To control the spread of the meningococcal serogroup B disease in the Saguenay–Lac-Saint-Jean region which has had a higher incidence rate compared with the rest of the province since 2004, a vaccination campaign was undertaken and targeted individuals 20 years and younger residing in or attending an educational institution in this region. An enhanced surveillance system was implemented to monitor the onset of adverse events following immunization (AEFI) in real time in order to be able to promptly notify the Ministère de la Santé et des Services sociaux (MSSS, Ministry of Health and Social Services) and the Direction de la santé publique (DSP, public health unit) of the Saguenay–Lac-Saint-Jean Health Region (RSS 02) about the occurrence of a safety issue in connection with this new quadrivalent serogroup B Meningococcal vaccine (4CMenB).

Methodology

This report covers the experiences of individuals residing in region 02 who…

In 2013, after 10 years of existence, the Comité d’éthique de santé publique [Public Health Ethics Committee] (CESP) felt compelled to review the experience that it had developed with regard to its specific mandate to provide ethical reviews of surveillance plans. This document summarizes all the ethical concerns identified by the Committee through the review of the different surveillance plans that were submitted to it between the time of its establishment and 2012. This summary of the opinions allows the Committee to cast a broader critical look on the ethical reflection surrounding the practice of ongoing surveillance of the population's health status and its determinants.

The ethical concerns outlined in the present summary essentially translate "field" knowledge, that is, they are drawn from the deliberative experience of the CESP through its review of surveillance plans that were submitted to it between 2003 and 2012. The critical examination of the Committee’s experie…

Vascular Access–Related Bloodstream Infections in Hemodialysis Patients
Surveillance results: 2013-2014

From April 1^st, 2013, to March 31^st, 2014, 44 hemodialysis units took part in the surveillance of vascular access–related bloodstream infections (VARBSIs) in hemodialysis (HD) patients, for a combined total of 54,878 patient-periods (Table 1). Participating units reported 157 VARBSIs in 149 patients. Patient-periods involving a fistula accounted for 44.9% of patient-periods. The VARBSI incidence rate was 0.10 cases per 100 patient-periods for patients with an arteriovenous (AV) fistula, 0.22 for patients with a synthetic fistula (graft), 0.38 for patients with a permanent catheter and 6.20 for patients with a temporary catheter. In 2013-2014, inciden…

Central Line–Associated Bloodstream Infections in Intensive Care Units
Surveillance results: 2013-2014

From April 1^st, 2013, to March 31^st, 2014, 70 intensive care units (ICUs) took part in surveillance of central line–associated bloodstream infections (CLABSIs), for a combined total of 132,376 catheter-days (Table 1). Participating ICUs reported 165 CLABSIs in 149 patients. Incidence rates were 0.65 per 1,000 catheter-days in coronary ICUs, 0.71 in teaching adult ICUs, 0.77 in non-teaching adult ICUs, 2.48 in pediatric ICUs and 4.01 in neonatal ICUs. The incidence rates in 2013-2014 were lower compared to 2009-2013 in teaching and non-teaching adult ICUs as well as in neonatal ICUs while pediatric and coronary ICUs pooled mean rates remained statistically sta…

Hospital-Wide Healthcare-associated Bloodstream Infections
Surveillance results: 2013-2014

From April 1^st, 2013, to March 31^st, 2014, 77 healthcare facilities took part on a voluntary basis in the hospital-wide surveillance of bloodstream infections (BSIs), for a combined total of 4,149,763 patient-days (Table 1). Participating facilities reported 2,689 BSIs in 2,495 patients. The total incidence rate was 5.4 cases per 10,000 patient-days. The incidence rate in 2013-2014 was significantly lower compared with the average rate for 2009-2013 in facilities that took part in both surveillance periods. Two teaching and 11 non-teaching facilities that were not included in the 2012-2013 study joined the program in 2013-2014. Data was extracted on May 15^th…

Vancomycin-Resistant Enterococci (VRE) Infections
Surveillance Results: 2013-2014

From April 1, 2013, to March 31, 2014, 89 healthcare facilities took part in the surveillance of healthcare-associated vancomycin-resistant enterococci (VRE) infections, for a combined total of 4,948,058 patient days (Table 1). In total, 92 VRE infections were reported among patients who contracted strain during a current or previous hospital stay in the reporting facility (categories 1a + 1b). The incidence rate of healthcare-associated VRE infections (cat. 1a + 1b) was 0.19 / 10,000 patient days. This incidence rate was two times higher than 2012-2013. The acquisition rate of healthcare-associated VRE colonization (cat. 1a + 1b) was 9.77 / 10,000 patient days. Data was extracted on May 15th, 2014.  

Updat…

Healthcare-Associated Infections Provincial Surveillance Program: Clostridium difficile–Associated Diarrhea (CDAD)
Surveillance results: 2013-2014

From April 1, 2013, to March 31, 2014, 95 healthcare facilities participated in the surveillance of Clostridium difficile–associated diarrhea (CDAD), for a combined total of 5,121,300 inpatient days (Table 1). The participating facilities reported 3,661 cases of healthcare-associated (HA) CDAD. The incidence rate of HA CDAD was 7.1 cases per 10,000 patient days. This incidence rate was stable compared to the rate of 2012–2013. The 10-day fatality rate was 9.1% (n = 322) while the 30-day rate was 15.1% (n = 534). In total, 46 (1.3%) colectomies were reported. Data was extracted on May 15th, 2014.  

Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infections
Surveillance Results: 2013–2014

From April 1, 2013, to March 31, 2014, 88 healthcare facilities participated in the surveillance of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, for a combined total of 4,939,160 inpatient days (Table 1). Together, these facilities reported 97 cases of healthcare-associated MRSA. The incidence rate was 0.20 / 10,000 patient-days. This incidence rate has declined over the past five years. The proportion of methicillin resistance in healthcare-associated S. aureus bloodstream infections was 16.9%. Data was extracted from Si-SPIN on May 23th, 2014 and updated on June 3st 2014 for complications.

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From April 1, 2012, to March 31, 2013, 89 healthcare facilities took part in the surveillance of healthcare-associated vancomycin-resistant enterococci (HA-VRE) infections, for a combined total of 5,017,791 patient days. In total, 41 cases of VRE infection were reported among patients who contracted the strain during a current or previous hospital stay in the reporting facility (categories 1a + 1b). The incidence rate of HA-VRE infection (cat. 1a + 1b) was 0.08/10,000 patient days. This incidence rate is similar to the one observed in 2011–2012. The acquisition rate of HA-VRE colonization (cat. 1a + 1b) was 8.26/10,000 patient days.

From April 1, 2012, to March 31, 2013, 88 healthcare facilities took part in the surveillance of methicillinresistant Staphylococcus aureus (MRSA) bloodstream infections, for a combined total of 5,011,231 patient days. Together, these facilities reported 147 cases of healthcare-associated MRSA bloodstream infections. The incidence rate was 0.29/10,000 patient days. This incidence rate has declined over the past five years. The proportion of methicillin resistance in healthcare-associated S. aureus bloodstream infections was 20%.