High rates of Staphylococcus aureus USA400 infection, Northern Canada.

Surveillance of Staphylococcus aureus infections in 3 northern remote communities of Saskatchewan was undertaken. Rates of methicillin-resistant infections were extremely high (146-482/10,000 population), and most (98.2%) were caused by USA400 strains.

Risk factors for and outcomes associated with clinical isolates of Escherichia coli and Klebsiella species resistant to extended-spectrum cephalosporins among patients admitted to Canadian hospitals.

Background: Clinical features associated with Gram-negative bacterial isolates with extended-spectrum beta-lactamase (ESBL)- and AmpC-mediated resistance identified in Canadian hospitals is largely unknown. The objective of the present study was to determine the demographics, risk factors and outcomes of patients with ESBL- or AmpC-mediated resistant organisms in Canadian hospitals.

Methods: Patients with clinical cultures of Escherichia coli or Klebsiella species were matched with patients with a similar organism but susceptible to third-generation cephalosporins.

Longitudinal phylogenetic surveillance identifies distinct patterns of cluster dynamics.

Objective: Through the application of simple, accessible, molecular epidemiology tools, we aimed to resolve the phylogenetic relationships that best predicted patterns of cluster growth using longitudinal population level drug resistance genotype data.

Methods: Analysis was performed on 971 specimens from drug naïve, first time HIV positive subjects collected in British Columbia between 2002 and 2005. A 1240bp fragment of the pol gene was amplified and sequenced with relationships among subtype B sequences inferred using Neighbour-Joining analysis.

A comparison of risk factors associated with community-associated methicillin-resistant and -susceptible Staphylococcus aureus infections in remote communities.

In this case-control study, cases [community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), n=79] and controls [community-associated methicillin-susceptible S. aureus (CA-MSSA), n=36] were defined as a laboratory-confirmed infection in a patient with no previous hospital-associated factors. Skin and soft tissue were the predominant sites of infection, both for cases (67.

A cross-sectional study of maternity care providers' and women's knowledge, attitudes, and behaviours towards influenza vaccination during pregnancy.

Background: Pregnant women are at increased risk of influenza-related complications, but research to examine barriers to maternal influenza vaccination has been limited and no studies have assessed the barriers to vaccinating pregnant women in Canada.

Objectives: The objectives of the study were to assess (1) how the knowledge, attitudes, and beliefs of Canadian maternity care providers influence their discussion and recommendation patterns, and (2) how the knowledge, attitudes, and beliefs of Canadian women, along with care providers' recommendations, influence their acceptance of influenza vaccine during pregnancy.

Methods: Two cross-sectional surveys, one of maternity care providers and one of postpartum women, were carried out between December 1, 2003, and March 31, 2004.

Investigation of the second wave (phase 2) of severe acute respiratory syndrome (SARS) in Toronto, Canada. What happened?

Background: Severe acute respiratory syndrome (SARS) was introduced to Toronto on 23 February, 2003. The outbreak was believed to be over in early May after two incubation periods had passed with no newly identified cases. However, on 20 May, 2003 a cluster of respiratory illnesses occurred in a rehabilitation facility in Toronto.

Vancomycin-resistant enterococci in Canada: results from the Canadian nosocomial infection surveillance program, 1999-2005.

Surveillance for vancomycin-resistant enterococci (VRE) in sentinel Canadian hospitals has been conducted since 1999. From 1999 to 2005, the rate of VRE detection increased from 0.37 to 1.

The emerging epidemiology of VRE in Canada: results of the CNISP Passive Reporting Network, 1994 to 1998.

Objective: To provide a rapid and efficient means of collecting descriptive epidemiological data on occurrences of vancomycin-resistant enterococcus (VRE) in Canada.

Design And Methods: Passive reporting of data on individual or cluster occurrences of VRE using a one-page surveillance form.

Setting: The surveillance form was periodically distributed to all Canadian Hospital Epidemiology Committee members, Community and Hospital Infection Control Association members, L'Association des professionnels pour la prevention des infections members and provincial laboratories, representing 650 health care facilities across Canada.

N-CDAD in Canada: results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project.

Background: A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC) sites revealed variations in the prevention, detection, management and surveillance of Clostridium difficile-associated diarrhea (CDAD). Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD) to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada) and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.

Infection control and antimicrobial restriction practices for antimicrobial-resistant organisms in Canadian tertiary care hospitals.

In 2003, a survey examining infection control and antimicrobial restriction policies and practices for preventing the emergence and transmission of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), and extended spectrum beta-lactamase (ESBL) was performed within Canadian teaching hospitals as part of the Canadian Nosocomial Infection Surveillance Program. Twenty-eight of 29 questionnaires were returned. The majority of facilities conducted admission screening for MRSA (96.

Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in Canadian hospitals.

Mupirocin resistance in Staphylococcus aureus is increasingly being reported in many parts of the world. This study describes the epidemiology and laboratory characterization of mupirocin-resistant methicillin-resistant S. aureus (MRSA) strains in Canadian hospitals.

A point prevalence survey of health care-associated infections in pediatric populations in major Canadian acute care hospitals.

Objective: To estimate the prevalence of pediatric health care-associated infections (HAI) in Canadian acute care hospitals.

Methods: A point-prevalence study conducted in February 2002 in 25 hospitals across Canada. Information on HAI, utilization of antimicrobial agents and invasive devices, isolation precautions, and microbial etiology was collected.

ampC gene expression in promoter mutants of cefoxitin-resistant Escherichia coli clinical isolates.

Reverse transcriptase polymerase chain reaction was used to determine the amount of overexpression of the ampC gene in 52 cefoxitin-resistant Escherichia coli clinical isolates that had previously characterized mutations in their ampC promoter/attenuator regions. The results showed that mutations that create a consensus -35 box (TTGACA) are the most important factor in strengthening the ampC promoter, followed by base pair insertions that increase the distance between the -35 and -10 boxes to 17 or 18 bp. Mutations in the -10 box are of lesser importance and those in the attenuator region appear to have little effect on ampC expression.

Cluster of cases of severe acute respiratory syndrome among Toronto healthcare workers after implementation of infection control precautions: a case series.

Objective: To review the severe acute respiratory syndrome (SARS) infection control practices, the types of exposure to patients with SARS, and the activities associated with treatment of such patients among healthcare workers (HCWs) who developed SARS in Toronto, Canada, after SARS-specific infection control precautions had been implemented.

Methods: A retrospective review of work logs and patient assignments, detailed review of medical records of patients with SARS, and comprehensive telephone-based interviews of HCWs who met the case definition for SARS after implementation of infection control precautions.

Results: Seventeen HCWs from 6 hospitals developed disease that met the case definition for SARS after implementation of infection control precautions.

Methicillin-resistant Staphylococcus aureus in Canadian aboriginal people.

We describe 279 hospitalized Canadian aboriginals in whom methicillin-resistant Staphylococcus aureus (MRSA) was detected. They were identified in 38 Canadian hospitals from 1995 through 2002. Compared with nonaboriginals, aboriginals were more likely to be younger than 18 years of age (OR, 1.

Clinical and epidemiologic features of methicillin-resistant Staphylococcus aureus in elderly hospitalized patients.

We describe characteristics of elderly patients with MRSA identified in 37 Canadian hospitals between 1995 and 2002. Of these inpatients, 6,613 (66%) were older than 65 years. They were more likely than younger patients to have been colonized without infection and to have had MRSA isolated from urine or the perineum.

Molecular characterization of cefoxitin-resistant Escherichia coli from Canadian hospitals.

A study designed to gain baseline information on strains of Escherichia coli displaying resistance to cefoxitin in Canada is described. A total of 29,323 E. coli isolates were screened at 12 participating hospital sites as part of an extended-spectrum beta-lactamase surveillance initiative.

Ambler class A extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. in Canadian hospitals.

This report describes a study carried out to gain baseline information on the molecular characteristics of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. in Canada. A total of 29,323 E.

Laboratory characterization of methicillin-resistant Staphylococcus aureus in Canadian hospitals: results of 5 years of National Surveillance, 1995-1999.

Two thousand seven hundred eighty single-patient, methicillin-resistant Staphylococcus aureus (MRSA) isolates collected between January 1995 and December 1999 at 17 tertiary care hospital sites across Canada were characterized by phenotypic and genotypic techniques. Six clonal types, as defined by pulsed-field gel electrophoresis, comprised 87% of all isolates and were labeled Canadian (C) MRSA-1 through -6. CMRSA-1 was the most prevalent clonal type, representing 45% of all MRSA.

Morbidity, mortality, and healthcare burden of nosocomial Clostridium difficile-associated diarrhea in Canadian hospitals.

Objective: To assess the healthcare burden, morbidity, and mortality of nosocomial Clostridium difficile-associated diarrhea (N-CDAD) in Canadian hospitals.

Design: Laboratory-based prevalence study.

Setting: Nineteen acute-care Canadian hospitals belonging to the Canadian Hospital Epidemiology Committee surveillance program.

The evolution of methicillin-resistant Staphylococcus aureus in Canadian hospitals: 5 years of national surveillance.

Background: To better understand the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Canadian hospitals, surveillance has been conducted in sentinel hospitals across the country since 1995. We report the results of the first 5 years of the program.

Methods: For each newly identified inpatient with MRSA, medical records were reviewed for demographic and clinical data.