To assess preparedness for Candida auris in Canadian hospitals.

Cross-sectional survey.

Canadian Nosocomial Infection Surveillance Program (CNISP) hospitals.

In June 2024, surveys were e-mailed to the infection prevention and control departments of 109 CNISP hospitals and their 33 microbiology laboratories. The surveys assessed policies for patient screening/management and laboratory processes supporting C. auris transmission prevention. Results were compared to a similar 2018 survey.

All 109 hospitals and 32/33 laboratories responded. Most hospitals had policies for admission screening (80%, 87/109) and policies/defined plans for post-exposure screening (95%, 104/109). Policy presence increased from 18% to 73% in 56 hospitals completing both 2018 and 2024 surveys (P < 0.001). Among hospitals with admission screening policies, 69% (60/87) screened for recent out-of-country hospitalization. All but one hospital implemented transmission-based precautions for cases; 70% (76/109) continued precautions indefinitely. Overall, 94% (99/105; excluding hospitals with exclusively private rooms) and 55% (60/109) of hospitals screened roommates and wardmates, respectively. Frequency and timing of screening and policies regarding precautions for exposed patients varied. All hospitals used axilla and groin swabs, at minimum, for screening. Most (81%, 26/32) laboratories identified all clinically significant Candida isolates to species level, increasing from 48% to 85% (P < 0.001) in the 27 laboratories completing both 2018 and 2024 surveys. Twenty-four laboratories (75%) had standard operating procedures for processing screening specimens; 96% (23/24) used direct plating onto chromogenic agar.

Despite progress in C. auris preparedness, areas for improvement remain. Variability in practice may be related to evidence gaps and resource constraints.

Antibiotics are essential to combating infections; however, misuse and overuse has contributed to antimicrobial resistance (AMR). Antimicrobial stewardship programs (ASPs) are a strategy to combat AMR and are mandatory in Canadian hospitals for accreditation. The Canadian Nosocomial Infection Surveillance Program (CNISP) sought to capture a snapshot of ASP practices within the network of Canadian acute care hospitals. Objectives of the survey were to describe the status, practices, and process indicators of ASPs across acute care hospitals participating in CNISP.

The survey explored the following items related to ASP programs: 1) program structure and leadership, 2) human, technical and financial resources allocated, 3) inventory of interventions carried and implemented, 4) tracking antimicrobial use; and 5) educational and promotional components.

CNISP developed a 34-item survey in both English and French. The survey was administered to 109 participating CNISP hospitals from June to August 2024, responses were analyzed descriptively.

Ninety-seven percent (106/109) of CNISP hospitals responded to the survey. Eighty-four percent (89/106) reported having a formal ASP in place at the time of the study. Ninety percent (80/89) of acute care hospitals with an ASP performed prospective audit and feedback for antibiotic agents and 85% (76/89) had formal surveillance of quantitative antimicrobial use. Additionally, just over 80% (74/89) provided education to their prescribers and other healthcare staff.

CNISP acute care hospitals employ multiple key aspects of ASP including implementing interventions and monitoring/tracking antimicrobial use. There were acute care hospitals without an ASP, highlighting areas for investigation and improvement.