Infographic: Canadian Nosocomial Infection Surveillance Program

Canadian Nosocomial Infection Surveillance Program (CNISP) 

Established in 1994, CNISP conducts national surveillance in sentinel acute-care hospitals across Canada on healthcare-associated infections such as bloodstream infections and on antimicrobial resistant organisms such as methicillin-resistant Staphylococcus aureus.

This time-line highlights the significant milestones initiated by CNISP which have provided the data needed to monitor and help reduce the impact of healthcare-associated and antimicrobial resistant


AMMI – Association of Medical Microbiology and Infectious Disease Canada
BSI – Bloodstream infection
CA – Community-Associated
CCDIC – Centre for Communicable Diseases and Infection Control
CHEC – Canadian Hospital Epidemiology Committee
CDI – Clostridium difficile infection
CNPHI – Canadian Network for Public Health Intelligence
CRGN - Carbapenem-resistant gram-negative bacterium
CVC – Central venous catheter
CSF – Cerebrospinal fluid
ESBL – Extended Spectrum Beta-Lactamase
HAI – Healthcare-Associated Infection
HA – Healthcare-Associated
ICU – Intensive Care Unit
MRSA – Methicillin-resistant Staphylococcus aureus
NML –  National Microbiology Laboratory, PHAC
PHAC – Public Health Agency of Canada
SSI – Surgical site infection
VRE – Vancomycin-resistant Enterococcus

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Type: Infographic

Organization: Public Health Agency of Canada

General Information

Data and specimens collected annually by CNISP produce national infection rates, identify organism strain types, monitor antimicrobial resistance and antibiotic usage patterns which all help to reduce the impact of HAIs and antimicrobial resistance in hospitals, which in turn impacts the community

Since 1995, CNISP has produced over 260 publications including scientific articles, reports and conference abstracts that provide scientific evidence to inform public health action to reduce infections

  • 18 hospitals join CNISP
  • CNISP established by a collaborative effort between PHAC (CCDIC, NML) and sentinel hospitals across Canada participating through CHEC/AMMI
  • MRSA surveillance initiated
  • NML initiated molecular characterization (strain typing) and antibiotic resistance testing of MRSA
  • 6-week HA-CDI surveillance study completed
  • BSI surveillance in ICUs and hemodialysis units conducted for 6-month pilot period
  • 1-year ESBL pilot study initiated
  • VRE surveillance initiated
  • NML initiated molecular characterization (strain typing) and antibiotic resistance testing of  VRE
  • 35 hospitals participate in CNISP
  • Post CSF shunt insertion SSI pilot study conducted from 2000-2002
  • Surveys of infection control practices relating to MRSA and VRE infections conducted
  • NML identifies a new gene that makes an Enterococci species resistant to the antibiotic vancomycin
  • A point prevalence survey counting all HAIs that were present during a 24-hour period in  acute-care hospitals was conducted
  • NML analyzed E.coli and Klebsiella organisms that produce enzymes making them resistant to the penicillin family of antibiotics
  • 43 hospitals participate in CNISP
  • Febrile respiratory illness surveillance among children in acute-care hospitals initiated
  • HA-CDI  6-month pilot surveillance and infection control practice study conducted  
  • NML identified molecular characteristics of E.coli resistant to the antibiotic cefoxitin
  • Post CSF shunt insertion SSI surveillance as well as influenza surveillance among hospitalized adult patients initiated
  • CVC-BSI surveillance piloted along with a survey regarding the prevention, insertion and maintenance of CVCs in adult, pediatric and neonatal intensive care units and stem cell transplant units
  • Ongoing HA- CDI and CVC-BSI surveillance initiated
  • Switched from paper-based surveillance data submission by CNISP hospitals to a secure on-line data collection platform housed on CNPHI thereby improving data quality
  • A second point prevalence survey counting all HAIs that were present during a 24-hour period in  acute care hospitals conducted
  • Pandemic H1N1 surveillance added to Adult flu surveillance, data sent to FluWatch thereby enhancing national flu data
  • Surveillance for organisms that are resistant to the group of last resort antibiotics known as carbapenems (CRGN) initiated  
  • Data collection on the usage of antibiotics in acute-care hospitals initiated
  • 52 hospitals participate in CNISP
  • Ongoing CNISP flu data submitted to FluWatch thereby enhancing national flu data
  • Post pediatric cardiac surgery SSI surveillance initiated
  • NML detects and molecularly characterizes first heterogeneous vancomycin intermediate resistant Staphylococcus aureus bacteria identified in Canada
  • Surveillance of SSIs post Hip and Knee prosthetic surgery initiated
  • NML molecularly characterized various strains of CA-MRSA
  • NML identified and characterized a C.difficile isolate with reduced susceptibility to vancomycin
  • NML analyzed four plasmids from E.coli and S.marcescens bacteria that carry a gene which makes them resistant to multiple antibiotics
  • Addition of CA and recurrent CDI added to HA-CDI surveillance
2016 and beyond
  • 65 hospitals now participate in CNISP
  • CNISP will continue to conduct surveillance on existing hospital-associated infections and their resistance patterns and monitor for new and emerging infections

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