARO rates.</p></sec><sec><title>Results</title><p>72.3% of Canadian acute care hospitals completed the RICH survey for 1999 and 60.1% for 2005. Hospital size was controlled for in analyses involving AROs and surveillance and control intensity levels. Methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) rates increased from 1999 to 2005 (F = 9.4, <italic>P</italic> = .003). In 2005, the mean MRSA rate was 5.2 (standard deviation [SD], 6.1) per 1000 admissions, and, in 1999, it was 2.0 (SD, 2.9). <italic>Clostridium difficile</italic>-associated diarrhea rates trended up from 1999 to 2005 (F = 2.9, <italic>P</italic> = .09). In 2005, the mean <italic>Clostridium difficile</italic>-associated diarrhea rate was 4.7 (SD, 4.3), and, in 1999, it was 3.8 (SD, 4.3). The proportion of hospitals that reported having new nosocomial vancomycin-resistant <italic>Enterococcus</italic> (VRE) cases was greater in 2005 than in 1999 (χ<sup>2</sup> = 10.5, <italic>P</italic> = .001). In 1999, 34.5% (40/116) of hospitals reported having new nosocomial VRE cases, and, in 2005, 61.0% (64/105) reported new cases. Surveillance intensity index scores increased from a mean of 61.7 (SD, 18.5) in 1999 to 68.1 (SD, 15.4) in 2005 (F = 4.1, <italic>P</italic> = .04). Control intensity index scores trended upward slightly from a mean of 60.8 (SD, 14.6) in 1999 to 64.1 (SD, 12.2) in 2005 (F = 3.2, <italic>P</italic> = .07). Infection control professionals (ICP) full-time equivalents (FTEs) per 100 beds increased from a mean of 0.5 (SD, 0.2) in 1999 to 0.8 (SD, 0.3) in 2005 (F = 90.8, <italic>P</italic> < .0001). However, the proportion of ICPs in hospitals certified by the Certification Board of Infection Control decreased from 53% (SD, 46) in 1999 to 38% (SD, 36) in 2005 (F = 8.7, <italic>P</italic> = .004).</p></sec><sec><title>Conclusion</title><p>Canadian infection control programs in 2005 continued to fall short of expert recommendations for human resources and surveillance and control activities. Meanwhile, nosocomial MRSA rates more than doubled between 1999 and 2005, and hospitals reporting new nosocomial VRE cases increased 77% over the same period. Although investments have been made toward infection control programs in Canadian acute care hospitals, the rapid rise in ICP positions has not yet translated into marked improvements in surveillance and control activities. In the face of substantial increases in ARO rates in Canada, continued efforts to train ICPs and support hospital infection control programs are necessary.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zoutman, D E" uniqKey="Zoutman D">D.E. Zoutman</name></author><author><name sortKey="Ford, B D" uniqKey="Ford B">B.D. Ford</name></author><author><name sortKey="Bryce, E" uniqKey="Bryce E">E. Bryce</name></author><author><name sortKey="Gourdeau, M" uniqKey="Gourdeau M">M. Gourdeau</name></author><author><name sortKey="Herbert, G" uniqKey="Herbert G">G. Herbert</name></author><author><name sortKey="Henderson, E" uniqKey="Henderson E">E. Henderson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zoutman, D E" uniqKey="Zoutman D">D.E. Zoutman</name></author><author><name sortKey="Ford, B D" uniqKey="Ford B">B.D. Ford</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Macias, A E" uniqKey="Macias A">A.E. Macias</name></author><author><name sortKey="Ponce De Leon, S" uniqKey="Ponce De Leon S">S. Ponce-de-Leon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shaw, K" uniqKey="Shaw K">K. Shaw</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Goldrick, B A" uniqKey="Goldrick B">B.A. Goldrick</name></author><author><name sortKey="Goetz, A M" uniqKey="Goetz A">A.M. Goetz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blair, R C" uniqKey="Blair R">R.C. Blair</name></author><author><name sortKey="Taylor, R A" uniqKey="Taylor R">R.A. Taylor</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Pepin, J" uniqKey="Pepin J">J. Pepin</name></author><author><name sortKey="Valiquette, L" uniqKey="Valiquette L">L. Valiquette</name></author><author><name sortKey="Cossette, B" uniqKey="Cossette B">B. Cossette</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eggertson, L" uniqKey="Eggertson L">L. Eggertson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pindera, L" uniqKey="Pindera