Central Venous Catheter - Associated Blood Stream Infections (CVC-BSI) in Intensive Care Units in Canadian Acute-Care Hospitals (2006, 2009 to 2011)

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Executive Summary

Adult Intensive Care Units (ICUs)

Among all adult ICUs, national central venous catheter-associated blood stream infections (CVC-BSI) rates have significantly decreased since 2006. Regionally, western CVC-BSI rates among all adult ICUs are relatively unchanged since 2006 while central and eastern rates have decreased.

Catheter utilization rates among all adult ICUs have shown a slight increase since 2006 in the west and central regions while the east has shown a slight decrease. Among medical, surgical and mixed adult ICUs, CVC-BSI rates have significantly decreased since 2006. Catheter utilization rates among medical, surgical and mixed adult ICUs are relatively unchanged since 2006 with the central region showing an increase and the east a decrease. Among adult cardiovascular surgery ICUs national CVC-BSI rates increased since 2006 along with catheter utilization rates.

Coagulase negative staphylococcus (CONS) remains the predominant microorganism identified from CVC-BSI in adult ICUs. Other microorganisms have remained relatively unchanged except VRE which has increased from 0 in 2006 to 4% in 2011. The majority of microorganisms identified in adult ICUs are Gram positive (63% in 2011) and there has been no significant change in the proportions identified since 2006 (70%).

Most patients (71% in 2011) in adult ICUs are alive at 30 days after onset of CVC-BSI and there has been no significant change in this proportion since 2006 (74%).

The decreasing CVC-BSI rates and proportion of CONS identified from CVC-BSI in these Canadian adult ICU data are similar to trends observed internationally.

Pediatric Intensive Care Units (PICUs)

Among all PICUs, national CVC-BSI rates have significantly decreased since 2006. Catheter utilization rates among PICUs have varied over time and an upward trend is seen since 2006.

Coagulase negative staphylococcus (CONS) remains the predominant microorganism identified from CVC-BSI in PICUs. Other microorganisms have remained relatively unchanged except Enterococcus which has increased from 3% in 2006 to 21% in 2011. The majority of microorganisms identified in PICUs are Gram positive (68% in 2011) and there has been no significant change in the proportions identified since 2006 (68%).

The majority of patients (88% in 2011) in PICUs are alive at 30 days after onset of CVC-BSI and there has been no significant change in this proportion since 2006 (91%).

The decreasing CVC-BSI rates in these Canadian PICU data are similar to trends observed internationally.

Neonatal Intensive Care Units (NICUs)

Among all NICUs, national CVC-BSI rates have significantly decreased overall and by birth weight and type of catheter since 2006. Catheter utilization rates overall and by birth weight in NICUs have remained relatively unchanged since 2006.

Coagulase negative staphylococcus (CONS) remains the predominant microorganism identified from CVC-BSI in NICUs. Other microorganisms have remained relatively unchanged except the proportion of Escherichia coli which increased from 2% in 2006 to 10% in 2011. The majority of microorganisms identified in NICUs are Gram positive (70% in 2011).

The majority of patients (93% in 2011) in NICUs are alive at 30 days after onset of CVC-BSI and there has been no change in this proportion since 2006 (92%).

The decreasing CVC-BSI rates and proportion of CONS identified from CVC-BSI in these Canadian NICU data are similar to trends observed internationally.

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