Surveillance & Reporting

Infection Prevention & Control

The Alberta Health Services IPC program partners with the Covenant Health to collect surveillance data at every acute care facility in the province.

IPC works with all AHS staff to prevent healthcare acquired infections and improve patient safety.

Surveillance is an essential component of Infection Prevention and Control. If carried out in a uniform manner, surveillance provides a measure of the burden of illness, establishes benchmark rates for internal and external comparison, identifies potential risk factors, and allows assessment of specific interventions.

Reports

Reporting of Hand Hygiene compliance is one of AHS’ performance measures of safety. Hand hygiene is an effective strategy to reduce transmission of infection in the healthcare setting and can be used to monitor how our health system is performing. These measures are reported quarterly.

Protocols

Published Literature, Conference Presentations, and Other Resources

2021

Published Literature

Du, T., Choi, K. B., Silva, A., Golding, G. R., Pelude, L., Hizon, R., Al-Rawahi, G. N., Brooks, J., Chow, B., Collet, J. C., Comeau, J. L., Davis, I., Evans, G. A., Frenette, C., Han, G., Johnston, J., Kibsey, P., Katz, K. C., Langley, J. M., ....Hota, S. S. (2022). Characterization of Healthcare-Associated and Community-Associated Clostridioides difficile Infections among Adults, Canada, 2015–2019. Emerging Infectious Diseases, 28(6), 1128-1136. https://doi.org/10.3201/eid2806.212262.

Leal, J., Jefferson, T., & Conly, J. (2022). SARS-CoV-2 Exposures of Healthcare Workers and Acquisition of COVID-19. Clinical Microbiology and Infection, 28 (11), 1403-1405. https://doi.org/10.1016/j.cmi.2022.07.012

Haverkate, M. R., Macfadden, D. R., Daneman, N., Leal, J., Otterstatter, M., Mahdavi, R., D’Souza, A. G., Rennert-May, E., Silverman, M., Schwartz, K. L., Morris, A. M., Saatchi, A., Patrick, D. M., & Marra, F. A Time Series Analysis Evaluating Antibiotic Prescription Rates in Long-Term Care during the COVID-19 Pandemic in Alberta and Ontario, Canada. Antibiotics 2022, 11, 1001. https://doi.org/10.3390/antibiotics11081001

Mponponsuo, K., Leal, J., Puloski, S., Chew, D., Chavda, S., Au, F., & Rennert-May, E. (2022). Economic burden of surgical management of surgical site infections following hip and knee replacements in Calgary, Alberta, Canada. Infection Control & Hospital Epidemiology, 43(6), 728-735. doi:10.1017/ice.2021.217

Liang, J. J., Rudnick, W., Mitchell, R., Brooks, J., Bush, K., Conly, J., Ellison, J., Frenette, C., Johnston, L., Lavallée, C., McGeer, A., Mertz, D., Pelude, L., Science, M., Simor, A., Smith, S., Stagg, P., Suh, K. N., Thampi, N., … Taylor, G. (2022). Antimicrobial use in Canadian acute-care hospitals: Findings from three national point-prevalence surveys between 2002 and 2017. Infection Control & Hospital Epidemiology, 43(11), 1558–1564. https://doi.org/10.1017/ice.2021.519

Versluys, K., Pfister T., Ellison, J., Bush, K. (2022). Hospital-acquired antibiotic-resistant organisms among patients with COVID-19. Canadian Journal of Infection Control, 37(2), 74-76.

Choi, K. B., Du, T., Silva, A., Golding, G. R., Pelude, L., Mitchell, R., Rudnick, W., Hizon, R., Al-Rawahi, G. N., Chow, B., Davis, I., Evans, G. A., Frenette, C., Johnstone, J., Kibsey, P., Katz, K. C., Langley, J. M., Lee, B. E., Longtin, Y., … Hota, S. S. (2022). Trends in clostridioides difficile infection rates in Canadian hospitals during the coronavirus disease 2019 (covid-19) pandemic. Infection Control & Hospital Epidemiology, 1–4. https://doi.org/10.1017/ice.2022.210

