Acknowledgements

PICNet acknowledges and thanks our colleagues in each of the health authorities, including Fraser Health (FH), Interior Health (IH), Island Health (ISLH), Northern Health (NH), Providence Health Care (PHC), Provincial Health Services Authority (PHSA), and Vancouver Coastal Health (VCH) for their collaboration in providing their health authority’s data, which supports building a provincial view of the five indicators. We also recognize the contributions of IPC professionals, laboratory teams, and epidemiology partners who support this work locally.

We would also like to specifically acknowledge the contribution and expertise of the following groups:

PICNet’s Leadership and Surveillance team
Provincial Infection Prevention and Control Surveillance Working Group (IPC SWG)
Provincial Infection Prevention and Control Steering Committee (PIPSC)
Public Health Laboratory (PHL), BC Centre for Disease Control (BCCDC)
Infection Prevention and Control Unit, Communicable Disease Prevention and Control Branch, BC Ministry of Health

First Nations Land Acknowledgement

We respectfully acknowledge that we work and live on the traditional, ancestral, and unceded territories of many BC First Nations. PICNet’s office is on the traditional territories of the xʷməθkʷəy̓əm (Musqueam), Skwxwú7mesh (Squamish), and səlilwətaɬ (Tsleil-Waututh) Nations. We also acknowledge the Métis Chartered Communities and Inuit who reside on these lands.

Abbreviations

Abbreviation	Definition
ACFs	Acute Care Facilities
BC	British Columbia
BCCDC	British Columbia Centre for Disease Control
C. auris	Candida auris
CDI	Clostridioides difficile infection
CPE	Carbapenemase-producing Enterobacterales
CPO	Carbapenemase-producing organisms
FH	Fraser Health
FY	Fiscal year
HAI	Health care-associated infections
HCA	Health care-associated
HCC	Hand cleaning compliance
HCW	Health-care worker
ICU	Intensive care unit
IH	Interior Health
IPC	Infection prevention and control
ISLH	Island Health
LOESS	Locally estimated scatterplot smoothing
LTC	Long-term care
LTCF	Long-term care facility
MoH	Ministry of Health
MRSA	Methicillin-resistant Staphylococcus aureus
NH	Northern Health
PHC	Providence Health Care
PHL	Public Health Laboratory
PHSA	Provincial Health Services Authority
PICNet	Provincial Infection Control Network of British Columbia
VCH	Vancouver Coastal Health

Executive Summary

This report shares trends in health care-associated infections (HAI) and colonizations, and community-associated cases in British Columbia (BC), spanning six fiscal years from April 2018 to March 2024. The findings reflect data collected by health authorities, whose ongoing surveillance efforts are essential to building a provincial picture of HAI trends. It focuses on five indicators in health-care facilities, monitored by Provincial Infection Control Network of British Columbia (PICNet): Clostridioides difficile infection (CDI), Methicillin-resistant Staphylococcus aureus (MRSA), Carbapenemase-producing organisms (CPO), Candida auris (C. auris), and hand cleaning compliance (HCC). The reported data is meant for the purpose of monitoring trends over time to guide system-wide strategies and inform action.

Over the six-year period, provincial rates of CDI and MRSA generally declined, HCC performance remained stable, and C. auris cases remained low. In contrast, CPO trends indicate increasing local detection, evidenced by rising case counts and the absence of typical risk factors, such as travel or health care received abroad.

In BC, most reported CPO cases are due to Carbapenemase-producing Enterobacterales (CPE). Provincial trends observed in BC mirror national data, which show a sharp increase in CPE rates since 2019, including among patients without recent travel history [1]. Similar trends are reported in the United States and Europe [2, 3].

In response to the concerning increases in CPO, PICNet collaborated with health authority infection prevention and control (IPC), BC Centre for Disease Control (BCCDC) Public Health Laboratory (PHL), and public health partners to develop a provincial CPO Action Plan. The plan focuses on enhancing surveillance and quarterly reporting. This includes improving how exposure is classified to show whether infections are acquired through local health care, in the community, or through travel or health care abroad. It also addresses information sharing across health authorities when cases identified in a facility appear connected. In addition, PICNet will work with health authority IPC to develop provincial IPC guidelines and education and knowledge translation resources for the prevention and management of CPO in health-care settings.

This year’s report features enhanced analytics, including the use of Locally Estimated Scatterplot Smoothing (LOESS) to identify long-term patterns and reduce the visual impact of year-to-year fluctuations. This approach improves the clarity of trend interpretation by smoothing short-term variability. More detail is provided in the Technical Notes section.

Key Findings (2018/19 – 2023/24)

Focus Area	Key Findings
Clostridioides difficile infection (CDI)	• The rate of new health care-associated (HCA) cases declined over the period
Clostridioides difficile infection (CDI)	• Serious complications associated with CDI remain rare
Methicillin-resistant Staphylococcus aureus (MRSA)	• Community and regional hospitals show modest declines in HCA cases over the reporting period
Methicillin-resistant Staphylococcus aureus (MRSA)	• Tertiary/referral hospitals show a slight increase in 2023/24
Carbapenemase-producing organisms (CPO)	• Reported cases declined during the pandemic then rose sharply once restrictions were lifted, surpassing pre-pandemic levels
Carbapenemase-producing organisms (CPO)	• Recently, more cases have a history of health care in BC
Candida auris (C. auris)	• Case counts remain low
Hand Cleaning Compliance (HCC)	• Provincial hand hygiene compliance met the 80% target in all areas except before patient contact and among physicians

Introduction

A HAI occurs when a patient becomes ill due to a pathogen acquired during health care. This can result in longer hospital stays, medical complications, and increased health-care costs. A colonization means the pathogen is present in the body without causing illness; however, it can spread to others or cause an infection in a susceptible person [4,5]. Managing colonized patients also requires added transmission-based precautions, which further adds to cost and burden on the health-care system and may contribute to emotional distress or isolation for the patient [6-9]. These precautions also generate additional resource use, such as single-use PPE, cleaning products, and energy, which has environmental implications alongside the financial and psychosocial impacts [10,11].

PICNet, mandated by the MoH, coordinates provincial surveillance by consolidating data from all health authorities, performing provincial-level analysis and interpretation, and sharing findings with health authorities, the Ministry of Health (MoH), and the public. A provincial-level view of trends supports IPC planning by informing provincial policies, protocols, and guideline development. Health authority IPC teams are mandated by the MoH to conduct surveillance of CDI, CPO, C. auris, and HCC. Although not mandated, health authority IPC teams have agreed to provide MRSA data to PICNet for provincial analysis and reporting of MRSA. The purposes of this report are to:

Fulfill mandated surveillance responsibilities by reporting provincial trends for CDI, CPO, C. auris, and HCC as required by the MoH.
Describe trends over time, using six years of surveillance data (April 1, 2018 to March 31, 2024) to highlight increases, declines, and patterns, including those affected by the COVID-19 pandemic.
Provide a provincial-level picture by aggregating data from all health authorities, enabling provincial benchmarking.
Inform IPC practices and surveillance protocols by identifying areas for improvement, supporting protocol refinement, and guiding the development of tools and resources to strengthen infection prevention across the province.

Detailed information on each surveillance indicator, including the pathogens under surveillance, data sources, surveillance populations, and case definitions, is provided in the Overview of Surveillance Indicators section that follows.

Surveillance insights in this report are based on data submitted quarterly by each health authority. Variations in screening policies, data collection methods, and patient populations across regions mean that direct comparisons between authorities or facilities are not appropriate. Instead, reported data are meant to illustrate trends over time and guide system-wide strategies, rather than rank individual health authorities or facilities.

This report reflects data available at the time of publication. Because data are subject to ongoing updates and revisions, counts, rates, and/or figures presented here may differ in future versions of this report or in other reports produced on different update cycles.

Overview of Surveillance Indicators

Clostridioides difficile Infections (CDI)
Clostridioides difficile (C. difficile) is a bacterium that can cause serious colon infections, especially when the natural gut flora is disrupted by antibiotics, chemotherapy, or underlying health conditions. CDI is primarily spread via spores that persist on surfaces and are transferred through contaminated hands or equipment. CDI spores are incredibly resilient, surviving for months on surfaces, and must be removed with specific disinfectants that are effective against spore-forming bacteria. Cleaning and disinfection in health-care facilities is an important element to reduce the risk of CDI along with hand cleaning by health-care workers (HCWs), patients, and visitors.

Surveillance includes aggregate, facility-level CDI data only (not colonization) from all participating acute care facilities across the province, with facility participation detailed in Appendix A by health authority, facility type, and size. CDI surveillance is guided by a standard provincial surveillance protocol, which is regularly updated and ensures that data are collected and reported consistently across all health authorities.

The surveillance population includes inpatients aged one year or older admitted to acute care facilities in BC. This includes patients admitted to emergency departments awaiting placement, in alternative levels of care, or in labour and delivery.

CDI cases are classified based on symptom timing and recent health-care exposure:

Classification	Case Type	Criteria
Health care-Associated (HCA)	New – Associated with Reporting Facility	Symptoms began >3 days after admission to the same facility OR began ≤3 days after admission and the patient stayed overnight at the same facility within the past 4 weeks, with symptom onset <4 weeks after discharge.
	New – Associated with Another Facility	Symptoms began ≤3 days after admission, and the patient stayed overnight at a different health-care facility within the past 4 weeks, with symptom onset <4 weeks after discharge.
	Relapse – Associated with Reporting Facility	Symptoms recurred 2–8 weeks after a previous CDI episode linked to the same facility.
	Relapse – Associated with Another Facility	Symptoms recurred 2–8 weeks after a previous CDI episode linked to a different facility.
Community-Associated (CA)	Community-Associated (CA)	Symptoms began in the community or ≤3 days after admission, and the patient had no overnight stays in any health-care facility in the past 4 weeks.
Unknown	Unknown	Not enough information is available to determine recent health-care exposure.

*See the provincial CDI surveillance protocol for detailed definitions, case exclusions, and classification rules.

Methicillin-Resistant Staphylococcus aureus (MRSA)
Staphylococcus aureus is a common bacterium found in both hospitals and the community. MRSA is a strain that has developed resistance to multiple antibiotics, making infections more difficult to treat. MRSA can cause a range of clinical outcomes, from asymptomatic colonization to severe infections such as bloodstream infections, pneumonia, and surgical site infections. In health-care settings, MRSA can spread easily through direct contact or contaminated surfaces.

Surveillance includes aggregate, facility-level MRSA data on colonizations and infections from all participating acute care facilities, with details provided in Appendix A by health authority, facility type and size. MRSA surveillance is guided by a standard provincial surveillance protocol, which is regularly updated and ensures that data are collected and reported consistently across all health authorities.

The surveillance population includes inpatients admitted to acute care facilities in BC. This includes patients in emergency departments awaiting placement, in alternative levels of care, in labour and delivery, or in mental health units.

MRSA cases are classified based on the date of MRSA identification and the patient’s health-care encounter history in the previous 12 months.

Classification	Definition
Health care-Associated with Current Admission to the Reporting Facility	MRSA identified >48 hours (i.e., on or after Day 3) after admission to the reporting facility. Note: Health authorities that use a ≥72-hour threshold may continue to do so with communication to PICNet
Health care-Associated with Previous Encounter with the Reporting Facility	MRSA identified ≤48 hours (i.e., Day 1–2) after admission and any of the following apply: Overnight admission to the same facility in the past 12 months; Presence of an indwelling device inserted by the facility; Weekly outpatient visits (e.g., dialysis, oncology) to the facility for more than 4 weeks in the past 12 months
Health care-Associated with Another Health-Care Facility	MRSA identified ≤48 hours after admission and any of the following apply: Overnight admission or ≥24-hour stay in another facility in the past 12 months; Weekly outpatient visits to another facility in the past 12 months; Indwelling device inserted by another facility
Community-Associated	MRSA identified ≤48 hours after admission with no documented history in the past 12 months of: Admission to an acute care facility; Residence in long-term care or rehab; Weekly outpatient clinic visits; Use of indwelling medical devices
Unknown	Insufficient information is available to determine health-care exposure in the past 12 months

*See the provincial MRSA surveillance protocol for detailed definitions, case exclusions, and classification rules.

Carbapenemase-Producing Organisms (CPO)
CPOs are gram-negative bacteria that are resistant to carbapenems, which are broad-spectrum antibiotics, that can result in infections that are difficult to treat. These bacteria are a serious concern in hospitals, especially for patients with comorbidities or who remain in health care for a long period of time.

Surveillance includes case-level CPO data on colonizations and infections from all participating acute care facilities, with details provided in Appendix A by health authority, facility type, and size. CPO surveillance is guided by a standard provincial surveillance protocol, which is regularly updated and ensures that data are collected and reported consistently.

The surveillance population includes all CPO cases identified in BC, including those detected in acute care settings as well as in the community, such as outpatient clinics, residential care facilities, and assisted living homes.

CPO cases are classified based on the health-care setting in which they are identified:

Classification	Definition
Acute care identified	Cases identified in patients who are admitted to an acute care facility or who are identified in an emergency department and subsequently admitted to acute care
Community identified	Cases identified in community health-care settings, including long-term care facilities, outpatient clinics, by community laboratories, or during emergency department visits where the patient was not subsequently admitted to acute care

*See the provincial CPO surveillance protocol for detailed definitions, case exclusions, and classification rules.

Candida auris (C. auris)
C. auris is an emerging, multidrug-resistant yeast that has caused outbreaks in health-care settings around the world. It can survive on surfaces and spreads easily between patients, especially in acute care hospitals and long-term care facilities. C. auris is resistant to many common disinfectants and antifungals, making targeted infection prevention and control measures essential to limiting transmission in health-care environments. Effective cleaning requires disinfectants capable of killing fungal pathogens. To support containment and response efforts, provincial interim C. auris guidelines are available and outline recommended prevention and control strategies.

PICNet collects data on both C. auris colonizations and infections through passive, laboratory-based surveillance for C. auris, coordinated with the BCCDC Public Health Laboratory (PHL). Surveillance began in 2018 in response to international concerns [12, 13] and is reported annually due to the small number of cases in BC. Surveillance is guided by a standard provincial surveillance protocol, which is regularly updated and ensures that data are collected and reported consistently.

The surveillance population includes all laboratory-confirmed cases reported by BCCDC PHL.

Hand Cleaning Compliance (HCC)
Hand hygiene is widely recognized as one of the most effective strategies to prevent transmission in health-care settings [14]. In BC, HCC data are collected through periodic observational audits conducted in health-care facilities, as outlined in the MoH’s BC Best Practices for Hand Hygiene document. These audits capture a subset of potential hand hygiene opportunities and are based on either four or five moments of hand hygiene, depending on health authority practice. The four moments include:

Before initial patient or patient environment contact;
Before an aseptic procedure;
After body fluid exposure risk;
After patient or patient environment contact.

Some health authorities separate the fourth moment into two distinct moments:

After patient contact;
After contact with the patient environment.

For provincial reporting, these moments are collapsed into two categories: before contact and after contact with a patient or their environment. Compliance rates are reported as the percentage of observed opportunities where appropriate hand hygiene was performed. Results are published publicly against a minimum 80% compliance target. Health authority IPC teams submit facility-level HCC data on a quarterly basis.

Figure User Guide

Clostridioides difficile Infection (CDI)

This section presents surveillance results for CDI in BC acute care facilities from April 1, 2018 to March 31, 2024. These include trends in the distribution of CDI case classifications (Figure 1), rates of new health care-associated cases (Figures 2–4), relapse rates (Figure 5), and CDI-related complications within 30 days of diagnosis (Figure 6).