L">L. Pindera</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Grundmann, H" uniqKey="Grundmann H">H. Grundmann</name></author><author><name sortKey="Aires De Sousa, M" uniqKey="Aires De Sousa M">M. Aires-de-Sousa</name></author><author><name sortKey="Boyce, J" uniqKey="Boyce J">J. Boyce</name></author><author><name sortKey="Tiemersma, E" uniqKey="Tiemersma E">E. Tiemersma</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Klevens, R M" uniqKey="Klevens R">R.M. Klevens</name></author><author><name sortKey="Morrison, M A" uniqKey="Morrison M">M.A. Morrison</name></author><author><name sortKey="Nadle, J" uniqKey="Nadle J">J. Nadle</name></author><author><name sortKey="Petit, S" uniqKey="Petit S">S. Petit</name></author><author><name sortKey="Gershman, K" uniqKey="Gershman K">K. Gershman</name></author><author><name sortKey="Ray, S" uniqKey="Ray S">S. Ray</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuijper, E J" uniqKey="Kuijper E">E.J. Kuijper</name></author><author><name sortKey="Coignard, B" uniqKey="Coignard B">B. Coignard</name></author><author><name sortKey="Tull, P" uniqKey="Tull P">P. Tüll</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simor, A E" uniqKey="Simor A">A.E. Simor</name></author><author><name sortKey="Ofner Agostini, M" uniqKey="Ofner Agostini M">M. Ofner-Agostini</name></author><author><name sortKey="Gravel, D" uniqKey="Gravel D">D. Gravel</name></author><author><name sortKey="Varia, M" uniqKey="Varia M">M. Varia</name></author><author><name sortKey="Paton, S" uniqKey="Paton S">S. Paton</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A. McGeer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ofner Agostini, M" uniqKey="Ofner Agostini M">M. Ofner-Agostini</name></author><author><name sortKey="Johnston, B L" uniqKey="Johnston B">B.L. Johnston</name></author><author><name sortKey="Simor, A E" uniqKey="Simor A">A.E. Simor</name></author><author><name sortKey="Embil, J" uniqKey="Embil J">J. Embil</name></author><author><name sortKey="Matlow, A" uniqKey="Matlow A">A. Matlow</name></author><author><name sortKey="Mulvey, M" uniqKey="Mulvey M">M. Mulvey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Boyle, C" uniqKey="O Boyle C">C. O'Boyle</name></author><author><name sortKey="Jackson, M" uniqKey="Jackson M">M. Jackson</name></author><author><name sortKey="Henly, S J" uniqKey="Henly S">S.J. Henly</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Scheckler, W E" uniqKey="Scheckler W">W.E. Scheckler</name></author><author><name sortKey="Brimhall, D" uniqKey="Brimhall D">D. Brimhall</name></author><author><name sortKey="Buck, A S" uniqKey="Buck A">A.S. Buck</name></author><author><name sortKey="Farr, B M" uniqKey="Farr B">B.M. Farr</name></author><author><name sortKey="Friedman, C" uniqKey="Friedman C">C. Friedman</name></author><author><name sortKey="Garibaldi, R A" uniqKey="Garibaldi R">R.A. Garibaldi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Farr, B" uniqKey="Farr B">B. Farr</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Infect Control</journal-id><journal-id journal-id-type="iso-abbrev">Am J Infect Control</journal-id><journal-title-group><journal-title>American Journal of Infection Control</journal-title></journal-title-group><issn pub-type="ppub">0196-6553</issn><issn pub-type="epub">1527-3296</issn><publisher><publisher-name>Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18834747</article-id><article-id pub-id-type="pmc">7132731</article-id><article-id pub-id-type="publisher-id">S0196-6553(08)00554-3</article-id><article-id pub-id-type="doi">10.1016/j.ajic.2008.02.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: Pre- and post-severe acute respiratory syndrome</article-title></title-group><contrib-group><contrib contrib-type="author" id="au1"><name><surname>Zoutman</surname><given-names>Dick E.