Silva, A., Du, T., Choi, K B., Pelude, L., Golding, G. R., Hizon, R., Lee, B. E., Chow, B., Srigley, J. A., Hota, S. S., Comeau, J. L., Thampi, N., & CNISP C.difficile working group. (2022). Epidemiology of primary and recurrent healthcare-associated and community-associated pediatric Clostridioides difficile infection in Canada, 2015-2020. Journal of the Pediatric Infectious Diseases Society, 2023;, piad003, https://doi.org/10.1093/jpids/piad003

Ismail, A., Leal, J., Au, F., Puloski, S., Mponponsuo, K., Smith, S., & Rennert-May, E. (2022). Retrospective analysis of the management strategies for surgical site infection post total hip or knee arthroplasty from tertiary care centres in Edmonton, Alberta. Journal of Hospital Infection, 129, 1–7. https://doi.org/10.1016/j.jhin.2022.07.015

Choi, K. B., Steele, V., Conly, J., Chow, B., Comeau, J. L., Embree, J., Lee, B. E., Lefebvre, M.-A., Mitchell, R., Pelude, L., Shephard, A. L., & Langley, J. M. (2022). Cerebrospinal fluid shunt–associated surgical site infection with three-month versus twelve-month surveillance periods in Canadian hospitals. Infection Control & Hospital Epidemiology, 1–4. https://doi.org/10.1017/ice.2022.119

Rennert-May, E., Raj, S., Leal, J., Exner, D., Manns, B., & Chew, D. (2021). An economic evaluation of an antibiotic impregnated envelope for preventing infection in cardiac implantable electronic devices. Eurospace, 23(5), 767-774

Rennert-May E, Leal J, Thang NX, Lang E, Dowling S, Manns B, Wasylak T, Ronksley PE. The impact of COVID-19 on hospital admissions and emergency department visits: a population-based study. PLoS ONE, 2021; 16(6):e0252441. https://doi.org/10.1371/journal.pone.0252441

Acosta N, Bautista MA, Hollman J, McCalder J, Beaudet AB, Mann L, Waddell BJ, Chen J, Li C, Kuzma D, Bhatnagar S, Leal J, Meddings J, Hu J, Cabaj JL, Ruecker NJ, Naugler C, Pillai DR, Achari G, Ryan MC, Conly JM, Frankowski K, Hubert CRJ, Parkins MD. A multicenter study investigating SARS-CoV-2 in tertiary care hospital wastewater. Viral burden correlates with increasing hospitalized cases as well as hospital-associated transmissions and outbreaks. Water Research. 2021. (Article pre-proof). https://doi.org/10.1016/j.watres.2021.117369

Shen Y, Ellison J, Leal J, Bush KR, Chandran AU, Fathima S, Conly JM. The use of laboratory-identified event surveillance to classify adverse outcomes due to Clostridioides difficile infection in Canadian long-term care facilities. Infect Control Hosp Epidemiol. 2021; 42(5):557-564. https://doi.org/10.1017/ice.2020.1269

Ellison, J., Boychuk, L., Chakravorty, D., Chandran, A., Conly, J., Howatt, A., . . . Bush, K. (2021). A comparison of surgical site infections following total hip replacement and total knee replacement surgeries identified by Infection Prevention and Control and the National Surgical Quality Improvement Program in Alberta, Canada. Infection Control & Hospital Epidemiology, 1-7. https://doi.org/10.1017/ice.2021.159

Mitchell, R., Choi, K. B., Pelude L., Rudnick, W., Thampi N., Taylor G. (2021). Patients in hospital with laboratory-confirmed COVID-19 in a network of Canadian acute care hospitals, Mar. 1 to Aug. 31, 2020: a descriptive analysis. CMAJ Open, 9 (1) E149-E156. https://doi.org/10.9778/cmajo.20200246

Conference Presentation

CNISP PHAC, Mitchell R., Frenette, C., Thampi, N., Brooks, J., Ellison, J., … Pelude, L. (2021) Risk factors for severe outcome in patients hospitalized with COVID-19 in a network of Canadian acute care hospitals, [poster presentation], AMMI conference 2021, virtual