Testing methods for CDI have evolved and become more standardized in recent years. All health authorities in BC now use a two-step testing process, though the timing of implementation varied by region. In a two-step process, an initial screening test is followed by a second test to confirm whether the bacteria are producing toxins that can cause illness. Some areas have also introduced multi-organism panel tests, which test for several pathogens at once. These changes can impact the number of reported CDI cases, contributing to shifts in case counts over time.

Figure 1 shows the number and percentage of CDI cases by case classification category, from 2018/19 to 2023/24. See the Overview of Surveillance Indicators section for classification definitions. Each category can be selected from the drop-down list.

New HCA cases associated with the reporting facility or another facility decreased from 1,112 in 2018/19 to 944 in 2021/22, rose to 1,029 in 2022/23, and declined to 950 in 2023/24. In total, these made up 53.8 to 57.7% of all reported CDI cases.
HCA relapse cases associated with the reporting facility or another facility fluctuated less over time, ranging from 96 to 115 cases annually. These accounted for 5.7% to 6.2% of CDI cases.
Community-associated cases varied over time, with a low of 603 cases in 2019/20 and a high of 748 in 2018/19, reaching 675 cases in 2023/24. These made up 33.7 to 38.3% of cases over time. Note that PHSA and Providence Health Care (PHC) are currently unable to identify new CDI cases associated with another facility. In addition, Vancouver Coastal Health (VCH), PHC, and Interior Health (IH) do not collect community-associated CDI cases. A summary of methodological variations is provided in the CDI section of the technical notes.

Figure 1. Distribution of CDI episodes reported in acute care facilities in BC by classification - Select count or percentage.

Notes:
- PHSA and PHC are unable to collect new or relapse CDI cases that were associated with another facility.
- VCH, PHC and IH do not collect community-associated or unknown CDI cases.

Figure 2 shows the rate of new HCA CDI cases associated with the reporting facility expressed per 10,000 inpatient days, from 2018/19 to 2023/24, for the province and each health authority. Case counts are also provided for reference. Health authority can be selected from the drop-down list.

At the provincial level, the rate showed a gradual decline over the six-year reporting period, with some year-to-year variation.

The rate decreased slightly from 3.4 in 2018/19 to 3.2 in 2019/20, followed by an increase to 3.6 in 2020/21.
After 2020/21, the rate declined each year, reaching 2.6 in 2023/24, the lowest rate observed during the reporting period.

Direct comparisons across health authorities should be avoided due to differences in testing, screening, case-finding, and application of the surveillance protocol. Methodological differences are detailed in the CDI section of the technical notes.

The annual rate of CDI associated with the reporting facility, and 95% confidence intervals, for participating acute care facilities is presented in Appendix C.

Figure 2. Count and rate of new HCA CDI cases associated with the reporting facility - Select BC or health authority.

Notes:
- Comparisons across health authorities should be avoided.
- The Locally Estimated Scatterplot Smoothing (LOESS) method creates a smooth trend line through the data by fitting simple curves to small groups of nearby data points.

Figure 3 presents the provincial rate of new CDI cases associated with the reporting facility per 10,000 inpatient days, from 2018/19 to 2023/24, stratified by acute care hospital type: regional, community, and tertiary/referral hospitals. See the general section of the technical notes for definitions of acute care hospital types.

Overall, CDI rates were more stable in community and tertiary/referral hospitals, while regional hospitals showed a greater overall decline and a distinct spike in 2020/21.

Regional hospitals experienced the most noticeable changes. Rates increased from 3.3 in 2018/19 to a peak of 4.3 in 2020/21, then declined steadily to 2.2 in 2023/24, indicating clear improvement over time.
Community hospitals showed more modest variation. Rates remained relatively stable in the earlier years, peaking at 2.6 in 2020/21, and declined to 1.7 in 2023/24, reflecting a small but steady improvement.
Tertiary/referral hospitals rates showed a gradual decline, dropping from 3.8 in 2018/19 to 3.3 in 2019/20, and further reaching 3.2 by 2023/24. Most tertiary/referral hospitals are also large facilities with more than 250 beds.

Figure 3. Provincial rate of new CDI cases associated with the reporting facility by type of acute care facility.

Figure 4 presents the provincial rate of new CDI cases associated with the reporting facility, per 10,000 inpatient days, from 2018/19 to 2023/24, stratified by acute care hospital size.

Overall, smaller and medium-sized hospitals showed more year-to-year variation, while larger hospitals had more stable rates across the six-year reporting period.

Large-sized hospitals (more than 250 beds) had the most consistent rates across the period, declining gradually from 3.6 cases per 10,000 inpatient days in 2018/19 to 3.1 in 2023/24. Currently, large hospitals report the highest rates of new CDI cases associated with the reporting facility. Most large hospitals are also classified as tertiary/referral hospitals.
Medium-sized hospitals (151–250 beds) experienced the most pronounced spike during the COVID-19 pandemic, with rates peaking at 4.4 in 2020/21, followed by a decline to 2.4 in 2023/24.
Smaller-sized hospitals (51–150 beds) exhibited a clear downward trend, with rates declining from 3.7 in 2018/19 to 2.1 in 2023/24.
The smallest hospitals (50 beds or fewer) showed an overall decline, with rates decreasing from 2.4 in 2018/19 to 1.6 in 2023/24.

Figure 4. Provincial rate of new CDI cases associated with the reporting facility by size of acute care facility.

Figure 5 shows the number and percentage of HCA CDI cases that were classified as relapses, from 2018/19 to 2023/24.

The number of relapse HCA CDI cases stayed relatively stable over time, ranging from a high of 115 in 2018/19 to a low of 96 in 2021/22. In 2023/24, there were 109 cases.
The percentage of all HCA CDI cases that were relapses also stayed mostly the same, ranging between 9.2% and 9.8%. In 2023/24, the proportion rose slightly to 10.3%.

Figure 5. Number and percentage of relapses among HCA CDI cases.

Figure 6 shows the percentage of CDI cases that resulted in serious complications within 30 days of diagnosis, from 2018/19 to 2023/24, including ICU admission, toxic megacolon, and colectomy.

These outcomes remained uncommon from 2018/19 to 2023/24, though some year-to-year variation was observed.

The percentage of CDI cases requiring ICU admission ranged from 2.5% to 3.3%, with a general decline between 2018/19 and 2022/23, followed by a slight increase in 2023/24.
Toxic megacolon was rare but showed a gradual increase, rising from a low of 0.3% in 2019/20 to 0.8% in 2023/24.
Colectomies also became slightly more frequent, increasing from 0.4% in 2021/22 to 1.2% in 2023/24.

For much of the reporting period, complication data for CDI was available from four health authorities (FH, ISLH, NH, and VCH). IH began submitting these data in Q3 of 2023/24.

Figure 6. Percentage of CDI-associated complications within 30 days of diagnosis.

Methicillin-Resistant Staphylococcus aureus (MRSA)

This section presents surveillance results for MRSA in BC acute care facilities from April 1, 2018 to March 31, 2024. These include trends in the distribution of MRSA case classifications (Figure 7), rates of new HCA cases by health authority (Figure 8), and provincial rates by facility type (Figure 9) and facility size (Figure 10).

Figure 7 presents the distribution of new MRSA cases in the province by classification, from 2018/19 to 2023/24. See the Overview of Surveillance Indicators section for classification definitions.

Health care-associated (HCA) cases linked to the current hospital admission increased in recent years, reaching 557 cases (23.6%) in 2023/24. Similarly, HCA cases associated with a previous hospital admission rose to 635 cases (26.8%) in the same year. These classifications were previously in decline up to 2020/21.
HCA with another facility showed a gradual decline, dropping from 498 (18.4% of cases) in 2018/19 to 365 (15.4%) in 2023/24. PHC is unable to collect new MRSA cases associated with another facility.
Community-associated cases peaked at 727 (26.8% of cases) in 2018/19, falling slightly to 629 (26.6%) in 2023/24. It is important to note that VCH, and PHC do not collect community-associated MRSA cases.
Cases with unknown classification declined overall, dropping from 220 (8.1%) in 2018/19 to 179 (7.6%) in 2023/24, despite a temporary spike to 337 cases (16.2%) during the COVID-19 pandemic in 2020/21. VCH and IH do not report on MRSA cases with unknown classification.

Figure 7. Distribution of new MRSA cases reported in acute care facilities in BC by classification - Select count or percentage.

Notes:
- PHC does not collect MRSA cases associated with another reporting facility and community-associated cases.
- VCH does not collect unknown and community cases data while IH does not collect unknown subtype data.

Figure 8 shows the rate of new MRSA cases associated with the reporting facility in the province and each health authority, expressed per 10,000 inpatient days, from 2018/19 to 2023/24. Health authority can be selected from the drop-down list. Counts are also presented for reference.

At the provincial level, the rate declined from 4.0 in 2018/19 to 3.1 in 2022/23, followed by a slight increase to 3.4 in 2023/24.

Direct comparisons between health authorities should be avoided, as differences may reflect variation in population characteristics, hospital services, and potential differences in screening, case-finding strategies, and application of the provincial surveillance protocol. Methodological differences are detailed in the MRSA section of the technical notes.

The annual rate and 95% confidence intervals for acute care facilities are provided in Appendix D.

Figure 8. Count and rate of new HCA MRSA cases associated with the reporting facility - Select BC or health authority.

Notes:
- Comparisons across health authorities should be avoided.
- The Locally Estimated Scatterplot Smoothing (LOESS) method creates a smooth trend line through the data by fitting simple curves to small groups of nearby data points.

Figure 9 shows the provincial rate of new MRSA cases per 10,000 inpatient days, stratified by hospital type, from 2018/19 to 2023/24. See the general section of the technical notes for definitions of acute care hospital types.

Rates varied by facility type:

Tertiary and referral hospitals had the highest MRSA rates at the start of the reporting period, with 4.2 in 2018/19. Rates dropped to 3.0 in 2020/21, then rose again to 3.7 in 2023/24.
Regional hospitals showed a modest overall decline from 3.8 in 2018/19 to 3.1 in 2021/22 and 2022/23, followed by a small rise to 3.2 in 2023/24.
Community hospitals had the lowest rates throughout the period, with a gradual decrease from a high of 3.6 in 2020/21 to 2.9 in 2023/24.

Figure 9. Provincial rate of new cases of MRSA associated with the reporting facility by facility type.

Figure 10 presents the provincial rate of new MRSA cases per 10,000 inpatient days, stratified by hospital size, from 2018/19 to 2023/24.

Most size categories showed an overall decrease over time, however slight increases were observed in 2023/24:

Large-sized hospitals (more than 250 beds) had relatively high rates, starting at 4.2 in 2018/19, decreasing to 3.1 in 2021/22 and 2022/23, and rising again to 3.6 in 2023/24.
Medium-sized hospitals (151–250 beds) had the highest rates overall, decreasing from 4.3 in 2018/19 to 3.1 in 2022/23, followed by a slight increase to 3.3 in 2023/24.
Smaller-sized hospitals (51–150 beds) reported the lowest rates overall, reaching a low of 2.7 in 2021/22 and rising to 3.2 in 2022/23, before declining to 2.9 in 2023/24.
The smallest hospitals (50 beds or fewer) had more year-to-year variation, with a peak of 3.8 in both 2018/19 and 2019/20, falling to 2.8 in 2022/23, ending with 3.0 in 2023/24.

Figure 10. Provincial rate of new cases of MRSA associated with the reporting facility by facility size.

Carbapenemase-Producing Organisms (CPO)

This section presents surveillance results for CPO in BC from April 1, 2018 to March 31, 2024. These include trends in new CPO colonizations and infections (Figures 11 and 17), distribution of carbapenemase gene types (Figure 12), reported exposures such as recent travel or health-care encounters (Figures 13–16), rate of new CPO colonizations and infections (Figure 17), and outcomes for acute care CPO infections (Figures 18 and 19).

CPO surveillance is gene-based, with each new case defined by the first identification of a unique carbapenemase gene in a patient. See the technical notes section for more information.

Figure 11 shows the rate of reported CPO cases in BC and by health authority, expressed per 10,000 hospital admissions, from 2018/19 to 2023/24. Health authority can be selected from the drop-down list.

Overall, the provincial rate increased from 4.2 cases per 10,000 hospital admissions in 2018/19 to 7.7 in 2023/24.
A temporary decline occurred in 2020/21 and 2021/22, likely due to impacts of the COVID-19 pandemic.
Rates increased sharply post-pandemic, possibly due to a combination of increased travel, expanded screening, and a rise in CPO cases in the identified in community health-care settings.

Comparisons across health authorities should be avoided due to variations in applying the provincial surveillance protocol, case finding strategies, patient demographics and risk profile and services provided. Methodological differences are detailed in the CPO section of the technical notes.

Note: FH and VCH are reported separately because their case counts are high enough to produce stable rates. FH serves the largest patient population in the province and is highly diverse. In addition, FH implements broader screening practices than those required by the provincial protocol. VCH serves the second-largest patient population and is also characterized by a very diverse demographic profile.

Figure 11. Count and rate of new cases of CPO, including both first-time colonizations and first-time infections - Select BC or health authority.

Notes:
- Comparisons across health authorities should be avoided.
- The Locally Estimated Scatterplot Smoothing (LOESS) method creates a smooth trend line through the data by fitting simple curves to small groups of nearby data points.

Figure 12 shows the percentage of new CPO cases in BC by carbapenemase gene type, from 2018/19 to 2023/24.

NDM remained the dominant gene type throughout the period, accounting for the largest share each year, from a high of 65.9% in 2018/19 to a low of 51.0% in 2020/21.
OXA-48 peaked in 2019/20 at 28.8% and remained relatively high in subsequent years.
KPC increased steadily until reaching 26.8% in 2021/22, then declined to 14.2% in 2023/24.
SME showed a brief increase in 2021/22 (4.1%) but declined in later years.
Other gene types consistently made up less than 3% of cases annually, with minor fluctuations.

Figure 12. Percentage new CPO Cases in BC by gene type.

Figure 13 presents the percentage of CPO cases identified in community health-care settings across BC, from 2018/19 to 2023/24. See the Overview of Surveillance Indicators section for details on community health-care settings.

The proportion of cases from community health-care settings declined from 9.6% in 2018/19 to a low of 3.1% in 2021/22, before rising again to 8.6% in 2023/24, approaching pre-pandemic levels.

Figure 13. Percentage of new CPO cases identified in community health-care settings by fiscal year.

Figure 14 shows the number and percentage of new CPO cases in BC where the individual had traveled outside Canada in the 12 months prior to identification, from 2018/19 to 2023/24.

The number of travel-associated cases rose from 122 (58.4%) in 2018/19 to a peak of 198 (50.3%) in 2023/24.
A sharp decline occurred during the time of pandemic-related travel restrictions, with 46 cases (40%) in 2020/21 and a low of 42 cases (32.3%) in 2021/22.
As travel resumed, cases rebounded to 166 (52.7%) in 2022/23 and 198 (50.3%) in 2023/24.

Figure 14. Count and percentage of new CPO cases in BC with travel outside Canada in the 12 months before presentation.

Figure 15 shows the number and percentage of new CPO cases where the individual received health care outside of Canada in the 12 months before identification, from 2018/19 to 2023/24.

Cases with international health-care exposure declined from 113 (54.1%) in 2018/19 to a low of 25 (19.2%) in 2021/22, coinciding with the COVID-19 pandemic.
As travel and medical care abroad resumed following the lifting of pandemic travel restrictions, cases increased to 118 (37.5%) in 2022/23 and 131 (33.2%) in 2023/24.
Despite the rebound, the percentage of cases with a history of international health care remains below pre-pandemic levels.

Figure 15. Count and percentage of new CPO cases in BC with a health-care encounter outside of Canada in the 12 months before presentation.

