Antimicrobial resistance (AMR) poses a serious threat to patient safety and worldwide public health. The diminishing effectiveness of current antimicrobials, including antibiotics, antivirals, and antifungals, against resistant organisms is a major concern. Infections acquired in health care settings contribute to prolonged hospital stays, higher mortality rates, and increased utilization of health care resources.

Given that antimicrobial-resistant organisms (AROs) serve as a significant reservoir for healthcare-associated pathogens, the spotlight is now on the crucial role of screening and surveillance programs. These initiatives play a pivotal role in enhancing our comprehension of the prevalence of AROs and the effectiveness of infection control programs within health care settings.

Annual Survey

In 2016, Public Health Ontario (PHO) and the Institute for Quality Management in Healthcare (IQMH) established a partnership to conduct an annual survey of AROs across all laboratories and public hospitals for surveillance. A survey to capture information about 2022 was distributed to all licensed microbiology laboratories and all public hospitals in Ontario.

Survey participants were asked questions on topics related to screening and infection control programs, and the prevalence of AROs. Additionally, the survey included questions designed to gain insights into the effects of the pandemic on the screening and management of health care-associated infections in hospitals across Ontario.

The 2022 Report on ARO Surveillance

The latest report, created in collaboration with PHO, outlines the results of the annual survey on antimicrobial resistance among common hospital pathogens in 2022. Notably, this marks the first year that the report incorporates details regarding the prevalence of Candida auris in Ontario, and insights into surveillance and infection control programs aimed at preventing its transmission in hospitals across the province.

Key Findings

• Incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) in Ontario increased in 2022 compared with 2021.
• The rate of carbapenemase-producing organisms (CPO) in Ontario hospitals is increasing, with rates nearly doubling from 2021 to 2022.
• While hospital-based rates of Clostridium difficile infection (CDI) have been decreasing since 2012, CDI prevalence rates from this survey increased from 2021 (5.3 per 10,000 population) to 2022 (8.6 per 10,000).
• Understanding the incidence of Candida auris in Ontario is difficult as only half of the responding laboratories reported established processes for identification and only ~20% of responding hospitals indicated they had screening programs in 2022.
• The hospital survey results describe some of the effects of the SARS-COV-2 pandemic on the screening and management of health care-associated infections in Ontario hospitals. While most disruptions due to the pandemic have been restored, some hospitals did report ongoing interruptions to their screening and management programs.

The outcomes of this survey are important to support our understanding of the impact of AROs and can play a crucial role in shaping recommendations to prevent their spread within Ontario.

Sustained surveillance of AROs remains essential to understand the current resistance landscape. The identification of regional variations in the incidence of these organisms can provide valuable insights, informing provincial and local decisions on the appropriate application of infection control policies.

View the ARO 2022 report.