CNISP PHAC, Mitchell R., Frenette, C., Thampi, N., Brooks, J., Ellison, J., … Pelude, L. (2021) Characteristics of healthcare personnel hospitalized with laboratory-confirmed SARS-CoV-2 in a network of Canadian acute care hospitals, [oral presentation], IPAC conference 2021, virtual

CNISP PHAC, Mitchell R., Frenette, C., Thampi, N., Brooks, J., Ellison, J., … Pelude, L. (2021) The Epidemiology of Long Term Care and Retirement Home Residents Hospitalized with Laboratory-Confirmed COVID-19 in a Network of Acute Care Hospitals, March 1 2020 to March 31, 2021, , [poster presentation], IPAC conference 2021, virtual

Mitchell, R., Chow, B., D’Arpino, M., Ellison, J., Hansen, G., Hunter Guttierrez, E. (2021) COVID 19 Surveillance- Reporting, learning and sharing from the Canadian Nosocomial Infection Surveillance Programs [Webex presentation], CPSI

2020

Published Literature

Almond, J., Leal, J., Bush, K., Rogers, E., Henderson, E.A., & Ellison, J. (2020). Hospital-acquired Clostridioides difficile infections in Alberta: The validity of laboratory-identified event surveillance versus clinical infection surveillance. American Journal of Infection Control, 48 (6), 633-637. https://doi.org/10.1016/j.ajic.2019.09.029.

Laupland, K. & Leal, J. (2020). Defining microbial invasion of the bloodstream: A structured review. Infectious Diseases, 52(6), 391-395. https://doi.org/10.1080/23744235.2020.1727948

Sharma, A., Leal, J., Kim, J., Pearce, C., Pillai, D. R., & Hollis, A. (2020) The cost of contact precautions: a systematic analysis. Canadian Journal of Infection Control. (Article in Press)

Sharma A, Pillai DR, Lu M, Doolan C, Leal J, Kim J, Hollis A. Impact of isolation precautions on quality of life: a meta-analysis. J Hosp Infect 2020; 105(1):35-42. https://doi.org/10.1016/j.jhin.2020.02.004

Crocker A, Kornilo A, Conly J, Henderson E, Rennert-May E, Leal J. Using administrative data to determine rates of surgical site infections following spinal fusion and laminectomy procedures. Am J Infect Control 2020; 49(6):759-763. https://doi.org/10.1016/j.ajic.2020.10.010

Pfister T, Rennert-May E, Ellison J, Bush K, Leal J. Clostridioides difficile infections in Alberta: The validity of administrative data using ICD-10 diagnostic codes for CDI surveillance versus clinical infection surveillance. Am J Infect Control. 2020; 48(12):1431-1436. https://doi.org/10.1016/j.ajic.2020.08.016

Conference Presentation

Ellison, J., Bush, K., Chow, B., Hearn, K., Howatt, A., Leal, J., . . . Yuan, C. (2020). Healthcare-Associated Infection Decisions of Antibiotic-Resistant Organisms: A Data Quality Review. Infection Control & Hospital Epidemiology, 41(S1), S246-S246. https://doi.org/10.1017/ice.2020.804

Ellison, J., Chakravorty, D., Conly, J., Kim, J., Litvinchuk, S., Pokhrel, A., . . . Bush, K. (2020). Comparison of Matched Patient Data for SSIs following Total Hip and Total Knee Arthroplasty: IPC Versus NSQIP Surveillance. Infection Control & Hospital Epidemiology, 41(S1), S177-S178. https://doi.org/10.1017/ice.2020.709

Ellison, J., Chow, B., Howatt, A., Pfister, T., & Bush, K. (2020). Hospital-Acquired Bloodstream Infections With MRSA and VRE: Standardized Admission Screening Did Not Impact Rates. Infection Control & Hospital Epidemiology, 41(S1), S253-S254. https://doi.org/10.1017/ice.2020.815