</given-names></name><degrees>MD, FRCPC</degrees><email>zoutmand@kgh.kari.net</email><xref rid="cor1" ref-type="corresp">∗</xref></contrib><contrib contrib-type="author" id="au2"><name><surname>Ford</surname><given-names>B. Douglas</given-names></name><degrees>MA</degrees></contrib></contrib-group><aff>Department of Pathology and Molecular Medicine, Queen's University and Infection Control Service, Kingston General Hospital, Kingston, Ontario, Canada</aff><author-notes><corresp id="cor1"><label>∗</label>Address correspondence to Dick E. Zoutman, MD, FRCPC, Department of Pathology and Molecular Medicine, Queen's University and Infection Control Service, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada. <email>zoutmand@kgh.kari.net</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>3</day><month>10</month><year>2008</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>12</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>3</day><month>10</month><year>2008</year></pub-date><volume>36</volume><issue>10</issue><fpage>711</fpage><lpage>717</lpage><permissions><copyright-statement>Copyright © 2008 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.</copyright-statement><copyright-year>2008</copyright-year><copyright-holder>Association for Professionals in Infection Control and Epidemiology, Inc.</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract><sec><title>Background</title><p>The Resources for Infection Control in Hospitals (RICH) project assessed infection control programs and rates of antibiotic-resistant organisms (AROs) in Canadian acute care hospitals in 1999. In the meantime, the severe acute respiratory syndrome (SARS) outbreak and the concern over pandemic influenza have stimulated considerable government and health care institutional efforts to improve infection control systems in Canada.</p></sec><sec><title>Methods</title><p>In 2006, a version of the RICH survey similar to the original RICH instrument was mailed to infection control programs in all Canadian acute care hospitals with 80 or more beds. We used χ<sup>2</sup>, analysis of variance, and analysis of covariance analyses to test for differences between the 1999 and 2005 samples for infection control program components and ARO rates.</p></sec><sec><title>Results</title><p>72.3% of Canadian acute care hospitals completed the RICH survey for 1999 and 60.1% for 2005. Hospital size was controlled for in analyses involving AROs and surveillance and control intensity levels. Methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) rates increased from 1999 to 2005 (F = 9.4, <italic>P</italic> = .003). In 2005, the mean MRSA rate was 5.2 (standard deviation [SD], 6.1) per 1000 admissions, and, in 1999, it was 2.0 (SD, 2.9). <italic>Clostridium difficile</italic>-associated diarrhea rates trended up from 1999 to 2005 (F = 2.9, <italic>P</italic> = .09). In 2005, the mean <italic>Clostridium difficile</italic>-associated diarrhea rate was 4.7 (SD, 4.3), and, in 1999, it was 3.8 (SD, 4.3). The proportion of hospitals that reported having new nosocomial vancomycin-resistant <italic>Enterococcus</italic> (VRE) cases was greater in 2005 than in 1999 (χ<sup>2</sup> = 10.5, <italic>P</italic> = .001). In 1999, 34.5% (40/116) of hospitals reported having new nosocomial VRE cases, and, in 2005, 61.0% (64/105) reported new cases. Surveillance intensity index scores increased from a mean of 61.7 (SD, 18.5) in 1999 to 68.1 (SD, 15.4) in 2005 (F = 4.1, <italic>P</italic> = .04). Control intensity index scores trended upward slightly from a mean of 60.8 (SD, 14.6) in 1999 to 64.1 (SD, 12.2) in 2005 (F = 3.2, <italic>P</italic> = .07). Infection control professionals (ICP) full-time equivalents (FTEs) per 100 beds increased from a mean of 0.5 (SD, 0.2) in 1999 to 0.8 (SD, 0.3) in 2005 (F = 90.8, <italic>P</italic> < .0001). However, the proportion of ICPs in hospitals certified by the Certification Board of Infection Control decreased from 53% (SD, 46) in 1999 to 38% (SD, 36) in 2005 (F = 8.7, <italic>P</italic> = .004).</p></sec><sec><title>Conclusion</title><p>Canadian infection control programs in 2005 continued to fall short of expert recommendations for human resources and surveillance and control activities. Meanwhile, nosocomial MRSA rates more than doubled between 1999 and 2005, and hospitals reporting new nosocomial VRE cases increased 77% over the same period. Although investments have been made toward infection control programs in Canadian acute care hospitals, the rapid rise in ICP positions has not yet translated into marked improvements in surveillance and control activities. In the face of substantial increases in ARO rates in Canada, continued efforts to train ICPs and support hospital infection control programs are necessary.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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