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Québec and nosocomial infections

Health care settings associated with complex interactions

Many people receive health care every day in hospitals. These individuals may be more vulnerable to infection, or may themselves be carrying a transmissible infection.

In Québec as elsewhere, experience has shown that many procedures and interventions performed in the care setting and the absence of certain measures will increase the likelihood of transmission of infection. The way people do things may lead to higher infection rates than expected. For this reason, constant monitoring is required of both intervention methods and procedures and the incidence of nosocomial (hospital acquired) infections.

The following bacteria that cause nosocomial infections are currently of particular concern:

  • C. difficile (Clostridium difficile)
  • VRE (Vancomycin-resistant Enterococci)
  • MRSA (Methicillin-resistant Staphylococcus Aureus)

A health care setting is the scene of complex interactions between patients, interventions and the hospital environment. A person's physical condition and microbial flora, the treatment given and instruments used are all factors affecting the risk of contracting and passing on an infection.

Because current knowledge does not enable us to eradicate this phenomenon, it is unavoidable. The goal is sound management of this risk in a context of quality care.

Effective prevention and control

In Québec, 80,000 to 90,000 people in health institutions, or 10% of admissions, are thought to have a nosocomial infection. Many studies show that the number of new cases can be cut by nearly a third if a properly structured program is set up. We have already observed positive impacts from the measures introduced since 2004 in response to the increased incidence of Clostridium difficile infections.

The prevention and control of nosocomial infections is nothing new in Québec. For many years, health professionals, particularly microbiologists, infectious disease specialists and infection prevention and control nurses, have been devoting time and energy in this area at health network institutions, which form the front line in the battle against these infections and have the main responsibility for preventing and controlling them.

The measures adopted since 2004 have made Québec a leader in prevention and control of nosocomial infections. With the new action plan, Plan d’action sur la prévention et le contrôle des infections nosocomiales 2006-2009, the Ministère de la Santé et des Services sociaux has taken another major step in containing and dealing with this problem, and materially improving the quality and safety of medical care.

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