Figure 16 presents the number and percentage of new CPO cases in BC where the individual received health care in the province in the year before identification, from 2019/20 to 2023/24.

The number of cases remained relatively stable during the pandemic, but the percentage increased sharply from 34.2% in 2019/20 to a peak of 58.5% in 2021/22, coinciding with a decline in travel-associated cases.
In more recent years, the number of cases rose from 62 in 2020/21 to 207 in 2023/24.
The percentage of cases with a history of health care in BC remained high: 53.3% in 2022/23 and 52.5% in 2023/24, even as travel-associated cases rebounded.

Figure 16. Count and percentage of new CPO cases in BC with a health-care encounter in BC in the 12 months before presentation.

Note: Data from 2019/20 onward are reported as history of a healthcare encounter in BC was consistently collected beginning in 2019/20.

Figure 17 shows annual rates of new CPO colonizations and infections per 10,000 hospital admissions in BC, from 2018/19 to 2023/24.

Colonizations (bacteria present without illness) were relatively stable at 3.4 and 3.7 per 10,000 admissions in 2018/19 and 2019/20, dropped to 1.7 in 2020/21, then climbed to 5.1 in 2022/23 and 5.6 in 2023/24.
Infections (bacteria causing illness) declined from 0.8 in 2018/19 to to 0.5 in 2020/21, then rose to 2.0 in 2023/24.

Figure 17. Rate of new CPO colonizations and infections in BC.

Figure 18 presents ICU admission status for patients with CPO infections in acute care facilities across BC, from 2018/19 to 2023/24.

Most patients were not admitted to ICU, a pattern consistent across all years.
The percentage admitted to ICU due to their infection was highest in 2018/19 (17.9%) and remained lower in recent years — 7% in 2022/23 and 10.2 in 2023/24.
The proportion already in ICU at the time of infection varied more, peaking at 31.0% in 2022/23, possibly reflecting longer ICU stays during the COVID-19 period.

Figure 18. Intensive care unit (ICU) admission status (%) for all reported acute care CPO infections in BC.

Included are all acute care infections reported to PICNet, covering both index infections and those that progressed from an index colonization within one year.

^aICU Admission indicates if ICU admission was required due to the infection or the complications associated with the infection within 30 days after identification of the infection.

Figure 19 shows outcomes for patients with CPO infections, measured within 30 days of diagnosis or until discharge, from 2018/19 to 2023/24.

Deaths from any cause ranged from 11.8% to 25.0%, peaking in 2020/21, possibly reflecting from patient complexity. These deaths may not be directly attributable to CPO infection.
Prolonged hospital stays (still in hospital after 30 days) ranged from 14.3% to 28.2%, potentially influenced by comorbidities or concurrent conditions such as COVID-19.
Survival and discharge ranged from 32.4% in 2019/20 to 49.1% in 2023/24.
survival with transfer to another facility varied, with no cases in 2021/22 and a peak of 23.5% in 2019/20.
Missing outcome data ranged from no missing in 2023/24 to 11.8% in 2019/20. PICNet continues to work with health authority partners to improve follow-up and data completeness.

Figure 19. CPO infection outcomes^a in BC (%) within 30 days of infection identification or until discharge.

Included are all acute care infections reported to PICNet, covering both index infections and those that progressed from an index colonization within one year.

^aWithin 30 days of infection identification or until discharge
^b“Patient died” reflects all-cause mortality

Candida auris (C. auris)

Figure 20 presents the number of new C. auris cases identified in BC from April 1, 2018 to March 31, 2024.

Four cases identified in 2018/19 were linked to an outbreak in an intensive care unit [12]. The outbreak was quickly contained through enhanced IPC measures.
Since 2019/20, case counts remain low overall, with three or fewer cases identified in the province each year.

Figure 20. Number of new C. auris cases in BC acute care facilities.

Hand Cleaning Compliance (HCC)

This section presents surveillance results for hand cleaning compliance (HCC) in BC health-care facilities from April 1, 2018 to March 31, 2024. These include trends in overall compliance in acute and long-term care settings (Figure 21), compliance by moment of hand hygiene (Figure 22), and compliance by health-care provider type (Figure 23). Tables 1 and 2 summarize average compliance rates by health authority for acute care and health authority-owned or operated long-term care facilities.

Figure 21 presents HCC in acute and long-term care facilities across BC, from 2018/19 to 2023/24. Facility type can be selected from the drop-down list.

Acute care HCC consistently met or exceed the 80% provincial target. The rate remained stable over time, ranging from 82.2% in 2022/23 to 84.8% in 2020/21, with a rate of 82.5% in 2023/24.
To account for variation in the number of observations across facilities, provincial acute care compliance was also weighted by inpatient days. Weighted rates were similar to unweighted rates, ranging from 81.9% in 2022/23 and 2023/24 to 84.7% in 2020/21. Details of weighting methodology are provided in the technical notes section.
HCC in long-term care peaked at 90.9% in 2020/21, then declined to 79.8% in 2022/23 and 80.4% in 2023/24.

Figure 21. HCC (%) in BC - Select acute care or long-term care .

Figure 22 shows HCC in acute care facilities, stratified by hand hygiene performed before or after contact with a patient or their environment, from 2018/19 to 2023/24.

Compliance after contact (moments 3 & 4) consistently exceeded the 80% target, ranging from 86% to 89% across the reporting period.
Compliance before contact (moments 1 & 2) ranged from 77% to 79%, remaining slightly below the target in all years.

Figure 22. HCC (%) in acute care facilities in BC before and after contact with a patient or their environment.

Figure 23 presents HCC in acute care facilities in the province by type of health-care provider, from 2018/19 to 2023/24.

Compliance among clinical support services, nursing staff, and other support services ranged from 81% to 86% across all years, consistently meeting or exceeding the provincial target of 80%.
Physician compliance ranged from 70% to 79%, remaining below the target throughout the reporting period. In 2023/24, physician compliance was 70%.

Figure 23. HCC (%) in acute care facilities in BC by health-care provider.

Table 1 shows HCC in acute care facilities by health authority from 2018/19 to 2023/24.

Direct comparisons across health authorities should be avoided because differences and changes in rates may reflect methodological shifts rather than true differences in performance. Methodological differences are detailed in the HCC section of the technical notes.

HCC, stratified by acute care facility, with 95% confidence intervals, is included in Appendix E.

Table 1. HCC (%) in acute care facilities by health authority.

Fiscal Year	FH	IH	ISLH	NH	PHC	PHSA	VCH
2018/19	82.1	87.5	77.3	86.2	75.9	92.7	87.8
2019/20	80.6	87.9	79.4	85.8	73.9	91.6	87.4
2020/21	85.6	83.5	81.0	91.7	75.9	90.9	87.5
2021/22	86.3	75.9	79.3	91.0	72.3	76.3	89.5
2022/23	85.8	71.7	78.3	92.0	75.7	66.3	87.8
2023/24	85.7	71.7	79.4	91.4	74.6	68.7	86.8

Notes:
- Comparisons across health authorities should be avoided.

Table 2 presents HCC in long-term care facilities, which are owned and operated by BC health authorities, from 2018/19 to 2023/24.

As with acute care HCC, direct comparisons across health authorities should be avoided because differences and changes in rates may reflect methodological shifts rather than true differences in performance. Methodological differences are detailed in the HCC section of the technical notes.

Table 2. HCC (%) in health authority-owned/operated long-term care facilities by health authority.

Fiscal Year	FH	IH	ISLH	NH	PHC	VCH
2018/19	90.3	82.6	88.7	80.9	54.5	94.3
2019/20	71.3	88.9	85.4	84.5	56.5	95.4
2020/21	NA	NA	90.6	88.3	NA	97.5
2021/22	NA	73.0	86.0	88.1	61.2	97.8
2022/23	NA	73.2	78.4	82.7	65.3	93.6
2023/24	89.6	71.6	78.9	83.4	68.9	77.1

Notes:
- Comparisons across health authorities should be avoided.

Discussion

Clostridioides difficile Infections (CDI)

CDI rates declined across all hospital sizes over the six-year reporting period, with the largest reductions in medium and smaller facilities. Large hospitals, most of which are tertiary/referral centres, consistently had the highest rates, likely reflecting higher patient acuity, longer hospital stays, and greater antimicrobial use.

Medium-sized hospitals showed the most noticeable pandemic-related spike in 2020/21, possibly due to reduced inpatient days when procedures were delayed or cancelled [15, 16]. Because rates are based on inpatient days, fewer days can inflate rates even if case counts are stable. Rates have since dropped markedly. Smaller hospitals fluctuated year to year, while the smallest hospitals declined steadily.

Relapse rates remained stable throughout the reporting period, with a modest increase in 2023/24. Complication rates were low but rose slightly in 2023/24, partly attributable to expanded reporting coverage following the inclusion of IH data.

The overall decline in CDI rates is encouraging and suggests that ongoing IPC efforts and surveillance practices are having a measurable impact.

Methicillin-Resistant Staphylococcus aureus (MRSA)

Provincial MRSA rates declined from 2018/19 to 2022/23, then rose slightly in 2023/24. Community and regional hospitals showed steady or modest declines, while tertiary/referral hospitals, most of which are large facilities, showed a recent increase. This may reflect the complexity of patient populations and care environments in these settings. MRSA rates in medium hospitals also rose slightly in 2023/24. Smaller hospitals fluctuated without clear trends.

MRSA case classification distributions were stable overall, though HCA cases linked to current or previous hospital admissions increased in recent years, and community-associated cases and HCA cases linked to another facility declined. These trends highlight the need for continued surveillance and targeted infection prevention strategies, particularly in complex care settings.

Carbapenemase-Producing Organisms (CPO)

CPO rates in BC declined temporarily during the COVID-19 pandemic (2020/21 and 2021/22), likely due to reduced admissions, delayed non-urgent care, and travel restrictions [15-17]. These factors limited opportunities for both importation and detection of CPO, particularly among individuals with international health-care exposure, a known risk factor for CPO introduction into the province. Pandemic-related resource constraints and a heightened focus on COVID-19 may have also impacted screening and surveillance activities. Rates increased sharply following the pandemic, which may reflect resumed travel, expanded screening practices, and/or increased transmission. The proportion of cases identified in community settings rebounded to near pre-pandemic levels.

These findings provide an overview of provincial rates and should be interpreted within the context of surveillance practices and population characteristics. Broader screening approaches and demographic diversity can influence detection, and these factors should be considered when interpreting health authority trends.

Gene type distributions were stable, with NDM as the dominant carbapenemase throughout the reporting period. However, fluctuations in OXA-48 and KPC proportions suggest evolving epidemiological patterns. Continued monitoring of gene types is essential to detect emerging threats and guide IPC strategies.

Risk factor history trends highlight the shifting dynamics of potential CPO acquisition. The proportion of cases with a history of international health-care encounters declined during the pandemic and rebounded as travel resumed, though it remains below pre-pandemic levels. In contrast, the proportion of cases with a history of health care in BC increased during the pandemic and has remained high. These patterns may reflect changes in patient movement, expanded screening, improved reporting, and an increase in local transmission. Colonization and infection rates both rose in the final two years of the reporting period. While infections pose the greatest clinical risk, increasing colonization rates signal heightened transmission potential and underscore the need for robust IPC measures.

Most patients with CPO infections were not admitted to ICU, a pattern that remained consistent across the reporting period. Admissions to ICU specifically due to CPO infection were highest early on but have been lower in more recent years. In contrast, the proportion of patients already in ICU at the time of infection fluctuated, peaking during the COVID-19 period, possibly reflecting longer stays and increased acquisition risk. Outcomes also varied, with all-cause mortality, discharge, and hospitalization over 30 days reflecting both infection impact and the underlying complexity of affected patients.

Candida auris (C. auris)

C. auris remains rare in BC, with 15 cases reported since 2018/19. A 2018 ICU outbreak was rapidly contained [12], demonstrating the value of early detection, coordinated IPC, and clear communication.

Although rare, C. auris warrants vigilance given its resistance, persistence, and transmission potential. Rising cases globally, including in Canada and the United States, emphasize the importance of sustained surveillance and preparedness.

Hand Cleaning Compliance (HCC)

Provincial HCC in acute care facilities remained stable over the six-year reporting period, consistently meeting or exceeding the provincial target of 80%. Weighted rates, which account for differences in inpatient volume across facilities, closely mirrored unweighted rates.

Provincial compliance in long-term care facilities peaked in 2020/21 but declined sharply in subsequent years. This may reflect operational challenges during and after the COVID-19 pandemic, including staffing pressures, or may reflect shifts in audit methodology rather than true differences in performance.

Compliance after contact with patients or their environment consistently exceeded the provincial target, while compliance before contact remained below target throughout the reporting period, highlighting a persistent gap.

Most provider groups met or exceeded the target, but physician compliance remained below the 80% target in all years, possibly reflecting both true performance differences and limitations in audit methodology, such as fewer observations due to patient privacy considerations, and challenges in audit timing for the physician group.

Across health authorities, several regions maintained strong compliance, while others consistently did not meet the provincial target over multiple years. Differences in auditing methods across health authorities may systematically produce higher or lower compliance rates. As a result, observed differences in performance may reflect methodological variation rather than true differences in hand hygiene behavior.

Overall, the stability of acute care compliance and consistently high rates after patient contact are encouraging signs of sustained practice. However, persistent gaps, particularly before patient contact and among physicians, point to areas for focused improvement. Continuing engagement with provider groups, refining audit approaches, and promoting more consistent measurement will be important to address these gaps and further improve hand hygiene performance and monitoring.

Overall Summary

Across surveillance indicators, several consistent themes emerged. The COVID-19 pandemic had an impact on case detection, with temporary declines in CDI and CPO and shifts in hand hygiene compliance. Larger and tertiary/referral hospitals generally reported higher rates of CDI and MRSA, particularly in recent years, suggesting patient acuity and complexity may influence observed patterns. There was a notable rise in CPO infections and colonizations following the pandemic, along with a shift in epidemiology, with an increase in cases that report a past health-care encounter in BC. Surveillance also highlighted lower hand hygiene compliance before patient contact and among physicians. Variation in data collection methods, particularly for hand hygiene audits, underscores the need for caution in interpreting regional differences. Overall, these findings reinforce the value of sustained infection prevention and control efforts, consistent surveillance practices, and targeted strategies to address emerging risks and ongoing gaps.

Conclusion

This six-year review demonstrates that infection prevention and control efforts in BC are making measurable progress, particularly with declining CDI rates and consistently strong hand hygiene compliance in acute care. At the same time, emerging and persistent challenges remain, notably rising CPO rates and ongoing gaps in hand hygiene before patient contact and among physicians. While the COVID-19 pandemic temporarily altered surveillance patterns, especially for CPO, recent trends underscore the need for sustained investment of IPC resources in order to support resilient, adaptive surveillance systems and implementation of IPC strategies at the patient/resident level of care.

Overall, the findings underscore the value of sustained provincial surveillance and the contributions of all health authorities in providing data that together create a comprehensive picture of healthcare-associated infections in BC. Continued attention to both long-standing and emerging challenges will help ensure that infection prevention and control efforts remain responsive and effective. By maintaining this shared focus, we can continue to reduce the burden of healthcare-associated infections and enhance patient safety across BC.

