The Canadian Nosocomial Infection Surveillance Program (CNISP):
- Last updated: 2024-08-20
Healthcare-Associated Infection (HAI) & Antimicrobial Resistant Organism (ARO) data
Healthcare-associated infections (HAIs), also known as nosocomial infections, are infectious diseases acquired in health-care facilities such as hospitals. Many HAIs are caused by antimicrobial-resistant organisms (AROs), such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). The Canadian Nosocomial Infection Surveillance Program (CNISP) is a sentinel surveillance system which collects epidemiologic and linked microbiology data from 106 Canadian acute-care hospitals across 10 provinces and one territory. CNISP summarizes trends in national incidence rates, antimicrobial resistance and molecular characterization for select HAIs and AROs. Additionally, CNISP collects data on Antimicrobial Use among inpatients, which can be accessed on the next tab or by clicking here.
CNISP is a collaboration between the Public Health Agency of Canada (PHAC), including the National Microbiology Laboratory (NML), the Association of Medical Microbiology and Infectious Disease (AMMI) Canada, and acute-care hospitals across Canada.
On this page
- Antimicrobial Resistant Organisms and Healthcare-associated Infections
- Device and surgical procedure-related infections
For more information on CNISP surveillance or how to join, please contact: cnisp-pcsin@phac-aspc.gc.ca.
Antimicrobial Resistant Organisms and Healthcare-associated Infections
This section presents the latest surveillance data on various HAIs and AROs including Clostridioides difficile infections (CDI), methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA BSI), vancomycin-resistant Enterococcus bloodstream infections (VRE BSI), carbapenemase-producing Enterobacterales (CPE) infections, and C. auris infections and colonizations. These data, collected from CNISP participating hospitals, offer insights into annual rates, antimicrobial resistance, and molecular trends.
Detailed case information
The tables and figures below reflect detailed case information provided to CNISP by participating hospitals. These data are subject to change as we receive new information over time.
For more detailed information on HAIs and AROs please refer to the most recent annual Canada Communicable Disease Report (CCDR) publication: Healthcare-associated infections and antimicrobial resistance in Canadian acute care hospitals, 2018–2022
Overall Incidence of HAIs and AROs
Figure 1 illustrates the overall incidence rate for all case types (Healthcare-associated (HA), Community-associated (CA) and unknown source of acquisition combined) for CDI, MRSA BSI, VRE BSI, and CPE Infections. The rates are displayed in 10,000 patient-days and the dropdown can be used to change the denominator to reflect rates per 1,000 patient admissions. Rates of C. auris infections are not calculated in Figure 1 given low case counts by year to date. This is subject to change as more cases with complete epidemiological information are reported.
Case types:
Healthcare-Associated (HA):
These are infections that a person acquires while receiving medical care or treatment in a healthcare facility, such as hospitals, nursing homes, clinics, or rehabilitation centers.Community-Associated (CA):
These are infections that individuals acquire outside of healthcare facilities, typically in the general community. These infections are not directly linked to healthcare interventions.All case types:
Combined data for both HA and CA infections. This category also includes cases with unknown sources of acquisition, and provides a comprehensive overview of infection trends, encompassing infections acquired both within healthcare settings and in the general community.Figure 1. Incidence Rates of CDI, MRSA BSI, VRE BSI, and CPE Infections (All Case Types)
Figure 1: Text Description
Figure 2. Incidence Rates by Case Type
Figure 2: Text Description
Figure 3. Incidence Rates by Region, Facility Type or Hospital Size
Hover over areas of the graph to display rates and highlight the corresponding group name in the legend. Use the interactive legend (click/unclick) to add/remove groups from the graph.
Figure 3: Text Description
Laboratory Data
Figures 4 and 5 illustrate resistance patterns and molecular data over time. Figure 4 provides insights into how these organisms respond to antimicrobial treatments over time, while Figure 5 reveals their genetic diversity and evolution over time.
Figure 4. Antimicrobial Resistance
Hover over areas of the graph to highlight the corresponding group name in the legend. Use the interactive legend (click/unclick) to add/remove groups from the graph.
Figure 4: Text Description
Figure 5.
Hover over areas of the legend to highlight the corresponding group in the graph. Use the interactive legend (click/unclick) to zoom in on the selected group.
Figure 5: Text Description
Device and surgical procedure-related infections
CNISP collects surveillance data for several device and surgical procedure-related infections including central-line associated bloodstream infections (CLABSI), cerebrospinal fluid (CSF) shunt surgical site infections (SSIs), hip and knee SSIs, and paediatric cardiac (paeds-card) SSIs. In this section you can filter for a specific device or surgical procedure-related infection to display annual incidence rate data.
Detailed case information
The tables and figures below represent detailed case information provided to CNISP by participating hospitals. These data are subject to change as we receive new information over time.
For more detailed information on device and surgical procedure-related infections, please refer to the most recent annual Canada Communicable Disease Report (CCDR) publication: Device and surgical procedure-related infections in Canadian acute care hospitals, 2018–2022
Figure 6. Incidence Rates by Type
Figure 6: Text Description
Figures 7 and 8 illustrate the most common pathogens identified, and their resistance patterns over time. These are reflected as proportions.
Figure 7. Distribution of the Most Frequently Reported Gram-negative, Gram-positive and Fungal Pathogens
Figure 7: Text Description
Figure 8. Antimicrobial Resistance by Pathogen
Antibiogram results are displayed for organisms with a minimum of thirty tested isolates.
Intrinsically resistant
* Less than 90% of isolates were reported
Figure 8: Text Description
R = Intrinsically resistant
* = Less than 90% of isolates were reported