Canada has a very high rate of health care acquired infections: WHO report

A new World Health Organization (WHO) study (Report on the Burden of Endemic Health Care Associated Infection Worldwide: Clean Care is Safer Care)  indicates that Canada has a high rate of Health Care Acquired Infections (HCAIs) compared to other developed countries.  

The study reports that Canada’s HAI incidence is 11.6%. Of the world’s economically advanced economies, only New Zealand reported a higher rate at 12%. (Notably, New Zealand also has very few hospital beds per capita.)  While Canada has a rate of 11.6% the HCAI prevalence in high income countries is 7.6%:


“According to published national or multicentre studies, pooled HCAI prevalence in mixed patient populations was 7.6% in high-income countries ...The estimated HCAI incidence rate in the USA was 4.5% in 2002, corresponding to 9 3 infections per 1000 patient-days and 1 7 million affected patients”


The Canadian rate is more than 50% higher than the rate reported for high income countries.  

While HCAI rates in developing countries are often higher than in Canada, some such countries have reported rates lower than Canada: Indonesia, Cuba, Latvia, Lithuania, Iran, Thailand, Lebanon, and Mongolia. 

The study underlines the large impact of HCAIs:


“In Europe, HCAIs cause 16 million extra-days of hospital stay, 37 000 attributable deaths, and contribute to an additional 110,000 every year  Annual financial losses are estimated at approximately € 7 billion, including direct costs only.  In the USA, approximately 99 000 deaths were attributed to HCAI in 2002 and the annual economic impact was estimated at approximately US$ 6.5 billion in 2004....

WHO reports that the incidence of HCAIs is especially associated with treatment in intensive care units: “In high-income countries, approximately 30% of ICU patients are affected by at least one episode of HCAI.”

The WHO study notes that HCAIs can be prevented:

“Robust evidence exists that HCAI can be prevented and the burden reduced by as much as 50% or more.  Solid recommendations have been issued by national and international organizations, but their application needs to be strengthened and accompanied by performance monitoring both in high-income and low- and middle income countries  HCAI must be treated as a priority patient safety issue within comprehensive approaches to be tackled effectively.”

The study suggests that HCAIs are the most common cause of death for residents in long term care facilities (as well as the most common reason for LTC residents to b e admitted to a hospital):

Several projects on infection control in long-term care facilities have been initiated in Europe over the last five years.  Accumulated evidence suggests that any resident living in these facilities develops one to three infections per year on average, most frequently urinary tract infection (UTI) and pneumonia  It was also demonstrated that the onset of infection represents the most common cause of hospital admission and death for residents in long-term care facilities, mainly from pneumonia.

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