Technical Notes

General

The provincial surveillance program for IPC is a collaboration between PICNet and BC health authorities. Provincial surveillance protocols for CDI, MRSA and CPOs are available on the PICNet website: www.picnet.ca
Standard provincial surveillance protocols were developed at the beginning of each program and are typically reviewed annually to reflect advances in scientific research and surveillance practice, however there are noted variations in how case definitions and inclusion/exclusion criteria are applied by HAs and health-care facilities, which can affect the findings in this report.
Provincial surveillance data for CDI, MRSA and HCC are collected by health authorities, aggregated by health-care facility and quarter, and reported to PICNet. Provincial surveillance data for CPO are submitted to PICNet at the case level by health authorities or care providers in community care settings. The First Nations Health Authority does not operate acute care facilities and so do not contribute to the surveillance data presented in this report.
Data are presented by fiscal quarter, as defined by financial departments across health authorities. The exceptions are CDI, MRSA and HCC data from PHSA, which are aggregated by calendar quarter. The time frame of each fiscal quarter varies by fiscal year. Generally, the fourth fiscal quarter (Q4) is longer than the other three quarters (Q1, Q2, and Q3). See Appendix B for the start and end date of fiscal year 2023/24.
Rates and 95% Confidence Interval Methodology
- The rate of HCA CDI or MRSA was calculated using the total number of new cases of HCA CDI or MRSA associated with the reporting facility as numerators divided by the total inpatient days during the same period as denominators, then multiplying by 10,000 to calculate a rate per 10,000 inpatient days.
- The rate of CPO was calculated using the total number of new cases of CPO identified in acute care facilities as numerators divided by the total admissions during the same period as denominators, then multiplying by 10,000 to calculate a rate per 10,000 admissions.
- The 95% confidence interval of each facility’s CDI, MRSA and CPO incidence rate was calculated using the Mid-P Poisson Confidence Interval method [18]. The Mid-P confidence interval is a method for calculating confidence intervals for count data (e.g., number of infections) that follow a Poisson distribution. It is particularly useful for low-count data (e.g., CDI or MRSA counts per quarter in a small facility). It adjusts the conservative nature of the exact Poisson confidence interval, providing a more accurate (less conservative) estimate.
- For HCC percentages in acute care facilities, the Mid-P Binomial method was used to calculate 95% confidence intervals.
Rates and HCC percentages calculated in this report are crude and were not adjusted for any risk factors such as patient acuity, comorbidities, or length of stay. While adjusted rates could offer a more nuanced understanding of differences over time or between regions, these adjustments are not currently feasible due to limitations in available data across health authorities. As such, direct comparison of CDI, MRSA and CPO rates, or HCC percentages, between HAs or health-care facilities are not recommended.
Acute Care Facility Types
- Tertiary/referral hospitals: Large hospitals that care for patients from across the region or even the whole province. They offer many kinds of specialized care, like major surgeries or intensive care. Patients are often sent to these hospitals from smaller ones when they need expert treatment.
- Regional hospitals: Serve people in a specific area and have more beds than community hospitals. They offer some specialist care, including surgeries and maternity care, and often have labs and intensive care units.
- Community hospitals: Focus on the local population and provide basic medical care. Family doctors work with hospital doctors to care for patients. These hospitals don’t usually offer highly specialized treatments.
LOESS Smoothing Methodology
- The Locally Estimated Scatterplot Smoothing (LOESS) method creates a smooth trend line through the data by fitting simple curves to small groups of nearby data points. This approach is particularly useful for revealing trends in data that may not follow a straight line.
- LOESS looks at each point (in this case, each fiscal year) and fits a simple curve — usually basic lines or gently curved lines — to the data points that are closest in time. A key parameter (the span) controls how many data points (fiscal years) are used to fit each local line. The process is repeated along the time series so that each segment reflects the local trend. When fitting the curve for a specific fiscal year, data points that are closer in time to that fiscal year are considered more relevant than those further away. We also apply robust weighting to lessen the influence of outlier fiscal years.

CDI

CDI episodes are classified as HCA or community-associated according to patients’ encounters with a health-care facility in the previous four weeks.
HCA CDI episodes among inpatients in acute care facilities (ACFs) are further classified as new cases or relapses based on the time frame of the episodes. A relapse may include recurrence of a previous CDI, re-infection with the same strain, or infection with a different strain of C. difficile that occurs between two and eight weeks after a previous HCA CDI episode.
CDI episodes among inpatients in acute care facilities that are classified as community-associated include both new cases and relapses.
Health authorities have adopted a two-step testing approach for CDI, which includes an initial screening test followed by a confirmatory test, at different times: FH began in October 2023, IH in February 2022, ISLH in October 2018, NH in November 2023, PHC in January 2017, PHSA in December 2023, and VCH in June 2023. This two-step testing method may lead to higher reported CDI cases due to its increased sensitivity.
Facilities in PHSA and PHC are unable to check patient health-care history outside their health authority and thus did not collect CDI cases that were associated with another facility (new and relapse).
VCH, PHC and IH do not collect community associated or unknown CDI data.
During the study period (FY 2018/19 to FY 2023/24), four health authorities: FH, VCH, ISLH and NH provided all quarters CDI complication data to PICNet. IH began submitting these data in Q3 of 2023/24.

MRSA

New MRSA cases are classified as HCA or community-associated according to patients’ encounters with a health-care facility in the previous 12 months.
A new MRSA case is defined as a colonization or infection identified for the first time in an inpatient in an acute care facility. MRSA infections identified in inpatients with previous MRSA colonization are not included.
PHC does not collect MRSA cases associated with another reporting facility and community-associated cases. IH does not collect unknown subtype data while VCH neither collect unknown or community cases data.

CPO

CPO Case Definition and Reporting
- CPO surveillance is gene-based. A new case is defined as the first identification of a specific carbapenemase gene in a patient.
- Repeat detection of the same gene in the same patient is not counted as a new case, regardless of organism or specimen type.
- Detection of a different carbapenemase gene in the same patient is counted as a separate case.
- Reporting pathways differ based on setting:
  - Cases identified in acute care facilities are reported to PICNet by health authority IPC teams.
  - Cases identified in community settings are reported to the local Medical Health Officer as a reportable condition, with public health coordination as appropriate.
CPO infections and colonizations are reportable to public health in BC. All CPO-suspect isolates are required to be sent to BCCDC PHL for molecular testing and genotyping. CPO testing results are then obtained from the PHL’s laboratory information system.
A new CPO case is defined as a carbapenemase gene that was identified for the first time from a given patient in the province. Different genes identified from the same patient are considered different cases.
Surveillance forms are required to be completed for new CPO cases (colonizations and infections) identified in both acute and community care settings and submitted to PICNet by health authorities or health-care providers in community care settings, such as outpatient clinics, emergency departments, long-term care or assisted living facilities and community clinics. Surveillance information is not available for a minority of CPO cases due to administrative challenges.
Exposure information collected on CPO surveillance forms includes: travel outside Canada, health-care encounters outside Canada and within BC, ongoing CPO transmission investigation in a patient care unit, and contact with a known CPO case or CPO in the environment in the previous twelve months. These exposures are not mutually exclusive.
Exposure information is reported only for the cases where surveillance information is available.
New CPO cases are reported based on where they were identified and reported, i.e. acute care facility in a health authority or community care setting.
IPC practices vary across health authorities and health-care facilities which affect identification of CPO cases. For example, FH has a robust screening program which captures patients reporting any health-care encounter outside of Canada as well as travelers returning from India, Pakistan, Bangladesh or Vietnam.

HCC

HCC is audited by health authorities. The percentage compliance reports how often, during an audit, health-care workers clean their hands before and after contact with a patient or the patient environment (e.g., changing bed linen, touching a bed rail or clearing a bedside table).
The goal for hand hygiene compliance is 100% for both before and after contact with the patient and patients’ environment for each health-care worker group. The provincial target of 80%, established by the Provincial Hand Hygiene Working Group, is a minimum standard health authorities should meet while striving for continuous quality improvement.
In acute care facilities, trained auditors observe a sample of health-care workers and record whether they clean their hands at the appropriate times.
Health care workers in ACFs are grouped into four categories:
- Nursing staff, including registered nurse, midwife, licensed practical nurse, care aide, and nursing/midwife student.
- Physicians, including medical doctor, resident, fellow, medical student, and nurse practitioner.
- Clinical support services, including occupational therapist, physiotherapist, respiratory therapist, speech therapist, social worker, dietician, psychologist, audiologist, porter, pastoral care, radiologist, and technician (e.g., ECG, EEG, phlebotomy).
- Other support services, including housekeeping, food services, and clerk.
Audits of HCC in acute care facilities are administrated by each health authority, and the number of observed opportunities varies across authorities and over time. To account for the impact of this variation, provincial acute care compliance rates are also calculated using a weighting factor based on acute care inpatient days. In this method, each health authority’s compliance rate is multiplied by its proportion of total provincial inpatient days, and these weighted values are summed to produce the provincial rate. This approach ensures that results from facilities or regions with higher patient volumes have a proportionally greater influence on the provincial estimate.
Due to the COVID-19 pandemic, compliance data from some health authorities acute care facilities were not available during the following periods: FH (Q4 of 2019/20 to Q2 of 2020/21), IH (Q1 of 2020/21), PHC (Q4 of 2019/20), and VCH (Q4 of 2019/20 to Q3 of 2020/21).
HCC is audited in long-term care facilities that are owned or operated by a health authority. Audit data are voluntarily reported by health authorities to PICNet for public reporting.
There are no long-term care facilities owned or operated by PHSA. PHSA’s HCC audit methods were modified during Q1 of 2021/22.
From Q2 of 2018/19 through Q4 of 2022/23, Fraser Health only reported observations performed by regional hand hygiene auditors in acute care facilities to PICNet. As a result, compliance data are unavailable for all long-term care facilities in Fraser Health for that time period, except for Q1 of 2018/19 data, and Q3 of 2019/20.
HCC audits were suspended in some health authorities long-term care facilities due to the COVID-19 pandemic response and diversion of resources to other priorities.
- Compliance data in all long-term care facilities in Interior Health are not available from Q1 of 2020/21 to Q2 of 2021/22.
- No HCC audits were done in PHC’s long-term care facilities from Q4 of 2019/20 Q4 to Q1 of 2021/22; HCC audits resumed in Q2 of 2021/22.
HCC is audited through direct observation in both acute care facilities and long-term care facilities; however, audit strategies and methods vary across health authorities and over time. Auditors are trained by health authorities and include dedicated hand hygiene auditors or coordinators, IPC professionals, university co-op students, and staff within health-care facilities (self-auditing). Observer bias and Hawthorne effect (i.e. behaviour changes due to awareness of being observed) may occur during auditing.

Appendices

Appendix A. Acute care facilities participating in the provincial surveillance programs in 2023/24.

Health authority	FH	IH	ISLH	NH	PHC	PHSA	VCH	Total
Total number of facilities	15	22	13	18	2	2	9	81
By facility type
Community hospital	8	16	9	9	1	0	5	48
Regional hospital	4	4	2	8	0	0	3	21
Tertiary/Referral hospital	3	2	2	1	1	2	1	12
By facility size
>250	4	1	3	0	1	0	1	10
151-250	5	2	0	1	0	0	2	10
51-150	2	3	4	2	1	2	1	15
<=50	4	16	6	15	0	0	5	46

Appendix B. Start and end date for quarters in 2023/24.

	Fiscal quarter		Calendar quarter
Quarter code	Start date	End date	Start date	End date
Q1	01-Apr-2023	22-Jun-2023	01-Apr-2023	30-Jun-2023
Q2	23-Jun-2023	14-Sep-2023	01-Jul-2023	30-Sep-2023
Q3	15-Sep-2023	07-Dec-2023	01-Oct-2023	31-Dec-2023
Q4	08-Dec-2023	31-Mar-2024	01-Jan-2024	31-Mar-2024

Appendix C. Rate of new HCA CDI cases associated with the reporting facility by acute care facility.

