The Emerging Epidemiology of VRE in Canada: Results of the CNISP Passive Reporting Network, 1994 to 1998

OBJECTIVE: To provide a rapid and efficient means of collecting descriptive epidemiological data on occurrences of vancomycin-resistant enterococcus (VRE) in Canada. DESIGN AND METHODS: Passive reporting of data on individual or cluster occurrences of VRE using a one-page surveillance form. SETTING: The surveillance form was periodically distributed to all Canadian Hospital Epidemiology Committee members, Community and Hospital Infection Control Association members, L'Association des professionnels pour la prevention des infections members and provincial laboratories, representing 650 health care facilities across Canada. PATIENTS: Patients colonized or infected with VRE within Canadian health care facilities. RESULTS: Until the end of 1998, 263 reports of VRE were received from 113 health care facilities in 10 provinces, comprising a total of 1315 cases of VRE, with 1246 cases colonized (94.7%), 61 infected (4.6%)and eight of unknown status. (0.6%). VRE occurrences were reported in 56% of acute care teaching facilities and 38% of acute care community facilities. All facilities of more than 800 beds reported VRE occurences compared with only 10% of facilities with less than 200 beds (r2=0.86). Medical and surgical wards accounted for 51.4% of the reported VRE occurences. Sixty-five (24.7%) reports indicated an index case was from a foreign country, with 85.2% from the United States and 14.8% from other countries. Some type of screening was conducted in 50% of the sites. CONCLUSIONS: A VRE passive reporting network provided a rapid and efficient means of providing data on the evolving epidemiology of VRE in Canada.