Survey Results Released: Antimicrobial Resistance in Common Hospital Pathogens in Ontario (2023)

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 2023 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 2023 Report on ARO Surveillance
Our report, produced collaboratively with IQMH, summarizes the findings of the annual survey on antimicrobial resistance of common hospital pathogens from 2023. 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:

• Compared to 2022, 2023 results showed no substantial changes to overall incidence of MRSA, VRE, CDI and C. auris in Ontario.
• CPO incidence nearly doubled between 2022 and 2023.
• Gram-negative bacilli, including Escherichia coli (E. coli) and Klebsiella spp., showed increasing resistance in 2023.
• There is regional variation across the province among pathogens. Additionally, infection control practices vary widely throughout hospitals in Ontario.

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.