	2018/19		2019/20		2020/21		2021/22		2022/23		2023/24
Health Authority and acute care facility	Number of new cases	Rate (95% CI)^a	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)
Fraser Health (FH)	308	3 (2.7, 3.4)	353	3.4 (3.1, 3.8)	362	3.9 (3.5, 4.3)	334	3.2 (2.9, 3.5)	341	3.1 (2.8, 3.4)	271	2.4 (2.1, 2.6)
Abbotsford Regional Hospital/Matsqui Sumas Abbotsford	45	3.8 (2.8, 5)	49	4.1 (3.1, 5.4)	37	3.7 (2.6, 5)	55	4.7 (3.6, 6.1)	23	1.9 (1.2, 2.8)	43	3.4 (2.5, 4.5)
Burnaby Hospital	26	2.7 (1.8, 3.9)	36	3.5 (2.5, 4.8)	40	4.7 (3.4, 6.3)	40	4.2 (3, 5.6)	27	2.5 (1.6, 3.5)	18	1.5 (0.9, 2.4)
Carelife Fleetwood	0	0.0	0	0.0	0	0.0	`*`	1.2 (0.1, 6)	0	0.0	`*`	1.3 (0.1, 6.2)
Chilliwack General Hospital	25	4.3 (2.8, 6.2)	14	2.3 (1.3, 3.8)	21	3.8 (2.4, 5.7)	15	2.4 (1.4, 3.8)	22	3.5 (2.2, 5.2)	13	1.9 (1.1, 3.2)
Delta Hospital	`*`	1.2 (0.3, 3.3)	`*`	3.6 (1.7, 6.8)	`*`	1.6 (0.4, 4.2)	`*`	0.9 (0.1, 2.9)	`*`	2.4 (1, 5)	`*`	1.6 (0.5, 3.9)
Eagle Ridge Hospital	`*`	1.4 (0.7, 2.6)	14	2.1 (1.2, 3.5)	21	3.7 (2.3, 5.5)	19	3 (1.9, 4.6)	18	2.7 (1.7, 4.2)	`*`	1.1 (0.5, 2.2)
Fellburn Care Center	0	0.0	`*`	1.4 (0.1, 6.8)	0	0.0	`*`	1.4 (0.1, 6.7)	`*`	2.5 (0.4, 8.4)	0	0.0
Fraser Canyon Hospital	0	0.0	`*`	2.6 (0.1, 12.8)	`*`	2.7 (0.1, 13.3)	`*`	5.3 (0.9, 17.4)	`*`	4.8 (0.8, 15.9)	0	0.0
Langley Memorial Hospital	27	3.7 (2.5, 5.3)	42	5.7 (4.2, 7.7)	63	9.4 (7.3, 11.9)	23	2.9 (1.9, 4.4)	29	3.5 (2.4, 5)	21	2.5 (1.6, 3.7)
Mission Memorial Hospital	`*`	4.4 (2.1, 8.1)	`*`	2 (0.6, 4.8)	`*`	2.2 (0.7, 5.3)	`*`	2.4 (0.9, 5.3)	`*`	2.7 (1, 6)	`*`	1.1 (0.2, 3.7)
Peace Arch Hospital	`*`	0.9 (0.4, 1.9)	20	3.1 (1.9, 4.7)	19	3.1 (1.9, 4.8)	21	3.1 (2, 4.6)	16	2.3 (1.4, 3.7)	`*`	1.1 (0.5, 2.1)
Queen’s Park Hospital	`*`	1.7 (0.6, 4.2)	`*`	1.6 (0.5, 3.8)	`*`	1.5 (0.4, 4.1)	`*`	1.5 (0.5, 3.7)	0	0.0	`*`	0.4 (0, 1.9)
Ridge Meadows Hospital	26	4.2 (2.8, 6.1)	41	6.7 (4.8, 9)	23	4.4 (2.8, 6.4)	26	4 (2.7, 5.8)	32	4.5 (3.1, 6.3)	19	2.5 (1.6, 3.9)
Royal Columbian Hospital	42	2.7 (2, 3.7)	40	2.7 (1.9, 3.6)	56	3.8 (2.9, 4.9)	26	1.6 (1.1, 2.3)	50	2.9 (2.2, 3.8)	27	1.5 (1, 2.2)
Surrey Memorial Hospital	86	3.5 (2.8, 4.3)	79	3.3 (2.6, 4.1)	71	3.2 (2.5, 4)	94	3.8 (3.1, 4.6)	109	4.3 (3.5, 5.1)	106	4 (3.3, 4.8)
Interior Health (IH)	235	5.2 (4.5, 5.9)	167	3.5 (3, 4.1)	139	3.3 (2.8, 3.9)	102	2.1 (1.7, 2.5)	130	2.4 (2, 2.9)	127	2.3 (2, 2.8)
100 Mile District Hospital	`*`	8.1 (3, 18)	0	0.0	`*`	2 (0.1, 9.6)	`*`	1.8 (0.1, 8.9)	0	0.0	`*`	1.8 (0.1, 8.8)
Arrow Lakes Hospital	`*`	23 (5.8, 62.5)	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Boundary Hospital	`*`	4.8 (0.8, 15.7)	`*`	2.7 (0.1, 13.4)	`*`	6 (1, 19.9)	0	0.0	0	0.0	0	0.0
Cariboo Memorial Hospital and Health Centre	`*`	2.7 (0.7, 7.4)	`*`	3 (0.8, 8.1)	0	0.0	`*`	1.9 (0.3, 6.2)	`*`	1.6 (0.3, 5.3)	`*`	2 (0.3, 6.7)
Creston Valley Hospital	`*`	1.8 (0.1, 8.8)	`*`	3.9 (0.6, 12.8)	0	0.0	`*`	1.7 (0.1, 8.3)	`*`	3.1 (0.5, 10.1)	`*`	2.9 (0.5, 9.6)
Dr. Helmcken Memorial Hospital & Health Centre	0	0.0	0	0.0	0	0.0	0	0.0	`*`	5.8 (0.3, 28.4)	0	0.0
East Kootenay Regional Hospital	19	7.9 (4.9, 12.1)	12	5 (2.7, 8.4)	14	7 (4, 11.5)	`*`	2.1 (0.8, 4.6)	11	4.2 (2.2, 7.2)	`*`	3.4 (1.6, 6.1)
Elk Valley Hospital	`*`	9.4 (3, 22.6)	0	0.0	`*`	2.7 (0.1, 13.4)	`*`	2.4 (0.1, 11.6)	0	0.0	0	0.0
Golden & District General Hospital	0	0.0	0	0.0	`*`	20.7 (6.6, 49.9)	0	0.0	`*`	4.6 (0.2, 22.7)	0	0.0
Invermere & District Hospital	0	0.0	0	0.0	0	0.0	0	0.0	`*`	3.8 (0.2, 18.5)	0	0.0
Kelowna General Hospital	84	6 (4.8, 7.4)	62	4.1 (3.2, 5.3)	44	3.4 (2.5, 4.5)	17	1.1 (0.7, 1.7)	36	2.2 (1.5, 2.9)	43	2.6 (1.9, 3.5)
Kootenay Boundary Regional Hospital	13	6 (3.4, 10.1)	17	7.4 (4.4, 11.5)	`*`	3.6 (1.6, 7.2)	`*`	4.2 (2, 7.7)	`*`	3.7 (1.8, 6.7)	`*`	3.9 (1.9, 7.1)
Kootenay Lake Hospital	`*`	0.9 (0, 4.6)	`*`	1 (0, 4.8)	`*`	3.5 (0.9, 9.4)	`*`	0.9 (0, 4.6)	`*`	0.9 (0, 4.3)	0	0.0
Lillooet Hospital and Health Centre	0	0.0	`*`	17.4 (2.9, 57.6)	`*`	8.5 (0.4, 41.7)	`*`	9.1 (0.5, 45.1)	0	0.0	`*`	6.5 (0.3, 32.1)
Nicola Valley Health Centre	`*`	16.5 (5.2, 39.8)	0	0.0	0	0.0	0	0.0	`*`	2.5 (0.1, 12.3)	`*`	2.7 (0.1, 13.4)
Penticton Regional Hospital	24	6.1 (4, 8.9)	13	2.9 (1.6, 4.8)	13	3 (1.7, 4.9)	16	3.2 (1.9, 5)	16	2.9 (1.7, 4.6)	12	2.1 (1.1, 3.6)
Princeton General Hospital	`*`	5.4 (0.3, 26.6)	`*`	5.4 (0.3, 26.7)	`*`	6.4 (0.3, 31.6)	`*`	5.5 (0.3, 27)	0	0.0	`*`	6.3 (0.3, 31.1)
Queen Victoria Hospital and Health Centre	`*`	4.7 (0.2, 23.4)	0	0.0	0	0.0	0	0.0	`*`	3 (0.2, 14.9)	`*`	6.4 (1.1, 21.2)
Royal Inland Hospital	46	4.9 (3.7, 6.5)	21	2.3 (1.5, 3.4)	26	3.2 (2.1, 4.6)	32	3.4 (2.4, 4.8)	21	2 (1.3, 3)	24	2.2 (1.4, 3.2)
Shuswap Lake General Hospital	`*`	1.8 (0.5, 4.9)	`*`	4 (1.8, 8)	`*`	0.7 (0, 3.6)	`*`	1.1 (0.2, 3.6)	`*`	2.3 (0.7, 5.6)	`*`	1.7 (0.4, 4.5)
South Okanagan General Hospital	0	0.0	`*`	3.9 (0.6, 12.8)	0	0.0	0	0.0	`*`	3.3 (0.5, 10.8)	`*`	1.5 (0.1, 7.5)
Vernon Jubilee Hospital	21	3.6 (2.3, 5.3)	23	3.6 (2.4, 5.3)	21	3.8 (2.4, 5.8)	13	1.9 (1.1, 3.2)	21	2.9 (1.8, 4.3)	16	2.1 (1.3, 3.4)
Island Health (ISLH)	158	2.7 (2.3, 3.1)	159	2.6 (2.3, 3.1)	158	3 (2.6, 3.5)	146	2.5 (2.1, 2.9)	153	2.5 (2.1, 2.9)	142	2.2 (1.9, 2.6)
Campbell River General Hospital	`*`	1.7 (0.7, 3.3)	`*`	1.2 (0.4, 2.6)	12	3.2 (1.8, 5.5)	`*`	1.4 (0.6, 2.9)	`*`	1.7 (0.8, 3.3)	`*`	1.7 (0.8, 3.3)
Comox Valley Hospital	11	2.1 (1.1, 3.7)	`*`	1.6 (0.8, 2.9)	`*`	2.1 (1, 3.9)	10	1.9 (1, 3.4)	13	2.4 (1.4, 4.1)	`*`	1.5 (0.7, 2.9)
Cormorant Island Community Health Centre	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Cowichan District Hospital	`*`	1.7 (0.8, 3.2)	14	3 (1.7, 5)	14	3.5 (2, 5.7)	`*`	2 (1, 3.6)	17	3.5 (2.1, 5.4)	17	3.6 (2.2, 5.6)
Lady Minto Gulf Islands Hospital	`*`	5.5 (1.4, 15)	0	0.0	`*`	3.6 (0.2, 17.5)	0	0.0	`*`	2.4 (0.1, 11.8)	0	0.0
Nanaimo Regional General Hospital	41	3.5 (2.5, 4.7)	47	3.9 (2.9, 5.1)	39	3.8 (2.7, 5.1)	39	3.3 (2.4, 4.4)	34	2.6 (1.8, 3.6)	38	2.9 (2.1, 3.9)
Port Hardy Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Port McNeill and District Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	`*`	3 (0.2, 14.9)
Royal Jubilee Hospital	47	3.1 (2.3, 4.1)	37	2.4 (1.7, 3.3)	41	3 (2.2, 4)	44	2.9 (2.1, 3.8)	43	2.7 (2, 3.6)	32	1.9 (1.3, 2.6)
Saanich Peninsula Hospital	12	4.9 (2.7, 8.4)	`*`	2.2 (0.8, 4.8)	`*`	1.6 (0.4, 4.2)	`*`	2.2 (0.8, 4.9)	`*`	1.6 (0.5, 3.9)	`*`	2.3 (0.9, 4.7)
Tofino General Hospital	`*`	5.3 (0.3, 26.1)	`*`	9.5 (1.6, 31.5)	`*`	4.4 (0.2, 21.8)	`*`	4.4 (0.2, 21.5)	`*`	3.7 (0.2, 18.3)	0	0.0
Victoria General Hospital	25	2 (1.3, 2.9)	35	2.7 (1.9, 3.8)	35	3 (2.1, 4.1)	28	2.3 (1.5, 3.2)	29	2.3 (1.6, 3.3)	28	2.1 (1.4, 3)
West Coast General Hospital	`*`	1.8 (0.5, 4.9)	`*`	2.9 (1.1, 6.4)	`*`	2.1 (0.5, 5.7)	`*`	2.7 (0.9, 6.6)	`*`	2.1 (0.5, 5.6)	`*`	2.4 (0.8, 5.7)
Northern Health (NH)	48	2.2 (1.6, 2.8)	62	2.8 (2.2, 3.5)	66	3.5 (2.7, 4.5)	48	2.3 (1.7, 3)	71	3.1 (2.4, 3.8)	72	3 (2.4, 3.7)
Bulkley Valley District Hospital	0	0.0	`*`	1.4 (0.1, 7.1)	`*`	5.5 (1.4, 14.9)	`*`	1.6 (0.1, 7.9)	`*`	4.1 (1, 11.2)	`*`	2.5 (0.4, 8.4)
Chetwynd General Hospital	0	0.0	0	0.0	`*`	7.2 (0.4, 35.3)	0	0.0	0	0.0	0	0.0
Dawson Creek And District Hospital	`*`	2.6 (0.9, 5.7)	`*`	3.8 (1.7, 7.6)	`*`	2 (0.5, 5.3)	`*`	1.2 (0.2, 3.9)	`*`	1.1 (0.2, 3.7)	`*`	0.5 (0, 2.5)
Fort Nelson General Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Fort St. John General Hospital	`*`	2.1 (0.7, 5.1)	`*`	1.6 (0.4, 4.5)	`*`	2.8 (0.9, 6.7)	`*`	1.2 (0.2, 4)	`*`	1.7 (0.4, 4.6)	`*`	2.5 (0.9, 5.5)
G.R. Baker Memorial Hospital	`*`	1.3 (0.2, 4.2)	`*`	1.8 (0.4, 4.8)	12	9.9 (5.4, 16.8)	`*`	1.5 (0.3, 5)	`*`	2.7 (0.8, 6.4)	`*`	2.5 (0.8, 6)
Haida Gwaii Hospital	0	0.0	`*`	5.7 (0.3, 28.2)	0	0.0	0	0.0	0	0.0	`*`	4.5 (0.2, 22)
Kitimat General Hospital	0	0.0	0	0.0	`*`	1.8 (0.1, 8.7)	`*`	2.8 (0.5, 9.2)	`*`	1.4 (0.1, 6.8)	0	0.0
Lakes District Hospital and Health Centre	0	0.0	0	0.0	0	0.0	`*`	2.7 (0.1, 13.5)	`*`	3.2 (0.2, 15.7)	0	0.0
Mackenzie and District Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
McBride and District Hospital	0	0.0	0	0.0	0	0.0	`*`	42.3 (10.8, 115.2)	0	0.0	`*`	24.5 (4.1, 81.1)
Mills Memorial Hospital	`*`	1.6 (0.4, 4.4)	0	0.0	`*`	1.8 (0.5, 4.9)	`*`	3.2 (1.3, 6.7)	`*`	1.5 (0.4, 4.1)	`*`	1.4 (0.4, 3.8)
Northern Haida Gwaii Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Prince Rupert Regional Hospital	`*`	3.8 (1.2, 9.2)	`*`	3 (0.8, 8.2)	`*`	1.1 (0.1, 5.5)	`*`	2.1 (0.3, 6.9)	`*`	6.1 (2.7, 12.1)	`*`	0.9 (0, 4.4)
St. John Hospital	0	0.0	0	0.0	0	0.0	`*`	5.1 (1.3, 14)	`*`	1.6 (0.1, 7.8)	`*`	1.7 (0.1, 8.4)
Stuart Lake Hospital	`*`	5.1 (0.3, 25.1)	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
University Hospital of Northern BC	28	2.9 (2, 4.2)	44	4.4 (3.2, 5.9)	38	4.3 (3.1, 5.9)	24	2.4 (1.6, 3.6)	46	4.2 (3.1, 5.6)	52	4.7 (3.6, 6.1)
Wrinch Memorial Hospital	`*`	2.1 (0.1, 10.1)	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Providence Health Care (PHC)	55	3 (2.3, 3.9)	54	3 (2.3, 3.9)	47	3.4 (2.5, 4.5)	76	5.1 (4.1, 6.4)	46	2.8 (2.1, 3.8)	82	4.1 (3.3, 5.1)
Mount Saint Joseph Hospital	12	3.7 (2, 6.2)	10	3.3 (1.7, 6)	`*`	3.1 (1.4, 6.2)	`*`	2.5 (1, 5.2)	`*`	3 (1.4, 5.6)	`*`	0.9 (0.2, 2.5)
St. Paul’s Hospital	43	2.8 (2.1, 3.8)	44	3 (2.2, 4)	40	3.4 (2.5, 4.6)	70	5.6 (4.4, 7.1)	38	2.8 (2, 3.8)	79	4.8 (3.8, 5.9)
Provincial Health Services Authority (PHSA)	35	6.3 (4.5, 8.7)	29	5.4 (3.7, 7.6)	13	2.4 (1.3, 4)	15	2.7 (1.6, 4.3)	`*`	1.5 (0.7, 2.8)	11	1.8 (0.9, 3.1)
BC Cancer	`*`	4.6 (0.8, 15.2)	`*`	2.6 (0.1, 12.9)	`*`	2.9 (0.1, 14.2)	0	0.0	NA	NA	NA	NA
BC Children’s Hospital	33	12.5 (8.8, 17.4)	26	9.9 (6.6, 14.2)	12	4.9 (2.7, 8.4)	15	5 (2.9, 8)	`*`	2.4 (1.1, 4.5)	11	3 (1.6, 5.1)
BC Women’s Hospital	0	0.0	`*`	0.8 (0.1, 2.8)	0	0.0	0	0.0	0	0.0	0	0.0
Vancouver Coastal Health (VCH)	179	3.9 (3.4, 4.5)	148	3.2 (2.7, 3.8)	159	3.8 (3.3, 4.5)	170	3.6 (3.1, 4.1)	216	4.3 (3.8, 4.9)	177	3.4 (2.9, 3.9)
Bella Coola General Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Lions Gate Hospital	22	2.8 (1.8, 4.1)	31	4 (2.7, 5.6)	23	3.2 (2.1, 4.8)	20	2.3 (1.5, 3.5)	35	3.8 (2.7, 5.2)	28	2.9 (2, 4.2)
Powell River General Hospital	`*`	3.2 (1, 7.7)	`*`	0.8 (0, 3.7)	`*`	2.2 (0.4, 7.1)	`*`	1.8 (0.3, 5.8)	0	0.0	`*`	1.4 (0.2, 4.6)
RW Large Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Richmond Hospital	33	4.6 (3.2, 6.4)	21	3 (1.9, 4.4)	28	4.4 (3, 6.2)	23	3.2 (2.1, 4.7)	28	3.6 (2.4, 5.1)	18	2.2 (1.4, 3.5)
Sechelt Hospital	`*`	2.5 (0.9, 5.5)	`*`	3.1 (1.4, 6.2)	`*`	1.3 (0.2, 4.3)	`*`	1.8 (0.4, 4.8)	`*`	3.3 (1.3, 6.8)	`*`	2.9 (1.2, 6.1)
Squamish General Hospital	0	0.0	`*`	3.5 (0.6, 11.6)	`*`	3.9 (0.7, 12.8)	`*`	1.7 (0.1, 8.4)	`*`	1.5 (0.1, 7.6)	`*`	4.5 (1.1, 12.2)
UBC Hospital	0	0.0	`*`	4.4 (1.8, 9.1)	11	7.4 (3.9, 12.9)	`*`	1.9 (0.7, 4.3)	10	3.6 (1.8, 6.3)	`*`	1.7 (0.7, 3.5)
Vancouver General Hospital	115	4.6 (3.8, 5.5)	80	3.2 (2.5, 3.9)	91	3.9 (3.2, 4.8)	116	4.5 (3.8, 5.4)	136	5.2 (4.4, 6.1)	114	4.2 (3.5, 5.1)

Notes:
* Represents the number of cases of CDI that was 1 to less than 10
^a Per 10,000 inpatient days

Appendix D. Rate of new HCA MRSA cases associated with the reporting facility by acute care facility.