Ellison, J., Chandran, U., Happe, J., Shen, Y., Shurgold, J., Taylor, G., & Bush, K. (2020). Prevalence of Healthcare-Associated Infections and Antimicrobial Resistance in Rural Alberta Acute-Care Facilities. Infection Control & Hospital Epidemiology, 41(S1), S76-S76. https://doi.org/10.1017/ice.2020.566

Ellison, J., Control, Chakravorty, D., Conly, J., Kim, J., Litvinchuk, S., . . . Control. (2020). Reporting Surgical Site Infections (SSIs) Using Different Surveillance Systems— Complexity of Infection Matters. Infection Control & Hospital Epidemiology, 41(S1), S372-S372. https://doi.org/10.1017/ice.2020.1001

Leal, J., Faris, P., Shen, Y., Bresee, L., Bush, K., Chow, B., . . . Conly, J. (2020). Impact of Seasonality and Influenza Rates on Interventions to Reduce Hospital-Acquired Clostridioides difficile Rates. Infection Control & Hospital Epidemiology, 41(S1), S265-S266. https://doi.org/10.1017/ice.2020.833

CNISP PHAC, Silva, A., Thampi, N., Choi, K., Pelude, L., Frenette, C., . . . Han, G. (2020). Epidemiological and Molecular Characterization of Clostridioides difficile Infection in Canadian Outpatient Settings, 2015–2019. Infection Control & Hospital Epidemiology, 41(S1), S472-S473. https://doi.org/10.1017/ice.2020.1148

Scott, M., Wilson, S., Bush, K., Control, Fluet, K., Gagnon, H., & Herrick, T. (2020). Process Surveillance and Follow-Up Monitoring to Increase Compliance to Standards in Medical Device Reprocessing. Infection Control & Hospital Epidemiology, 41(S1), S360-S360. https://doi.org/10.1017/ice.2020.983

Shen, Y., Ellison, J., Chandran, U., Fathima, S., Kanji, J., Lee, B., . . . Bush, K. (2020). A 6-Year Review of Carbapenemase-Producing Organisms in Alberta, Canada. Infection Control & Hospital Epidemiology, 41(S1), S104-S105. https://doi.org/10.1017/ice.2020.608

2019

Published Literature

Bush, K., Ellison, J., Hearn, K., Pfister, T., & Taylor, G. (2019). A comparison of extended-spectrum beta-lactamase (ESBL) – producing Escherichia coli and Klebsiella pneumoniae bloodstream infections in Alberta using a provincial surveillance system. Infection Control and Hospital Epidemiology, 40(3), 388.

Martin, P., Nour Abou Chakra, C., Williams, V., Bush, K., Dyck, M., Zahir Hirji, M. Simor, A.E. (2019). Prevalence of antibiotic-resistant organisms in Canadian Hospitals. Comparison of point-prevalence survey results from 2010, 2012, and 2016. Infection Prevention and Control Canada, 40(1), 53-59.

Leal, J.R., Conly, J., Weaver, R., Wick, J., Henderson, E.A., Manns, B., & Ronksley, P. (2019). Attributable costs and length of stay of hospital-acquired Clostridioides difficile: A population-based matched cohort study in Alberta, Canada. Infection Control and Hospital Epidemiology, 40(10), 1135-1143. https://doi.org/10.1017/ice.2019.178.

Leal, J., Ronksley, P., Henderson, E.A., Conly, J., & Manns, B. (2019). Predictors of mortality and length of stay in patients with hospital-acquired Clostridioides difficile infection: A population-based study in Alberta, Canada. Journal of Hospital Infection, 103(1):85-91. https://doi.org/10.1016/j.jhin.2019.04.007.

Mitchell, R., Taylor, G., Rudnick, W., Alexandre, S., Bush, K., Forrester, L., Frenette, L., Granfield, B., Gravel-Tropper, D., Happe, J., John, M., Lavallee, C., McGeer, A., Mertz, D., Pelude, D., Science, M., Simor, A., Smith, S., Suh, K.N., … Amaratunga, K. (2019). Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys. Canadian Medical Association Journal, 191(36):E981-E988.

