Infectious disease

Advisory report on the Human Papillomavirus (HPV) Vaccination Schedule

A lot of new data on the immunogenicity, efficacy and effectiveness of fewer than three doses of HPV vaccine have become available since the publication of the CIQ report on the 2012 knowledge update. The two-dose schedule has become a standard that is widely accepted around the world. Such schedules are currently in use in more than half (48/82) of the countries offering HPV vaccination programs. The same schedule has been approved and recommended by the World Health Organization (W HO) and the Global Alliance for Vaccines and Immunization (GAVI).

A number of clinical and ecological studies have even come up with some interesting and promising results in terms of the immunogenicity and efficacy of single-dose HPV vaccination. Immunogenicity studies have shown that sero-conversion rates after a single dose of vaccine are often in excess of 95%, although with considerably lower geometric mean titers (GMTs) than those observed after two or three doses. However, antibody titers…

Comité sur l'immunisation du Québec

Identification guide for ticks found in Québec

The Identification guide for ticks found in Québec was developed for physicians, veterinarians and other health professionals to inform them about the main types of ticks found in Québec and to help them identify specimens brought to them by their patients.

There are about 900 tick species worldwide. Ticks are Acari that parasitize most vertebrates, including humans, by feeding on their blood.

In Québec, 12 tick species have been identified so far. Some tick species are reservoirs and vectors of viruses, bacteria and parasites: they are the second leading vector of human disease, after the mosquito. The black-legged tick (Ixodes scapularis) is the tick that transmits the bacterium Borrelia burgdorferi, the agent responsible for Lyme disease (in french).

Scientific advisory on the optimal schedule for childhood immunization against pneumococcal disease in Québec

The childhood immunization program was implemented in Québec to reduce the burden of pneumococcal disease, with the primary objective of lowering the incidence of invasive pneumococcal disease (IPD). The program began in 2002, targeting children with a high risk of IPD, and in 2004 it became a universal program for all children under age five. A schedule of four doses (3+1) is recommended for high-risk children and three (2+1) for other children. 

The initial 7-valent pneumococcal conjugate vaccine (PCV7) was replaced by the 10-valent vaccine (PCV10) in 2009, and then by the 13-valent vaccine (PCV13) in 2011. Since the program began, immunization coverage rates have been high: over 90% of children receive the recommended number of doses. At the request of the Ministère de la Santé et des Services sociaux du Québec (Ministry of Health and Social Services, or MSSS), the Québec Immunization Committee (CIQ) prepared an scientific advisory regarding the choice…

Comité sur l'immunisation du Québec

Vascular Access–Related Bloodstream Infections in Hemodialysis Patients Surveillance results: 2016-2017

Vascular Access–Related Bloodstream Infections in Hemodialysis Patients
Surveillance results: 2016-2017

From April 1st, 2016, to March 31st, 2017, 48 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 57,570 patient-periods (Table 1). Participating units reported 127 VARBSIs in 120 patients. Patient-periods involving a fistula account for 40.7% of patient-periods. The VARBSI incidence rate is 0.06 cases per 100 patient-periods for patients with an arteriovenous (AV) fistula, 0.10 for patients with a synthetic fistula (graft), 0.32 for patients with a tunneled catheter and 1.24 for patients with a non-tunneled catheter. In 2016–2017, incidenc…

Surveillance provinciale des infections nosocomiales

Central Line–Associated Bloodstream Infections in Intensive Care Units Surveillance results: 2016-2017

Central Line–Associated Bloodstream Infections in Intensive Care Units
Surveillance results: 2016-2017

From April 1st, 2016, to March 31st, 2017, 69 intensive care units (ICUs) took part in surveillance of central line–associated bloodstream infections (CLABSIs), for a combined total of 135,114 catheter days (Table 1). Participating ICUs report 133 CLABSIs in 125 patients. Incidence rates are 0.91 per 1,000 catheter days in coronary ICUs, 0.62 in teaching adult ICUs, 0.46 in non-teaching adult ICUs, 2.16 in pediatric ICUs and 2.78 in neonatal ICUs. The incidence rates in 2016–2017 are lower compared to 2012–2016 in neonatal ICUs while they remain statistically stable in other ICU types. Compared to 2015-2016, one adult non-teaching ICUs with less than 10 beds has stopped…