	2018/19		2019/20		2020/21		2021/22		2022/23		2023/24
Health Authority and acute care facility	Number of new cases	Rate (95% CI)^a	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)	Number of new cases	Rate (95% CI)
Fraser Health (FH)	559	5.2 (4.8, 5.7)	480	4.5 (4.1, 4.9)	380	3.9 (3.5, 4.3)	395	3.6 (3.3, 4)	372	3.2 (2.9, 3.6)	414	3.5 (3.1, 3.8)
Abbotsford Regional Hospital/Matsqui Sumas Abbotsford	81	6.4 (5.1, 7.9)	69	5.4 (4.3, 6.8)	46	4.3 (3.2, 5.7)	50	4.1 (3, 5.3)	39	3 (2.2, 4.1)	64	4.8 (3.7, 6.1)
Burnaby Hospital	35	3.5 (2.5, 4.8)	50	4.7 (3.6, 6.2)	33	3.7 (2.6, 5.1)	33	3.3 (2.3, 4.6)	25	2.2 (1.5, 3.2)	38	3.1 (2.2, 4.2)
Carelife Fleetwood	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Chilliwack General Hospital	34	5.7 (4, 7.8)	24	3.9 (2.6, 5.7)	17	3 (1.8, 4.7)	30	4.7 (3.2, 6.6)	20	3.1 (1.9, 4.7)	27	3.9 (2.7, 5.7)
Delta Hospital	23	9.4 (6.1, 13.9)	12	5.4 (2.9, 9.1)	`*`	2.6 (1, 5.7)	`*`	0.9 (0.1, 2.9)	`*`	2.8 (1.2, 5.5)	`*`	0.4 (0, 2)
Eagle Ridge Hospital	24	3.8 (2.5, 5.6)	29	4.5 (3, 6.3)	30	5.2 (3.6, 7.4)	34	5.4 (3.8, 7.5)	25	3.7 (2.5, 5.5)	26	3.7 (2.5, 5.3)
Fellburn Care Center	`*`	4.5 (1.2, 12.3)	`*`	4.1 (1.1, 11.3)	0	0.0	`*`	2.7 (0.5, 9)	`*`	1.3 (0.1, 6.3)	`*`	2.4 (0.4, 8)
Fraser Canyon Hospital	0	0.0	`*`	2.6 (0.1, 12.8)	`*`	16.2 (6.6, 33.8)	`*`	7.9 (2, 21.5)	`*`	4.8 (0.8, 15.9)	`*`	4.8 (0.8, 15.8)
Langley Memorial Hospital	30	3.9 (2.7, 5.5)	18	2.4 (1.4, 3.7)	27	3.9 (2.6, 5.5)	25	3.1 (2, 4.5)	34	4 (2.8, 5.5)	44	5 (3.7, 6.7)
Mission Memorial Hospital	`*`	3.9 (1.8, 7.4)	11	5.4 (2.9, 9.5)	`*`	4.4 (2, 8.3)	`*`	2.4 (0.9, 5.3)	`*`	2.2 (0.7, 5.2)	`*`	2.2 (0.7, 5.4)
Peace Arch Hospital	37	5.5 (3.9, 7.4)	27	4.1 (2.7, 5.9)	33	5.3 (3.7, 7.4)	21	3 (1.9, 4.6)	`*`	1.3 (0.6, 2.4)	`*`	1.2 (0.6, 2.2)
Queen’s Park Hospital	12	5.2 (2.8, 8.9)	`*`	2.8 (1.2, 5.4)	19	9.6 (6, 14.7)	`*`	1.5 (0.5, 3.7)	`*`	1.9 (0.7, 4.2)	`*`	0.4 (0, 1.9)
Ridge Meadows Hospital	30	4.8 (3.3, 6.7)	34	5.4 (3.8, 7.5)	18	3.3 (2, 5.2)	31	4.7 (3.3, 6.6)	27	3.7 (2.5, 5.3)	27	3.5 (2.4, 5)
Royal Columbian Hospital	61	3.7 (2.9, 4.7)	48	3 (2.2, 3.9)	49	3.1 (2.3, 4.1)	45	2.5 (1.9, 3.4)	57	3.1 (2.3, 3.9)	56	2.9 (2.2, 3.8)
Surrey Memorial Hospital	181	6.8 (5.8, 7.8)	147	5.7 (4.8, 6.6)	89	3.7 (3, 4.6)	110	4.2 (3.4, 5)	117	4.3 (3.5, 5.1)	113	4 (3.3, 4.8)
Interior Health (IH)	109	2.2 (1.8, 2.6)	127	2.4 (2, 2.9)	80	1.7 (1.4, 2.1)	89	1.6 (1.3, 2)	110	1.9 (1.6, 2.3)	115	2 (1.7, 2.4)
100 Mile District Hospital	`*`	4.9 (1.2, 13.3)	`*`	2.9 (0.5, 9.7)	`*`	2 (0.1, 9.7)	0	0.0	`*`	8.2 (3, 18.2)	`*`	1.8 (0.1, 8.8)
Arrow Lakes Hospital	0	0.0	0	0.0	`*`	13.1 (0.7, 64.5)	0	0.0	0	0.0	0	0.0
Boundary Hospital	0	0.0	0	0.0	0	0.0	`*`	4.6 (0.8, 15.1)	0	0.0	0	0.0
Cariboo Memorial Hospital and Health Centre	`*`	4.5 (1.6, 10)	`*`	5.9 (2.4, 12.2)	0	0.0	`*`	2.8 (0.7, 7.7)	`*`	2.4 (0.6, 6.5)	`*`	1 (0.1, 5)
Creston Valley Hospital	0	0.0	`*`	1.9 (0.1, 9.5)	0	0.0	0	0.0	`*`	1.5 (0.1, 7.5)	0	0.0
Dr. Helmcken Memorial Hospital & Health Centre	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
East Kootenay Regional Hospital	`*`	1.8 (0.7, 4.1)	10	3.6 (1.8, 6.4)	`*`	0.9 (0.1, 2.9)	`*`	1.4 (0.5, 3.5)	`*`	2.3 (1, 4.6)	`*`	2.6 (1.2, 5)
Elk Valley Hospital	0	0.0	`*`	11.8 (4.3, 26.2)	0	0.0	0	0.0	`*`	4 (0.7, 13.1)	`*`	3.2 (0.5, 10.4)
Golden & District General Hospital	0	0.0	0	0.0	0	0.0	`*`	5.1 (0.3, 25.3)	0	0.0	0	0.0
Invermere & District Hospital	0	0.0	0	0.0	0	0.0	`*`	4.2 (0.2, 20.7)	0	0.0	0	0.0
Kelowna General Hospital	32	2 (1.4, 2.8)	40	2.4 (1.7, 3.2)	35	2.4 (1.7, 3.3)	36	2.1 (1.5, 2.8)	29	1.6 (1.1, 2.2)	32	1.7 (1.2, 2.4)
Kootenay Boundary Regional Hospital	`*`	2.3 (0.9, 4.9)	`*`	1.1 (0.3, 3)	`*`	0.4 (0, 2.2)	0	0.0	`*`	1.8 (0.7, 3.9)	`*`	0.4 (0, 1.9)
Kootenay Lake Hospital	`*`	1.9 (0.3, 6.2)	`*`	3.8 (1.2, 9.3)	`*`	2.3 (0.4, 7.6)	`*`	1.8 (0.3, 6.1)	`*`	1.7 (0.3, 5.8)	`*`	2.8 (0.7, 7.6)
Lillooet Hospital and Health Centre	`*`	19.4 (3.2, 64)	0	0.0	`*`	8.5 (0.4, 41.8)	0	0.0	`*`	6.8 (0.3, 33.7)	0	0.0
Nicola Valley Health Centre	`*`	4.1 (0.2, 20.3)	`*`	3.7 (0.2, 18.1)	0	0.0	0	0.0	0	0.0	0	0.0
Penticton Regional Hospital	`*`	2 (1, 3.7)	11	2.2 (1.2, 3.8)	`*`	0.8 (0.3, 2)	`*`	1.3 (0.6, 2.5)	`*`	1.2 (0.5, 2.3)	18	2.9 (1.8, 4.5)
Princeton General Hospital	`*`	5.4 (0.3, 26.6)	`*`	5.4 (0.3, 26.8)	0	0.0	`*`	5.5 (0.3, 27)	0	0.0	0	0.0
Queen Victoria Hospital and Health Centre	0	0.0	0	0.0	0	0.0	0	0.0	`*`	3 (0.2, 14.9)	0	0.0
Royal Inland Hospital	24	2.5 (1.6, 3.6)	23	2.2 (1.4, 3.3)	17	1.8 (1.1, 2.8)	17	1.6 (1, 2.5)	29	2.7 (1.8, 3.8)	32	2.9 (2, 4)
Shuswap Lake General Hospital	`*`	3.6 (1.4, 7.4)	`*`	1.7 (0.4, 4.7)	`*`	4.4 (1.8, 9.1)	`*`	3.2 (1.3, 6.7)	`*`	2.9 (1.1, 6.5)	`*`	2.2 (0.7, 5.4)
South Okanagan General Hospital	0	0.0	0	0.0	`*`	2.2 (0.1, 10.7)	`*`	3.3 (0.5, 10.8)	0	0.0	`*`	1.5 (0.1, 7.5)
Vernon Jubilee Hospital	13	2 (1.1, 3.3)	17	2.4 (1.5, 3.8)	`*`	1.5 (0.7, 2.7)	`*`	0.9 (0.4, 1.9)	13	1.7 (0.9, 2.8)	12	1.5 (0.8, 2.5)
Island Health (ISLH)	169	2.5 (2.2, 2.9)	183	2.7 (2.3, 3.1)	185	3.1 (2.7, 3.6)	191	2.9 (2.5, 3.3)	235	3.4 (3, 3.8)	243	3.4 (3, 3.9)
Campbell River General Hospital	11	2.6 (1.4, 4.5)	`*`	1.4 (0.6, 2.8)	13	3.4 (1.9, 5.7)	12	2.8 (1.5, 4.7)	18	3.8 (2.3, 6)	15	3.2 (1.8, 5.1)
Comox Valley Hospital	`*`	1.2 (0.5, 2.4)	16	2.5 (1.5, 4)	17	3.4 (2.1, 5.4)	17	2.8 (1.7, 4.4)	18	3 (1.8, 4.6)	10	1.7 (0.9, 3)
Cormorant Island Community Health Centre	0	0.0	`*`	15.9 (0.8, 78.7)	0	0.0	0	0.0	0	0.0	0	0.0
Cowichan District Hospital	17	3.1 (1.9, 4.9)	24	4.6 (3, 6.7)	23	5 (3.2, 7.4)	26	5 (3.3, 7.2)	31	5.7 (3.9, 8)	24	4.5 (3, 6.7)
Lady Minto Gulf Islands Hospital	0	0.0	0	0.0	0	0.0	`*`	2.4 (0.1, 11.8)	0	0.0	0	0.0
Nanaimo Regional General Hospital	58	4.4 (3.4, 5.6)	51	3.8 (2.8, 4.9)	55	4.7 (3.6, 6)	50	3.7 (2.8, 4.9)	62	4.3 (3.3, 5.5)	73	5 (4, 6.3)
Port Hardy Hospital	`*`	4.8 (0.2, 23.5)	`*`	3.4 (0.2, 16.9)	0	0.0	0	0.0	0	0.0	0	0.0
Port McNeill and District Hospital	`*`	7.2 (0.4, 35.3)	`*`	5.2 (0.3, 25.5)	`*`	5.1 (0.3, 25.3)	`*`	3.8 (0.2, 18.9)	0	0.0	0	0.0
Royal Jubilee Hospital	42	2.3 (1.7, 3.1)	54	2.9 (2.2, 3.8)	42	2.6 (1.9, 3.4)	45	2.4 (1.8, 3.2)	54	2.8 (2.1, 3.6)	74	3.7 (2.9, 4.6)
Saanich Peninsula Hospital	`*`	0.8 (0.1, 2.7)	`*`	1.7 (0.6, 4.2)	`*`	0.5 (0, 2.6)	`*`	0.9 (0.1, 2.9)	`*`	1.2 (0.3, 3.3)	`*`	2.3 (0.9, 4.7)
Tofino General Hospital	`*`	5.2 (0.3, 25.8)	`*`	4.7 (0.2, 23.3)	`*`	17.6 (5.6, 42.5)	`*`	8.7 (1.5, 28.7)	`*`	3.7 (0.2, 18.2)	`*`	4.4 (0.2, 21.6)
Victoria General Hospital	26	1.9 (1.2, 2.7)	18	1.3 (0.8, 2)	20	1.5 (1, 2.3)	24	1.7 (1.1, 2.6)	37	2.7 (1.9, 3.7)	33	2.3 (1.6, 3.2)
West Coast General Hospital	`*`	1.6 (0.4, 4.2)	`*`	3 (1.2, 6.2)	`*`	5.4 (2.6, 10)	11	6.4 (3.4, 11.2)	11	6.5 (3.4, 11.2)	`*`	3.6 (1.6, 7.1)
Northern Health (NH)	120	5.4 (4.5, 6.4)	95	4.3 (3.5, 5.2)	91	4.9 (3.9, 5.9)	88	4.1 (3.3, 5.1)	104	4.5 (3.7, 5.4)	116	4.8 (4, 5.7)
Bulkley Valley District Hospital	`*`	2.9 (0.5, 9.6)	0	0.0	`*`	5.5 (1.4, 14.9)	`*`	3.2 (0.5, 10.6)	`*`	2.7 (0.5, 9.1)	`*`	3.8 (1, 10.4)
Chetwynd General Hospital	0	0.0	`*`	7.7 (0.4, 38)	`*`	7.2 (0.4, 35.3)	0	0.0	`*`	4.1 (0.2, 20.4)	0	0.0
Dawson Creek Hospital	16	8.2 (4.9, 13)	`*`	3.8 (1.7, 7.6)	`*`	5.2 (2.4, 9.9)	11	6.4 (3.4, 11.2)	10	5.5 (2.8, 9.9)	13	6.7 (3.7, 11.1)
Fort Nelson General Hospital	`*`	3.1 (0.2, 15.4)	`*`	10.3 (2.6, 28)	`*`	4.3 (0.2, 21.3)	0	0.0	`*`	7 (1.2, 23.2)	0	0.0
Fort St. John General Hospital	`*`	3.7 (1.6, 7.3)	`*`	3.8 (1.7, 7.6)	`*`	4.2 (1.7, 8.7)	`*`	2.4 (0.8, 5.8)	`*`	3.4 (1.4, 7)	11	5.5 (2.9, 9.6)
G.R. Baker Memorial Hospital	`*`	3.8 (1.5, 7.9)	`*`	1.8 (0.4, 4.8)	`*`	4.1 (1.5, 9.1)	`*`	4.5 (1.8, 9.4)	`*`	4.6 (2, 9.2)	`*`	5.6 (2.7, 10.3)
Haida Gwaii Hospital	`*`	5.1 (0.3, 25.2)	0	0.0	`*`	5.7 (0.3, 28)	0	0.0	0	0.0	0	0.0
Kitimat General Hospital	`*`	2.8 (0.5, 9.1)	`*`	7.6 (2.8, 16.8)	0	0.0	`*`	4.2 (1.1, 11.4)	`*`	4.1 (1, 11.2)	0	0.0
Lakes District Hospital	`*`	2.4 (0.1, 11.7)	`*`	2.4 (0.1, 11.6)	0	0.0	`*`	2.7 (0.1, 13.5)	0	0.0	0	0.0
Mackenzie and District Hospital	`*`	6.8 (0.3, 33.7)	0	0.0	0	0.0	0	0.0	`*`	9.6 (0.5, 47.3)	`*`	8.2 (0.4, 40.4)
McBride and District Hospital	`*`	8.4 (0.4, 41.3)	0	0.0	0	0.0	`*`	14.1 (0.7, 69.6)	0	0.0	0	0.0
Mills Memorial Hospital	18	9.6 (5.9, 14.9)	14	7.7 (4.4, 12.7)	11	6.6 (3.5, 11.6)	`*`	3.7 (1.6, 7.4)	17	8.4 (5.1, 13.2)	17	8 (4.8, 12.5)
Northern Haida Gwaii Hospital	`*`	7 (0.3, 34.4)	0	0.0	`*`	10.3 (0.5, 50.9)	`*`	7 (0.3, 34.3)	0	0.0	0	0.0
Prince Rupert Regional Hospital	`*`	4.7 (1.7, 10.5)	`*`	5 (1.8, 11.2)	`*`	10.1 (4.9, 18.5)	`*`	6.2 (2.5, 12.9)	`*`	6.1 (2.7, 12.1)	`*`	5.3 (2.2, 11.1)
St. John Hospital	`*`	1.4 (0.1, 6.8)	0	0.0	`*`	5.1 (0.9, 16.9)	`*`	5.1 (1.3, 14)	0	0.0	`*`	1.7 (0.1, 8.4)
Stuart Lake Hospital	0	0.0	`*`	4.7 (0.2, 23.1)	0	0.0	0	0.0	0	0.0	0	0.0
University Hospital of Northern BC	53	5.6 (4.2, 7.2)	46	4.6 (3.4, 6.1)	41	4.6 (3.4, 6.2)	43	4.4 (3.2, 5.8)	47	4.3 (3.2, 5.7)	53	4.8 (3.6, 6.2)
Wrinch Memorial Hospital	`*`	8.2 (2.6, 19.8)	`*`	4.3 (0.7, 14.2)	`*`	5.5 (0.9, 18.2)	0	0.0	`*`	2.4 (0.1, 11.7)	`*`	3.9 (0.7, 12.9)
Providence Health Care (PHC)	83	4.4 (3.5, 5.4)	53	3 (2.2, 3.8)	57	4.1 (3.1, 5.2)	61	4.1 (3.2, 5.2)	55	3.6 (2.8, 4.7)	70	4.4 (3.4, 5.5)
Mount Saint Joseph Hospital	`*`	1.8 (0.7, 3.8)	`*`	1.7 (0.6, 3.7)	`*`	2.2 (0.8, 4.9)	`*`	2.5 (1, 5.2)	`*`	2 (0.7, 4.4)	`*`	1.9 (0.7, 4.2)
St. Paul’s Hospital	77	4.9 (3.9, 6.1)	48	3.2 (2.4, 4.2)	52	4.4 (3.3, 5.8)	55	4.4 (3.3, 5.7)	50	4 (3, 5.2)	65	4.8 (3.8, 6.1)
Provincial Health Services Authority (PHSA)	23	2.4 (1.6, 3.6)	12	1.2 (0.7, 2.1)	12	1.3 (0.7, 2.2)	32	3.3 (2.3, 4.6)	24	2.6 (1.7, 3.8)	44	4.5 (3.3, 6)
BC Cancer	0	0.0	0	0.0	0	0.0	0	0.0	NA	NA	NA	NA
BC Children’s Hospital	`*`	1.5 (0.5, 3.3)	`*`	1.2 (0.4, 2.8)	`*`	0.7 (0.1, 2.2)	10	2.7 (1.4, 4.8)	12	2.9 (1.6, 4.9)	`*`	2 (1, 3.7)
BC Women’s Hospital	18	3.1 (1.9, 4.8)	`*`	1.4 (0.6, 2.6)	10	1.7 (0.9, 3)	22	3.7 (2.4, 5.5)	12	2.4 (1.3, 4)	35	6.6 (4.6, 9)
Vancouver Coastal Health (VCH)	200	4.4 (3.8, 5)	169	3.7 (3.2, 4.3)	132	3.2 (2.6, 3.7)	177	3.7 (3.2, 4.2)	150	3 (2.5, 3.5)	190	3.6 (3.1, 4.1)
Bella Coola General Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Lion’s Gate Hospital	37	4.5 (3.2, 6.1)	36	4.4 (3.1, 6.1)	27	3.7 (2.5, 5.2)	21	2.4 (1.5, 3.6)	34	3.6 (2.5, 5)	28	2.8 (1.9, 4.1)
Powell River General Hospital	`*`	4.7 (1.9, 9.8)	`*`	2.2 (0.6, 6.1)	`*`	1.1 (0.1, 5.3)	`*`	5.2 (2.1, 10.8)	`*`	1.6 (0.3, 5.2)	`*`	2.8 (0.9, 6.7)
RW Large Hospital	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Richmond Hospital	29	3.9 (2.6, 5.5)	16	2.1 (1.3, 3.4)	27	4.1 (2.7, 5.8)	42	5.6 (4.1, 7.5)	30	3.7 (2.5, 5.2)	22	2.6 (1.7, 3.9)
Sechelt Hospital	`*`	3.4 (1.5, 6.7)	18	7.9 (4.9, 12.3)	`*`	0.6 (0, 3.1)	`*`	5.2 (2.5, 9.5)	`*`	4.3 (2, 8.2)	19	9.2 (5.7, 14.1)
Squamish General Hospital	0	0.0	`*`	1.6 (0.1, 8)	`*`	5.3 (1.3, 14.3)	`*`	1.5 (0.1, 7.6)	`*`	2.8 (0.5, 9.3)	`*`	4.1 (1, 11.1)
UBC Hospital	`*`	2.2 (0.6, 6.1)	`*`	3.6 (1.3, 8.1)	`*`	1.3 (0.2, 4.5)	`*`	1.5 (0.5, 3.7)	`*`	0.4 (0, 1.8)	`*`	0.3 (0, 1.4)
Vancouver General Hospital	118	4.8 (4, 5.7)	90	3.7 (3, 4.5)	71	3.1 (2.4, 3.9)	94	3.7 (3, 4.5)	73	2.8 (2.2, 3.5)	113	4.2 (3.5, 5)

