Surveillance & Reporting

Infection Prevention & Control

The Alberta Health Services IPC program partners with the Covenant Health to collect surveillance data at every acute care facility in the province.

IPC works with all AHS staff to prevent healthcare acquired infections and improve patient safety.

Surveillance is an essential component of Infection Prevention and Control. If carried out in a uniform manner, surveillance provides a measure of the burden of illness, establishes benchmark rates for internal and external comparison, identifies potential risk factors, and allows assessment of specific interventions.


Reporting of Hand Hygiene compliance is one of AHS’ monitoring measures of safety. Hand hygiene is an effective strategy to reduce transmission of infection in the healthcare setting and can be used to monitor how our health system is performing. These measures are reported quarterly.


Published Literature & Resources


Published Literature

Acosta, N., Bautista, M. A., Waddell, B. J., Du, K., McCalder, J., Pradhan, P., Sedaghat, N., Papparis, C., Beaudet, A. B., Chen, J., Van Doorn, J., Xiang, K., Chan, L., Vivas, L., Low, K., Lu, X., Lee, J., Westlund, P., Chekouo, T., … Parkins, M. D. (2023). Surveillance for sars‐cov‐2 and its variants in wastewater of tertiary care hospitals correlates with increasing case burden and outbreaks. Journal of Medical Virology, 95(2), 1–11. 

Ellison, J., Cayen, J., Pelude, L., Mitchell, R., & Bush, K. (2023). Evaluation of the accuracy in the application of the Canadian Nosocomial Infection Surveillance Proram (CNISP) bloodstream infection surveillance definitions. Canadian Journal of Infection Control, 38(41)19-22.

Gagnon, H., Pokhrel, A., Bush, K., Cordoviz, M., Ewashko, T., Galetta, F., & Leal, J. (2023). Limited reduction in Clostridioides difficile and Methicillin-Resistant Staphylococcus aureus with the use of an aerosolized hydrogen peroxide disinfection system in tertiary healthcare facilities in Alberta, Canada. American Journal of Infection Control.

Jeon, D., Chavda, S., Rennert-May, E., & Leal, J. (2023). Clinical prediction tools for identifying antimicrobial-resistant organism (ARO) carriage on hospital admissions: a systematic review. The Journal of Hospital Infection, 134, 11-26.

Leal, J. O’Grady, H., Armstrong, L., Dixit, D., Khawaja, Z., Snedeker, K., Ellison, J., Erebor, J., Jamieson, P., Weiss, A., Salcedo, D., Roberts, K., Wiens, K., Croxen, M., Berenger, B. M., Pabbaraju, K., Lin, Y-C., Evans, D. & Conly, J. M. (2023). Patient and ward related risk factors in a multi ward nosocomial outbreak of COVID 19: Outbreak investigation and matched case–control study. Antimicrobial Resistance & Infection Control, 12 (21).

Mitchell, R., Cayen, J., Thampi, N., Frenette, C., Bartoskzo, J., Choi, K. B., Comeau, J. L., Conly, J., Ellis, C., Ellison, J., Embil, J., Evans, G., Johnston, L., Johnstone, J., Katz, K. C., Kibsey, P., Lee, B., Lefebvre, M.-A., Longtin, Y., … Pelude, L. (2023). Trends in severe outcomes among adult and pediatric patients hospitalized with COVID-19 in the Canadian nosocomial infection surveillance program, March 2020 to May 2022. JAMA Network Open, 6(4).

Mitchell, R., Lee, D., Pelude, L., Comeau, J .L., Conly, J., Ellis, C., Ellison, J., Embil, J., Evans, G., Johnston, L., Johnstone, J., Katz, K. C., Kibsey, P., Lee, B., Lefebvre, M-A., Longtin, Y., McGeer, A., Mertz, D., Minion, J.,... Frenette, C. (2023). A descriptive analysis of nirmatrelvir-ritonavir use among adults hospitalized with COVID-19 during the Omicron phase of the COVID-19 pandemic, Canadian Nosocomial Infection Surveillance Program. Canada Communicable Disease Report, 49(7/8), 351–7.

Tsang, C. C., Holroyd-Leduc, J. M., Ewa, V., Conly, J. M., Leslie, M. M., & Leal, J. R. (2023). Barriers and facilitators to the use of personal protective equipment in long-term care: A scoping review. Journal of the American Medical Directors Association, 24(1).