Surveillance provinciale des infections nosocomiales

Hospital-Wide Healthcare-associated Bloodstream Infections Surveillance results: 2016-2017

Hospital-Wide Healthcare-associated Bloodstream Infections
Surveillance results: 2016-2017

From April 1st, 2016, to March 31st, 2017, 89 healthcare facilities took part in the hospital-wide surveillance of bloodstream infections (BSIs), for a combined total of 4,830,348 patient days (Table 1). Participating facilities reported 3,167 BSIs in 2,982 patients. The total incidence rate was 5.43 cases per 10,000 patient days. The incidence rate in 2016–2017 is stable compared with the average rate for 2012–2016. Two non-teaching facilities joined the program in 2016–2017. Data were extracted on May 5th, 2017.

Update: October 5, 2017

Surveillance provinciale des infections nosocomiales

Clostridium difficile–Associated Diarrhea Surveillance results: 2016-2017

Clostridium difficile–Associated Diarrhea
Surveillance results: 2016-2017

From April 1st, 2016 to March 31st, 2017, 95 healthcare facilities participated in the Clostridium difficile–associated diarrhea (CDAD) surveillance program, for a combined total of 5,022,104 patient days (Table 1). These participating facilities reported 2,330 healthcare-associated CDAD (HA-CDAD), either acquired during a current or previous hospitalization (categories 1a and 1b). The HA-CDAD incidence rate was 4.64 cases per 10,000 patient days. This incidence rate has declined for a third consecutive year and this decline was statistically and significantly lower than the 2015–2016 rate. The 10-day fatality rate was 6.3% (n = 130) while the 30-day fatality rate was 12.4% (n…

Surveillance provinciale des infections nosocomiales

Carbapenemase-Producing Gram Negative Bacilli Infections Surveillance results: 2016-2017

Carbapenemase-Producing Gram Negative Bacilli Infections
Surveillance results: 2016-2017

From April 1st, 2016, to March 31st, 2017, 82 healthcare facilities took part in the surveillance of carbapenemase-producing Gram negative bacilli (CPGNB) infections, for a total of 4,448,999 patient days (Table 1). These facilities reported 17 healthcare-associated CPGNB (HA-CPGNB) infections among patients who acquired their strain during a current or previous hospitalization (categories 1a and 1b). The incidence rate of HA-CPGNB infection was 0.04 per 10,000 patient days. The acquisition rate of HA-CPGNB colonization was 0.57 per 10,000 patient days. Eight infections were observed among healthcare facilities that joined the surveillance this year. Two teaching and one non-teaching facilities discontinued their participation this y…

Surveillance provinciale des infections nosocomiales

Vancomycin-Resistant Enterococci Infections Surveillance results: 2016-2017

Vancomycin-Resistant Enterococci Infections
Surveillance results: 2016-2017

From April 1st, 2016 to March 31st, 2017, 89 healthcare facilities took part in the surveillance of vancomycin-resistant enterococci (VRE) infections, for a combined total of 4,827,659 patient days (Table 1). These facilities reported 44 healthcare-associated VRE (HA-VRE) infections, either acquired during a current or previous hospitalization (categories 1a and 1b). The HA-VRE infection rate was 0.09 per 10,000 patient days. This incidence rate was down from 2015-2016. The acquisition rate of HA-VRE colonization (cat. 1a and 1b) in 2016-2017 was 7.43 per 10,000 patient days and was lower compared to 2015-2016. For all results, analyses include facilities that participated for a minimum of 11 periods. Data were extracted on June 1s…

Surveillance provinciale des infections nosocomiales

Methicillin-Resistant Staphylococcus aureus Bloodstream Infections Surveillance results: 2016-2017

Methicillin-Resistant Staphylococcus aureus Bloodstream Infections
Surveillance results: 2016-2017

From April 1st, 2016 to March 31st, 2017, 89 healthcare facilities participated in the surveillance of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, for a combined total of 4,835,605 patient days (Table 1). Together, these facilities reported 66 cases of healthcare-associated MRSA bloodstream infections (HA-MRSA-BSI) acquired during a current or previous hospitalization (categories 1a and 1b). The HA-MRSA-BSI incidence rate was 0.14 per 10,000 patient days. While this incidence rate has been declining for the past five years, this year was comparable to the last one. The proportion of methicillin resistance in healthcare-associated S. aur…

Surveillance provinciale des infections nosocomiales