Notes:
* Represents the number of cases of MRSA that was 1 to less than 10
^a Per 10,000 inpatient days

Appendix E. HCC by acute care facilities.

	2018/19		2019/20		2020/21		2021/22		2022/23		2023/24
Health Authority and acute care facility	Total observations	Percent Compliance (95% CI)	Total observations	Percent Compliance (95% CI)	Total observations	Percent Compliance (95% CI)	Total observations	Percent Compliance (95% CI)	Total observations	Percent Compliance (95% CI)	Total observations	Percent Compliance (95% CI)
Fraser Health (FH)	44337	82.1 (81.7, 82.4)	27197	80.6 (80.1, 81.1)	25818	85.6 (85.2, 86.1)	47884	86.3 (86, 86.6)	49289	85.8 (85.5, 86.1)	53224	85.7 (85.4, 86)
Abbotsford Regional Hospital/Matsqui Sumas Abbotsford	1592	82.6 (80.7, 84.4)	3863	82.2 (81, 83.4)	2926	82.3 (80.9, 83.7)	4763	84.2 (83.1, 85.2)	5348	84.3 (83.3, 85.2)	5575	82.5 (81.5, 83.5)
Burnaby Hospital	8174	86.1 (85.4, 86.9)	4082	82.7 (81.5, 83.8)	3017	87.1 (85.9, 88.3)	5528	85.5 (84.5, 86.4)	5992	85.7 (84.8, 86.6)	5785	86.7 (85.8, 87.5)
CareLife Fleetwood	`*`	`*`	201	85.6 (80.2, 89.9)	`*`	`*`	325	94.5 (91.6, 96.6)	325	93.8 (90.8, 96.1)	350	94.3 (91.5, 96.4)
Chilliwack General Hospital	3782	81.3 (80, 82.5)	2128	78.8 (77, 80.5)	1762	82.5 (80.7, 84.2)	3002	83.3 (81.9, 84.6)	3135	81.9 (80.5, 83.2)	3525	83.6 (82.3, 84.8)
Delta Hospital	1988	78.2 (76.4, 80)	901	80.1 (77.4, 82.6)	678	86.3 (83.5, 88.7)	1300	83.8 (81.8, 85.8)	1300	85.1 (83.1, 86.9)	1400	86.4 (84.6, 88.1)
Eagle Ridge Hospital	3596	79.1 (77.7, 80.4)	2057	74.9 (73, 76.7)	1601	85.1 (83.3, 86.8)	2924	85.3 (84, 86.5)	2825	87 (85.7, 88.2)	3150	86.5 (85.3, 87.7)
Fellburn Care Centre	250	88 (83.5, 91.6)	225	89.3 (84.8, 92.9)	`*`	`*`	325	91.7 (88.3, 94.3)	300	85.7 (81.4, 89.3)	350	90.9 (87.5, 93.6)
Fraser Canyon Hospital	573	79.2 (75.8, 82.4)	428	87.6 (84.2, 90.5)	350	86.6 (82.7, 89.8)	600	88 (85.2, 90.4)	689	86.1 (83.3, 88.5)	700	82.3 (79.3, 85)
Langley Memorial Hospital	3494	79.8 (78.4, 81.1)	2389	80.5 (78.9, 82.1)	2058	85 (83.4, 86.5)	4100	88.1 (87.1, 89.1)	4155	86.1 (85, 87.1)	4800	80.9 (79.8, 82)
Mission Memorial Hospital	1577	87.5 (85.8, 89.1)	676	77.4 (74.1, 80.4)	526	82.3 (78.9, 85.4)	975	85.1 (82.8, 87.3)	975	84.7 (82.4, 86.9)	1050	84.8 (82.5, 86.8)
Peace Arch Hospital	4550	84.5 (83.5, 85.6)	2676	82.9 (81.5, 84.3)	2067	86.6 (85, 88)	4163	86.5 (85.4, 87.5)	3523	86.2 (85, 87.3)	3850	86.4 (85.3, 87.5)
Queen’s Park Care Centre - Acute	753	80.3 (77.4, 83.1)	625	83.5 (80.5, 86.3)	526	94.3 (92.1, 96.1)	975	92.3 (90.5, 93.9)	975	94.5 (92.9, 95.8)	1050	91.3 (89.5, 92.9)
Ridge Meadows Hospital	3885	82.4 (81.2, 83.6)	2140	76.7 (74.9, 78.5)	1752	89.7 (88.2, 91)	3229	89.8 (88.7, 90.8)	3085	85.5 (84.2, 86.7)	3450	87 (85.8, 88.1)
Royal Columbian Hospital	7554	79.7 (78.7, 80.6)	4806	80.3 (79.1, 81.4)	3175	85.1 (83.9, 86.3)	5850	85 (84.1, 85.9)	7162	84.1 (83.2, 84.9)	7689	84.8 (84, 85.6)
Surrey Memorial Hospital	2494	80.1 (78.5, 81.6)	NA	NA	5028	85.6 (84.6, 86.5)	9825	87 (86.3, 87.6)	9500	87.7 (87, 88.4)	10500	88.5 (87.9, 89.1)
Interior Health (IH)	18090	87.5 (87, 88)	24378	87.9 (87.5, 88.3)	20170	83.5 (83, 84)	34360	75.9 (75.4, 76.3)	19052	71.7 (71, 72.3)	15323	71.7 (70.9, 72.4)
100 Mile District Hospital	`*`	`*`	`*`	`*`	`*`	`*`	217	66.4 (59.9, 72.4)	`*`	`*`	229	79.9 (74.3, 84.7)
Arrow Lakes Hospital	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`
Boundary Hospital	`*`	`*`	`*`	`*`	313	78.6 (73.8, 82.9)	637	76.6 (73.2, 79.8)	`*`	`*`	`*`	`*`
Cariboo Memorial Hospital	`*`	`*`	301	87.4 (83.3, 90.8)	438	82.6 (78.9, 86)	535	69.2 (65.1, 73)	348	62.1 (56.9, 67.1)	`*`	`*`
Creston Valley Hospital	`*`	`*`	201	82.6 (76.9, 87.4)	210	88.6 (83.7, 92.4)	331	82.8 (78.4, 86.6)	`*`	`*`	203	79.8 (73.9, 84.9)
Dr Helmcken Memorial Hospital and Health Centre	`*`	`*`	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
East Kootenay Regional Hospital	1140	86.8 (84.7, 88.6)	1401	79.5 (77.3, 81.6)	1831	84.4 (82.7, 86)	2565	80.6 (79, 82.1)	1188	71 (68.4, 73.6)	1081	77.2 (74.7, 79.7)
Elk Valley Hospital	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	356	73 (68.2, 77.5)
Golden and District Hospital	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`
Invermere District Hospital	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`
Kelowna General Hospital	5814	88.9 (88, 89.7)	7679	90.6 (89.9, 91.2)	5251	88.1 (87.2, 89)	9178	77.2 (76.4, 78.1)	5337	74.5 (73.3, 75.7)	4264	68.5 (67.1, 69.9)
Kootenay Boundary Regional Hospital	907	85.6 (83.2, 87.7)	1222	85.5 (83.5, 87.4)	1548	83.9 (82, 85.7)	2744	84.1 (82.7, 85.4)	1470	76.9 (74.7, 79)	501	76.8 (73, 80.4)
Kootenay Lake Hospital	713	87.9 (85.4, 90.2)	916	89 (86.8, 90.9)	1089	85 (82.8, 87.1)	2151	83 (81.4, 84.6)	798	75.9 (72.9, 78.8)	305	78.4 (73.5, 82.7)
Lillooet Hospital and Health Centre	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
Nicola Valley Health Centre	`*`	`*`	NA	NA	NA	NA	NA	NA	NA	NA	`*`	`*`
Penticton Regional Hospital	2094	86.8 (85.3, 88.2)	3026	88.3 (87.1, 89.4)	1918	85.7 (84, 87.2)	3774	77.7 (76.3, 79)	1981	80 (78.2, 81.7)	1595	75.8 (73.6, 77.9)
Princeton General Hospital	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	`*`	`*`
Queen Victoria Hospital	`*`	`*`	NA	NA	NA	NA	NA	NA	`*`	`*`	`*`	`*`
Royal Inland Hospital	3498	89.3 (88.2, 90.2)	5006	87 (86.1, 87.9)	4054	80.8 (79.6, 82)	6903	68.7 (67.6, 69.8)	4241	64.3 (62.8, 65.7)	4032	74.1 (72.8, 75.5)
Shuswap Lake General Hospital	980	90.3 (88.3, 92)	1273	89.6 (87.9, 91.2)	1058	83.4 (81, 85.5)	1520	79.5 (77.4, 81.4)	1015	75.4 (72.6, 77.9)	413	67.3 (62.7, 71.7)
South Okanagan General Hospital	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	NA	NA	265	80.8 (75.7, 85.2)
Vernon Jubilee Hospital	2101	82.6 (81, 84.2)	2722	86.8 (85.5, 88.1)	2041	74.5 (72.5, 76.3)	3269	67.7 (66, 69.3)	2072	66.3 (64.3, 68.3)	1455	62.4 (59.9, 64.9)
Island Health (ISLH)	31151	77.3 (76.9, 77.8)	33247	79.4 (79, 79.9)	30974	81 (80.5, 81.4)	28368	79.3 (78.8, 79.8)	25420	78.3 (77.8, 78.8)	28091	79.4 (79, 79.9)
Campbell River Hospital	1459	77 (74.8, 79.1)	1495	78.5 (76.4, 80.6)	1896	84.5 (82.9, 86.1)	1604	81.3 (79.3, 83.1)	1493	80.5 (78.4, 82.5)	1575	82.3 (80.4, 84.2)
Comox Valley Hospital	1486	68.7 (66.3, 71)	1160	72.8 (70.2, 75.3)	1198	80.1 (77.8, 82.3)	1213	78 (75.6, 80.3)	1125	76.7 (74.2, 79.1)	1542	77.8 (75.6, 79.8)
Cormorant Island CHC	`*`	`*`	`*`	`*`	`*`	`*`	NA	NA	`*`	`*`	`*`	`*`
Cowichan District Hospital	3306	80.9 (79.6, 82.3)	3325	79.6 (78.2, 81)	3359	76.9 (75.4, 78.3)	2303	85 (83.5, 86.4)	2054	79 (77.2, 80.7)	1648	77.3 (75.2, 79.3)
Lady Minto Hospital	231	85.3 (80.3, 89.4)	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`	`*`
Nanaimo Regional General	4806	74.5 (73.3, 75.7)	7036	79.1 (78.1, 80)	6868	83.2 (82.3, 84.1)	4877	76.5 (75.3, 77.7)	4728	76.7 (75.4, 77.9)	4855	79.3 (78.1, 80.4)
Port Hardy Hospital	`*`	`*`	`*`	`*`	`*`	`*`	NA	NA	`*`	`*`	`*`	`*`
Port McNeill Hospital	`*`	`*`	`*`	`*`	NA	NA	NA	NA	`*`	`*`	`*`	`*`
Royal Jubilee Hospital	9133	75.5 (74.6, 76.4)	10487	80.1 (79.3, 80.8)	9257	81.6 (80.8, 82.4)	9179	78.7 (77.9, 79.5)	8079	79.2 (78.3, 80)	8355	80 (79.1, 80.8)
Saanich Peninsula Hospital	1376	91.8 (90.2, 93.2)	1101	76.4 (73.8, 78.8)	942	80.1 (77.5, 82.6)	880	76.2 (73.4, 79)	1303	76 (73.6, 78.2)	1249	81.2 (78.9, 83.3)
Tofino General Hospital	`*`	`*`	`*`	`*`	`*`	`*`	NA	NA	NA	NA	`*`	`*`
Victoria General Hospital	8033	78 (77.1, 78.9)	7442	80.1 (79.2, 81)	6145	78.3 (77.3, 79.3)	7109	80.2 (79.2, 81.1)	5755	79.3 (78.2, 80.3)	7914	79.1 (78.2, 80)
West Coast General	1024	77.2 (74.6, 79.7)	1013	80 (77.4, 82.3)	1121	84.7 (82.6, 86.8)	1121	79.1 (76.7, 81.4)	863	74.5 (71.5, 77.3)	820	76.8 (73.8, 79.6)
Northern Health (NH)	21373	86.2 (85.7, 86.6)	18399	85.8 (85.3, 86.3)	19701	91.7 (91.3, 92)	17214	91 (90.6, 91.5)	18260	92 (91.6, 92.4)	14911	91.4 (90.9, 91.8)
Bulkley Valley District Hospital	834	76.4 (73.4, 79.2)	308	80.5 (75.8, 84.7)	713	87.1 (84.5, 89.4)	578	85.6 (82.6, 88.3)	`*`	`*`	`*`	`*`
Chetwynd General Hospital	`*`	`*`	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
Dawson Creek Hospital	941	70.1 (67.2, 73)	1314	87.3 (85.4, 89)	1197	89.9 (88.1, 91.5)	469	80.2 (76.4, 83.6)	297	75.4 (70.3, 80.1)	446	75.1 (70.9, 79)
Fort Nelson General Hospital	482	82.2 (78.5, 85.4)	345	76.8 (72.1, 81)	485	94.4 (92.1, 96.2)	786	94.7 (92.9, 96.1)	860	97.8 (96.6, 98.6)	801	97 (95.6, 98)