Wu, G., Cheligeer, C., Southern, C. A., Martin, E. A., Xu, Y., Leal, J., Ellison, J., Bush, K., Williamson, T., Quan, H., & Eastwood, C. A. (2023). Development of machine learning models for the detection of surgical site infections following total hip and knee arthroplasty: a multicenter cohort study. Antimicrobial Resistant Infection Control, 12 (88).


Published Literature

Bush, K., Leal, J., Acorn, L., Cordoviz, M., Cundict, F., Devine, A., Edwards, C. L., Fletcher, P., Gable, Y., Gagnon, H., Gallinger, S., Gill, V., Heinrichs, B., McFerran, B., Pearce, C., Pfister, T., & Meyers, G., (2022). Developing a competency framework for all staff roles in an infection prevention and control program. Canadian Journal of Infection Control, 37 (4): 184-188.

Choi, K. B., Du, T., Silva, A., Golding, G. R., Pelude, L., Mitchell, R., Rudnick, W., Hizon, R., Al-Rawahi, G. N., Chow, B., Davis, I., Evans, G. A., Frenette, C., Johnstone, J., Kibsey, P., Katz, K. C., Langley, J. M., Lee, B. E., Longtin, Y., … Hota, S. S. (2022). Trends in clostridioides difficile infection rates in Canadian hospitals during the coronavirus disease 2019 (covid-19) pandemic. Infection Control & Hospital Epidemiology, 1–4.

Choi, K. B., Steele, V., Conly, J., Chow, B., Comeau, J. L., Embree, J., Lee, B. E., Lefebvre, M. A., Mitchell, R., Pelude, L., Shephard, A. L., & Langley, J. M. (2022). Cerebrospinal fluid shunt–associated surgical site infection with three-month versus twelve-month surveillance periods in Canadian hospitals. Infection Control & Hospital Epidemiology, 1–4.

Du, T., Choi, K. B., Silva, A., Golding, G. R., Pelude, L., Hizon, R., Al-Rawahi, G. N., Brooks, J., Chow, B., Collet, J. C., Comeau, J. L., Davis, I., Evans, G. A., Frenette, C., Han, G., Johnston, J., Kibsey, P., Katz, K. C., Langley, J. M., ....Hota, S. S. (2022). Characterization of Healthcare-Associated and Community-Associated Clostridioides difficile Infections among Adults, Canada, 2015–2019. Emerging Infectious Diseases, 28(6), 1128-1136.

Haverkate, M. R., Macfadden, D. R., Daneman, N., Leal, J., Otterstatter, M., Mahdavi, R., D’Souza, A. G., Rennert-May, E., Silverman, M., Schwartz, K. L., Morris, A. M., Saatchi, A., Patrick, D. M., & Marra, F. A. (2022). Time Series Analysis Evaluating Antibiotic Prescription Rates in Long-Term Care during the COVID-19 Pandemic in Alberta and Ontario, Canada. Antibiotics 2022, 11, 1001.

Ismail, A., Leal, J., Au, F., Puloski, S., Mponponsuo, K., Smith, S., & Rennert-May, E. (2022). Retrospective analysis of the management strategies for surgical site infection post total hip or knee arthroplasty from tertiary care centres in Edmonton, Alberta. Journal of Hospital Infection, 129, 1–7.

Leal, J., Jefferson, T., & Conly, J. (2022). SARS-CoV-2 Exposures of Healthcare Workers and Acquisition of COVID-19. Clinical Microbiology and Infection, 28 (11), 1403-1405.

Liang, J. J., Rudnick, W., Mitchell, R., Brooks, J., Bush, K., Conly, J., Ellison, J., Frenette, C., Johnston, L., Lavallée, C., McGeer, A., Mertz, D., Pelude, L., Science, M., Simor, A., Smith, S., Stagg, P., Suh, K. N., Thampi, N., … Taylor, G. (2022). Antimicrobial use in Canadian acute-care hospitals: Findings from three national point-prevalence surveys between 2002 and 2017. Infection Control & Hospital Epidemiology, 43(11), 1558–1564.