2018

Published Literature

Rennert-May, E., Conly, J.M., Leal, J., Smith, S., Manns, B. (2018). Economic evaluations and their use in infection prevention and control: a narrative review. Antimicrobial Resistance and Infection Control, 7(31), 1-6. https://doi.org/10.1186/s13756-018-0327-z.

Rennert-May, E.D., Manns, B., Smith, S., Puloski, S., Henderson, E., Au MA, F. … Conly, J. (2018). Validity of administrative data in identifying complex surgical site infections from a population-based cohort after primary hip and knee arthroplasty in Alberta, Canada. American Journal of Infection Control, 40 (10), 1123-1126.

Conference Presentation

Yuan, C., Gagnon, H., Ellison, J., Dudenhoeffer, V., Edwards, CL., Erebor, J. … Hart, M. (2018). Hand hygiene compliance reviews by site-based reviewers. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada

Devine, A., Bush, K., Meyers, G., Lalany, A. (2018). Filling the gap between orientation and mentorship of infection control professionals using a provincial preceptorship program. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada.

Ellison, J., Hearn, K., Bush, K., Chow, B., Howatt, A., Leal, J., Shen, Y. (2018). In the Clear: An evaluation of a provincial IPC protocol to clear patients of their ARO active status/remove their ARO flag in clinical information systems. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada.

Scott, M., Wilson, S., Karin Fluet. (2018). Patient safety behind closed doors: Medical device reprocessing (MDR) reviews. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada.
Lee, S., Kim, J., Hope, K., Bush, K., Alfieri, N., Chow, B. … Henderson, E. (2018). Assessing changes to antimicrobial resistant organism (ARO) admission screening protocols in Calgary zone. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada.

Heinrichs, B., Buchanan-Chell, M., Walter, N., McFerran, B., Wilson, S., Scott, M. … Happe, J. (2018) Updating the Alberta Health Services infection prevention and control orientation manual. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada.

Ellison, J., Bush, K., Shen, Y., Alfieri, N., Barclay, J., Dekker, L, Henderson. E. A. (2018) Preliminary findings of the 2017 Alberta acute care point prevalence study. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada.

Shen, Y., Ellison, J., Fathima, S., Crocker, A., Ross, T., Bush, K., Conly, J. (2018) Adverse outcomes following Clostridium difficile infection in continuing care facilities across Alberta. [poster presentation]. IPAC conference 2018, Banff, Alberta, Canada.

2017

Published Literature

Lindeman, C., Leal, J., Rusk, A., Bush, K., Simmonds, K., Chandran, A.U., Henderson, E. (2017). Clostridium difficile infection in Alberta’s long-term care facilities. Canadian Journal of Infection Control, 32(2), 87-92.

Leal, J.R., Conly, J., Henderson, E.A., Manns, B.J. (2017). How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations. Antimicrobial Resistance and Infection Control, 6, 53-64.

Ramirez Mendoza J, Daneman N, Elias M, Amuah J, Bush K, Couris C, Leeb K. A comparison of administrative data versus surveillance data for hospital-associated methicillin-resistant Staphlococcus aureus infections in Canadian hospitals. Infection Control and Hospital Epidemiology, 2017; 1-8. doi:10.1017/ice.2016.302

2016

Published Literature

Bruzzese S, Bush K, Leal J, Kim J, Vickers D, Rusk A, Fathima S, Li V, Chui L, Louie M, Henderson E. Comparing the epidemiology of hospital-acquired methicillin-resistant Staphlococcus aureus clone groups in Alberta, Canada. Epidemiology and Infection, 144(10), 2184-2190. doi:10.1017/S0950268816000376

Bush K, Rusk A, Buchanan-Chell M, Chandran U, Acorn L, Chow B, Ellison J, Happe J, Herrick T, Hobbs D, Howatt A, Linton K, McCombie R, McGill K, Patel S, Pearce C, Pitchko J, Sauerborn K, Siminoski L, Henderson E. Measuring the performance of a surveillance system: validation of antimicrobial resistant organisms incident infection cases in a complete infection prevention and control surveillance network. Canadian Journal of Infection Control, Summer 2016;31(2):95-100.

