Survey Results Released: Antimicrobial Resistance in Common Hospital Pathogens in Ontario (2022)

Antimicrobial resistance (AMR) poses a serious threat to patient safety and global public health, as current antimicrobials (antibiotics, antivirals, antifungals etc.) become less effective at treating resistant organisms. Health care-associated infections contribute to increased length of hospitalization, mortality and use of health care resources.

As antimicrobial resistant organisms (AROs) are a major reservoir for health care-associated pathogens, the importance of screening and surveillance programs has been put into the spotlight. Such programs further our understanding of the burden of AROs and the impact of infection control programs in health care settings.

Annual survey on AROs

In 2016, Public Health Ontario (PHO) and the Institute for Quality Management in Healthcare (IQMH) established a partnership to conduct an annual survey of antimicrobial resistant organisms (AROs) across all laboratories and public hospitals for surveillance. A survey to capture information about 2022 was distributed to all licensed microbiology labs and all public hospitals in Ontario.

Participants were surveyed on screening and infection control programs, as well as the prevalence of AROs. The survey also included questions to better understand the impact of the pandemic on the screening and management of health care-associated infections in Ontario hospitals.

New report on ARO surveillance

Our new report, Antimicrobial Resistance in Common Hospital Pathogens in Ontario, produced collaboratively with IQMH, summarizes the findings of the annual survey on antimicrobial resistance of common hospital pathogens from 2022. This is the first year this report includes information about the prevalence of Candida auris in Ontario and surveillance and infection control programs to prevent its transmission in Ontario hospitals.

Key Findings from the report include:

• Incidence rates of MRSA and VRE in Ontario increased in 2022 compared with 2021
• The rate of CPO in Ontario hospitals is increasing, with rates nearly doubling from 2021 to 2022.
• While hospital-based rates of CDI have been decreasing since 2012, CDI prevalence rates from this survey increased from 2021 (5.3 per 10,000 population) to 2022 (8.6 per 10,000).
• Understanding the incidence of Candida auris in Ontario is difficult as only half of the responding laboratories reported established processes for identification and only ~20% of responding hospitals indicated they had screening programs in 2022.
• The hospital survey results describe some of the effects of the SARS-COV-2 pandemic on the screening and management of health care-associated infections in Ontario hospitals. While most disruptions due to the pandemic have been restored, some hospitals did report ongoing interruptions to their screening and management programs.

The results of this survey are important to support our understanding of the impact of AROs and can help inform recommendations to prevent spread within Ontario.

Continued surveillance of AROs is necessary to understand the current landscape of resistance. Identifying regional variation in incidence of organisms can inform provincial and local decisions regarding appropriate application of infection control policies.