The 2017 global point prevalence survey of antimicrobial consumption and resistance in Canadian hospitals.


Journal

Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411

Informations de publication

Date de publication:
11 07 2020
Historique:
received: 10 02 2020
accepted: 11 06 2020
entrez: 13 7 2020
pubmed: 13 7 2020
medline: 13 7 2021
Statut: epublish

Résumé

Patient-level surveillance (indication, appropriate choice, dosing, route, duration) of antimicrobial use in Canadian hospitals is needed to reduce antimicrobial overuse and misuse. Patient-level surveillance has not been performed on a national level in Canada. The Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) is an international collaborative to monitor antimicrobial use and resistance in hospitals worldwide. Global-PPS locally documents on a single day patient-level antimicrobial prescribing practices. This article presents the results of the 2017 Global-PPS in Canadian hospitals with established antimicrobial stewardship programs. Hospitals part of the Canadian Nosocomial Infection Surveillance Program were invited to participate. Surveys could be performed any time in the 2017 calendar year. All in-patient wards in each hospital were surveyed by a physician, pharmacist or nurse with infectious disease training. Fourteen Canadian hospitals participated in the survey. Of 4118 patients, 1400 patients (34.0%) received a total of 2041 antimicrobials. Overall, 73.1% (n = 1493) of antimicrobials were for therapeutic use, 14.2% (n = 288) were for medical prophylaxis, 8.3% (n = 170) were for surgical prophylaxis, 1.8% (n = 37) were for other reasons, and 0.2% (n = 3) were used as prokinetic agents. Only 2.5% (n = 50) were for unknown reasons. For antimicrobials for therapeutic use, 29.9% of patients were treated for lower respiratory tract (343/1147), 10.5% for intra-abdominal (120/1147), 9.3% for skin and soft tissue (107/1147) and 7.5% for gastro-intestinal (86/1147) infections. Standardized methodology amongst Global-PPSs allows the comparison of our results to the 2015 Global-PPS. The prevalence of antimicrobial use on medical, surgical, and intensive care wards are similar to those previously observed in North America. Indication of antimicrobials has not been previously reported on such a large scale in Canadian hospitals. This report serves as a comparison for further point prevalence surveys that are currently underway. It will be used for identifying opportunities and benchmarking in antibiotic stewardship.

Sections du résumé

BACKGROUND
Patient-level surveillance (indication, appropriate choice, dosing, route, duration) of antimicrobial use in Canadian hospitals is needed to reduce antimicrobial overuse and misuse. Patient-level surveillance has not been performed on a national level in Canada. The Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) is an international collaborative to monitor antimicrobial use and resistance in hospitals worldwide. Global-PPS locally documents on a single day patient-level antimicrobial prescribing practices. This article presents the results of the 2017 Global-PPS in Canadian hospitals with established antimicrobial stewardship programs.
METHODS
Hospitals part of the Canadian Nosocomial Infection Surveillance Program were invited to participate. Surveys could be performed any time in the 2017 calendar year. All in-patient wards in each hospital were surveyed by a physician, pharmacist or nurse with infectious disease training.
RESULTS
Fourteen Canadian hospitals participated in the survey. Of 4118 patients, 1400 patients (34.0%) received a total of 2041 antimicrobials. Overall, 73.1% (n = 1493) of antimicrobials were for therapeutic use, 14.2% (n = 288) were for medical prophylaxis, 8.3% (n = 170) were for surgical prophylaxis, 1.8% (n = 37) were for other reasons, and 0.2% (n = 3) were used as prokinetic agents. Only 2.5% (n = 50) were for unknown reasons. For antimicrobials for therapeutic use, 29.9% of patients were treated for lower respiratory tract (343/1147), 10.5% for intra-abdominal (120/1147), 9.3% for skin and soft tissue (107/1147) and 7.5% for gastro-intestinal (86/1147) infections.
CONCLUSIONS
Standardized methodology amongst Global-PPSs allows the comparison of our results to the 2015 Global-PPS. The prevalence of antimicrobial use on medical, surgical, and intensive care wards are similar to those previously observed in North America. Indication of antimicrobials has not been previously reported on such a large scale in Canadian hospitals. This report serves as a comparison for further point prevalence surveys that are currently underway. It will be used for identifying opportunities and benchmarking in antibiotic stewardship.

Identifiants

pubmed: 32653046
doi: 10.1186/s13756-020-00758-x
pii: 10.1186/s13756-020-00758-x
pmc: PMC7353732
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

104

Références

Clin Infect Dis. 2017 Aug 15;65(suppl_1):S58-S63
pubmed: 28859341
Infect Control Hosp Epidemiol. 2015 Aug;36(8):949-56
pubmed: 25998898
Med J Aust. 2010 Oct 18;193(S8):S114-7
pubmed: 20955139
Infect Control Hosp Epidemiol. 2019 Jan;40(1):53-59
pubmed: 30394232
Lancet Glob Health. 2018 Jun;6(6):e619-e629
pubmed: 29681513
Infect Control Hosp Epidemiol. 2019 Aug;40(8):920-921
pubmed: 31182182
Can J Infect Dis Med Microbiol. 2015 Mar-Apr;26(2):85-9
pubmed: 26015790
N Engl J Med. 2018 Nov 1;379(18):1732-1744
pubmed: 30380384

Auteurs

Charles Frenette (C)

McGill University Health Center, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.

David Sperlea (D)

Faculty of Pharmacy, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, Quebec, H3T 1J4, Canada.

Greg J German (GJ)

Health PEI, 16 Garfield St, Charlottetown, Prince Edward Island, C1A 6A5, Canada.

Kevin Afra (K)

Fraser Health, 2733 Heather Street, Vancouver, British Columbia, V5Z VGH, Canada.

Jennifer Boswell (J)

Health PEI, 16 Garfield St, Charlottetown, Prince Edward Island, C1A 6A5, Canada.

Sandra Chang (S)

Richmond Hospital, 7000 Richmond Hwy, Richmond, British Columbia, V6X 1A2, Canada.

Herman Goossens (H)

Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Antwerp, Belgium.

Jennifer Grant (J)

Vancouver General Hospital, 899 W12th Ave, Vancouver, British Columbia, V5Z 1M9, Canada.

Marie-Astrid Lefebvre (MA)

Montreal Children Hospital, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.

Allison McGeer (A)

Mount Sinai Hospital, 600 University Ave, Toronto, Ontario, M5G 1X5, Canada.

Dominic Mertz (D)

Hamilton Health Sciences, 711 Concession Street, Hamilton, Ontario, L8V 1C3, Canada.

Michelle Science (M)

The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada.

Ann Versporten (A)

Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Wilrijk, Antwerp, Belgium.

Daniel J G Thirion (DJG)

McGill University Health Center, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada. daniel.thirion@umontreal.ca.
Faculty of Pharmacy, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, Quebec, H3T 1J4, Canada. daniel.thirion@umontreal.ca.

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