Rennert-May E, Bush K, Vickers D, Smith S. Use of a provincial surveillance system to characterize postoperative surgical site infections after primary hip and knee arthroplasty in Alberta, Canada. American Journal of Infection Control, Available from http://dx.doi.org/10.1016/j.ajic.2016.03.021

Rusk A, Bush K, Brandt M, Smith C, Howatt A, Chow B, Henderson E. Improving surveillance for surgical site infections following total hip and knee arthroplasty using diagnosis and procedure codes in a provincial surveillance network. Infection Control & Hospital Epidemiology, Available on CJO 2016. doi:10.1017/ice.2016.53

Sun J, Chow B, Hanowski B, Henderson E. Correlation between hand hygiene compliance and methicillin-resistant Staphylococcus aureus incidence. Canadian Journal of Infection Control, Winter 2016;31(4):215-220.

Conference Presentations

Molecular and Epidemiological Features of Carbapenemase Producing Enterobacteriaceae and Acinetobacter in Alberta 2013-2015.  K Simmonds, A Rusk, K Bush, J Fuller, G Taylor, M Mulvey, K Fakharuddin, EA Henderson (oral presentation, AMMI-Canada Conference 2016).

Is Your Data Reliable? – Maintaining Accuracy, Timeliness, Comparability, Usability, and Relevance in Alberta Health Services’ Provincial infection prevention and Control Surveillance Program. B Chow, K Bush, J Leal,  A Rusk, J Happe, U Chandran, T Herrick, E Henderson (poster, IPAC Conference 2016).

Using Public Participation Techniques to Evaluate Alberta Health Services’ Clostridium difficile Surveillance Program. B Chow, J Happe, K Bush,  J Leal,  A Rusk, U Chandran, T Herrick, E Henderson (oral presentation, IPAC Conference 2016).

2015

Published Literature

Bush K, Leal J, Fathima S, Li V, Vickers D, Chui L, Louie M, Taylor G, Henderson E. The molecular epidemiology of incident methicillin-resistant Staphylococcus aureus cases among hospitalized patients in Alberta, Canada: a retrospective cohort study. Antimicrobial Resistance and Infection Control, 2015;4:35. doi:10.1186/s13756-015-0076-1

Taylor G, Bush K, Leal J, Henderson E, Chui L, Louie M. Epidemiology of methicillin-resistant Staphylococcus aureus bloodstream infections in Alberta, Canada. Journal of Hospital Infection, 2015 Feb; 89(2):132-135. doi:10.1016/j.jhin.2014.11.008

Conference Presentations

Use of a Provincial Surveillance System to Characterize Post-Operative Surgical Site Infections Following Primary Hip and Knee Arthroplasty in Alberta, Canada.  E Rennert-May, K Bush, D Vickers, S Smith, AHS IPC Program (poster, ID-Week, SHEA/IDSA/HIVMA/PEDSID conjoint conference 2015)

A Qualitative Inter-rater Reliability Analysis of Provincial Hand Hygiene Compliance Reviews in AHS. B Chow, D Vickers, J Leal,  K Bush, R Walia, EA Henderson (poster, IPAC Conference 2015).

Understanding the Data Quality of Central Venous Catheter Bloodstream Infections. B Chow, M Buchanan-Chell, K Bush, J Leal,  B Lee, EA Henderson (poster, IPAC Conference 2015).

Other Resources

Other Resources

Best Practices for Surveillance of Health Care-associated Infections in Patient and Resident Populations Provincial Infectious Disease Advisory Committees (PIDAC, Ontario), 2014

Canadian Institute for Health Information, The CIHI Data Quality Framework, 2009. Ottawa, ON; CIHI, 2009

Canadian Nosocomial Infection Surveillance Program (CNISP) Monitors healthcare-associated infections at Canadian healthcare facilities and publishes infection control guidelines.

CDC/NHSN Surveillance Definitions for Specific Types of Infections Center for Disease Control, 2017

Centers for Disease Control and Prevention. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working group. Morb Mortal Wkly Rep 2001; 50:14-24

Recommended practices for surveillance: Association for Professionals in Infection Control and Epidemiology Am J Infect Control 2007;35:427-40