Fort St. John General Hospital	1293	77 (74.7, 79.3)	1083	76.5 (73.9, 78.9)	990	82 (79.5, 84.3)	941	80.2 (77.6, 82.7)	995	76.7 (74, 79.2)	791	73.1 (69.9, 76.1)
G.R. Baker Memorial Hospital	375	64 (59, 68.7)	585	62.1 (58.1, 65.9)	493	81.9 (78.4, 85.2)	467	79.9 (76.1, 83.3)	480	69 (64.7, 73)	583	95.9 (94, 97.3)
Haida Gwaii Hospital	NA	NA	NA	NA	NA	NA	`*`	`*`	NA	NA	NA	NA
Kitimat General Hospital	942	93.4 (91.7, 94.9)	526	83.7 (80.3, 86.6)	500	88.4 (85.4, 91)	`*`	`*`	`*`	`*`	583	82.7 (79.4, 85.6)
Lakes District Hospital	NA	NA	NA	NA	NA	NA	NA	NA	`*`	`*`	NA	NA
Mackenzie and District Hospital	1300	87 (85.1, 88.8)	736	86.8 (84.2, 89.1)	`*`	`*`	NA	NA	NA	NA	NA	NA
McBride and District Hospital	1357	95.2 (94, 96.3)	1193	97.7 (96.7, 98.4)	1430	99.4 (98.9, 99.7)	919	98.3 (97.2, 99)	1243	99.8 (99.3, 99.9)	854	99.6 (99, 99.9)
Mills Memorial Hospital	1076	83.6 (81.3, 85.8)	853	82.9 (80.2, 85.3)	846	85.3 (82.8, 87.6)	759	80 (77, 82.7)	560	76.8 (73.2, 80.1)	363	84.6 (80.6, 88)
Northern Haida Gwaii Hospital	1299	98.9 (98.2, 99.4)	714	97.2 (95.8, 98.2)	931	98.4 (97.4, 99.1)	1959	99 (98.5, 99.4)	3923	99.8 (99.6, 99.9)	2588	99.6 (99.3, 99.8)
Prince Rupert Regional Hospital	1052	76.7 (74.1, 79.2)	843	69.5 (66.3, 72.6)	356	72.8 (67.9, 77.2)	238	55 (48.7, 61.3)	NA	NA	480	93.3 (90.8, 95.3)
Queen Charlotte Islands Hospital	`*`	`*`	205	80.5 (74.6, 85.5)	NA	NA	NA	NA	NA	NA	NA	NA
St. John Hospital	674	86.6 (83.9, 89.1)	959	97.3 (96.1, 98.2)	729	96 (94.4, 97.3)	1101	95.1 (93.7, 96.3)	881	95.8 (94.3, 97)	253	93.3 (89.7, 95.9)
Stuart Lake Hospital	`*`	`*`	NA	NA	`*`	`*`	NA	NA	NA	NA	NA	NA
University Hospital of Northern BC	9222	88.7 (88.1, 89.4)	8384	87.8 (87.1, 88.5)	10294	92.9 (92.4, 93.4)	8721	92.5 (92, 93.1)	8723	91.1 (90.5, 91.7)	6748	91.1 (90.4, 91.7)
Wrinch Memorial Hospital	`*`	`*`	351	71.8 (66.9, 76.3)	427	84.5 (80.9, 87.7)	236	83.1 (77.9, 87.4)	`*`	`*`	381	75.3 (70.8, 79.5)
Providence Health Care (PHC)^a	4656	75.9 (74.6, 77.1)	3433	73.9 (72.4, 75.4)	3906	75.9 (74.6, 77.3)	4727	72.3 (71, 73.6)	4778	75.7 (74.4, 76.9)	4540	74.6 (73.4, 75.9)
Provincial Health Services Authority (PHSA)	3852	92.7 (91.8, 93.4)	3682	91.6 (90.7, 92.5)	3777	90.9 (90, 91.8)	1106	76.3 (73.7, 78.7)	2767	66.3 (64.5, 68)	2738	68.7 (67, 70.5)
BC Cancer	740	93.4 (91.4, 95)	570	91.4 (88.9, 93.5)	720	90.4 (88.1, 92.4)	411	89.1 (85.8, 91.8)	858	81 (78.3, 83.5)	883	79.6 (76.9, 82.2)
BC Children’s Hospital	1920	93.3 (92.1, 94.3)	1920	90.9 (89.6, 92.2)	1820	91.5 (90.2, 92.8)	`*`	`*`	561	70.1 (66.2, 73.7)	606	65.3 (61.5, 69.1)
BC Mental Health & Substance Use	NA	NA	NA	NA	`*`	`*`	304	63.8 (58.3, 69.1)	907	55.3 (52.1, 58.6)	901	60.8 (57.6, 64)
BC Women’s Hospital	1192	91.2 (89.5, 92.7)	1192	92.8 (91.2, 94.2)	1182	91.4 (89.7, 92.9)	248	71.4 (65.5, 76.7)	441	55.3 (50.7, 59.9)	348	67.5 (62.5, 72.3)
Vancouver Coastal Health (VCH)	7666	87.8 (87, 88.5)	6036	87.4 (86.5, 88.2)	857	87.5 (85.2, 89.6)	7094	89.5 (88.8, 90.2)	4269	87.8 (86.8, 88.8)	6763	86.8 (86, 87.6)
Bella Bella General Hospital	`*`	`*`	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
Bella Coola General Hospital	`*`	`*`	`*`	`*`	NA	NA	266	89.1 (84.9, 92.4)	NA	NA	NA	NA
Lions Gate Hospital	1362	83.8 (81.8, 85.7)	1049	86.4 (84.2, 88.3)	222	82 (76.5, 86.6)	657	86.5 (83.7, 88.9)	839	85.5 (82.9, 87.7)	1472	87.6 (85.8, 89.2)
Powell River General Hospital	580	79.5 (76.1, 82.6)	445	81.1 (77.3, 84.6)	NA	NA	679	85.1 (82.3, 87.7)	NA	NA	`*`	`*`
Richmond Hospital	1304	89.4 (87.7, 91)	983	86.9 (84.7, 88.9)	213	88.3 (83.4, 92.1)	888	88.2 (85.9, 90.2)	917	87.4 (85.1, 89.4)	1021	87.8 (85.6, 89.7)
Sechelt Hospital	203	94.6 (90.8, 97.1)	`*`	`*`	NA	NA	`*`	`*`	NA	NA	`*`	`*`
Squamish General Hospital	`*`	`*`	`*`	`*`	`*`	`*`	211	87.7 (82.7, 91.6)	`*`	`*`	`*`	`*`
UBC Hospital	338	87.3 (83.4, 90.5)	330	84.2 (80, 87.9)	`*`	`*`	1022	91.6 (89.8, 93.2)	277	83.8 (79.1, 87.8)	377	84.9 (81, 88.2)
Vancouver General Hospital	3607	89.9 (88.8, 90.8)	2863	89.7 (88.5, 90.7)	372	90.6 (87.3, 93.3)	3331	90.9 (89.9, 91.8)	2091	89.4 (88, 90.7)	3447	87.9 (86.8, 89)
Whistler Health Care	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	`*`	`*`

Notes:
NA means no audit was conducted for that site during that fiscal year
* Represents the number of observations that was less than 200 opportunities. For these cases, the associated Percent Compliance (95% CI) values are not provided.
^a Represents three facilities data from PHC, while individual facility data of PHC were not available to PICNet

References

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Annual surveillance report: Trends of health care-associated infections and hand cleaning compliance in British Columbia Surveillance dates: 2018-04-01 to 2024-03-31

Acknowledgements

First Nations Land Acknowledgement

Abbreviations

Executive Summary

Introduction

Overview of Surveillance Indicators

Figure User Guide

Clostridioides difficile Infection (CDI)

Figure 1. Distribution of CDI episodes reported in acute care facilities in BC by classification - Select count or percentage.

Figure 2. Count and rate of new HCA CDI cases associated with the reporting facility - Select BC or health authority.

Figure 3. Provincial rate of new CDI cases associated with the reporting facility by type of acute care facility.

Figure 4. Provincial rate of new CDI cases associated with the reporting facility by size of acute care facility.

Figure 5. Number and percentage of relapses among HCA CDI cases.

Figure 6. Percentage of CDI-associated complications within 30 days of diagnosis.

Methicillin-Resistant Staphylococcus aureus (MRSA)

Figure 7. Distribution of new MRSA cases reported in acute care facilities in BC by classification - Select count or percentage.

Figure 8. Count and rate of new HCA MRSA cases associated with the reporting facility - Select BC or health authority.

Figure 9. Provincial rate of new cases of MRSA associated with the reporting facility by facility type.

Figure 10. Provincial rate of new cases of MRSA associated with the reporting facility by facility size.

Carbapenemase-Producing Organisms (CPO)

Figure 11. Count and rate of new cases of CPO, including both first-time colonizations and first-time infections - Select BC or health authority.

Figure 12. Percentage new CPO Cases in BC by gene type.

Figure 13. Percentage of new CPO cases identified in community health-care settings by fiscal year.

Figure 14. Count and percentage of new CPO cases in BC with travel outside Canada in the 12 months before presentation.

Figure 15. Count and percentage of new CPO cases in BC with a health-care encounter outside of Canada in the 12 months before presentation.

Figure 16. Count and percentage of new CPO cases in BC with a health-care encounter in BC in the 12 months before presentation.

Figure 17. Rate of new CPO colonizations and infections in BC.

Figure 18. Intensive care unit (ICU) admission status (%) for all reported acute care CPO infections in BC.

Figure 19. CPO infection outcomesa in BC (%) within 30 days of infection identification or until discharge.

Candida auris (C. auris)

Figure 20. Number of new C. auris cases in BC acute care facilities.

Hand Cleaning Compliance (HCC)

Figure 21. HCC (%) in BC - Select acute care or long-term care .

Figure 22. HCC (%) in acute care facilities in BC before and after contact with a patient or their environment.

Figure 23. HCC (%) in acute care facilities in BC by health-care provider.

Table 1. HCC (%) in acute care facilities by health authority.

Table 2. HCC (%) in health authority-owned/operated long-term care facilities by health authority.

Discussion

Conclusion

Technical Notes

General

CDI

MRSA

CPO

HCC

Appendices

Appendix A. Acute care facilities participating in the provincial surveillance programs in 2023/24.

Appendix B. Start and end date for quarters in 2023/24.

Appendix C. Rate of new HCA CDI cases associated with the reporting facility by acute care facility.

Appendix D. Rate of new HCA MRSA cases associated with the reporting facility by acute care facility.

Appendix E. HCC by acute care facilities.

References

Annual surveillance report:
Trends of health care-associated infections and hand cleaning compliance in British Columbia

Surveillance dates: 2018-04-01 to 2024-03-31

Figure 19. CPO infection outcomes^a in BC (%) within 30 days of infection identification or until discharge.