Mponponsuo, K., Leal, J., Puloski, S., Chew, D., Chavda, S., Au, F., & Rennert-May, E. (2022). Economic burden of surgical management of surgical site infections following hip and knee replacements in Calgary, Alberta, Canada. Infection control and hospital epidemiology, 43(6), 728–735.

O'Grady HM, Dixit D, Khawaja Z, Snedeker K, Ellison J, Erebor J, Jamieson P, Weiss A, Salcedo D, Roberts K, Wiens K, Etches N, Leal J, Conly JM. (2022) Asymptomatic Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Infection in Adults is Uncommon using Rigorous Symptom Characterization and Follow-up in an Acute Care Adult Hospital Outbreak. Infect Control Hosp Epidemiol. 2022 Jul 7:1-25. https://doi: 10.1017/ice.2022.168. Epub ahead of print. PMID: 35796198.

Silva, A., Du, T., Choi, K. B., Pelude, L., Golding, G. R., Hizon, R., Lee, B. E., Chow, B., Srigley, J. A., Hota, S. S., Comeau, J. L., Thampi, N., & CNISP C.difficile working group. (2022). Epidemiology of primary and recurrent healthcare-associated and community-associated pediatric Clostridioides difficile infection in Canada, 2015-2020. Journal of the Pediatric Infectious Diseases Society, 2023piad003;,

Versluys, K., Pfister T., Ellison, J., Bush, K. (2022). Hospital-acquired antibiotic-resistant organisms among patients with COVID-19. Canadian Journal of Infection Control, 37(2), 74-76.


Published Literature

Acosta, N., Bautista, M.A., Hollman, J., McCalder, J., Beaudet, A.B., Mann, L., Waddell, B.J., Chen, J., Li, C., Kuzma, D., Bhatnagar, S., Leal, J., Meddings, J., Hu, J., Cabaj, J.L., Ruecker, N.J., Naugler, C., Pillai, D.R., Achari, G., Ryan, M.C., Conly, J.M., Frankowski, K., Hubert, C.RJ., & Parkins, M.D. (2021). A multicenter study investigating SARS-CoV-2 in tertiary care hospital wastewater. Viral burden correlates with increasing hospitalized cases as well as hospital-associated transmissions and outbreaks. Water Research, 201(1).

Ellison, J., Boychuk, L., Chakravorty, D., Chandran, A., Conly, J., Howatt, A., . . . Bush, K. (2021). A comparison of surgical site infections following total hip replacement and total knee replacement surgeries identified by Infection Prevention and Control and the National Surgical Quality Improvement Program in Alberta, Canada. Infection Control & Hospital Epidemiology, 1-7.

Mitchell, R., Choi, K. B., Pelude L., Rudnick, W., Thampi N., & Taylor G. (2021). Patients in hospital with laboratory-confirmed COVID-19 in a network of Canadian acute care hospitals, Mar. 1 to Aug. 31, 2020: a descriptive analysis. CMAJ Open, 9 (1) E149-E156 

Rennert-May, E., Leal, J., Thang, N. X., Lang, E., Dowling, S., Manns, B., Wasylak, T., & Ronksley, P. E. (2021).The impact of COVID-19 on hospital admissions and emergency department visits: a population-based study. PLoS ONE, 2021; 16(6):e0252441.

Rennert-May, E., Raj, S., Leal, J., Exner, D., Manns, B., & Chew, D. (2021). An economic evaluation of an antibiotic impregnated envelope for preventing infection in cardiac implantable electronic devices. Eurospace, 23(5), 767-774 E156.

Shen, Y., Ellison, J., Leal, J., Bush, K. R., Chandran, A. U., Fathima, S., & Conly, J. M. (2021). The use of laboratory-identified event surveillance to classify adverse outcomes due to Clostridioides difficile infection in Canadian long-term care facilities. Infection Control Hospital Epidemiology, 42(5), 557-564.


Published Literature

Almond, J., Leal, J., Bush, K., Rogers, E., Henderson, E. A., & Ellison, J. (2020). Hospital-acquired Clostridioides difficile infections in Alberta: The validity of laboratory-identified event surveillance versus clinical infection surveillance. American Journal of Infection Control, 48 (6), 633-637.

Crocker, A., Kornilo, A., Conly, J., Henderson, E., Rennert-May, E., & Leal, J. (2020). Using administrative data to determine rates of surgical site infections following spinal fusion and laminectomy procedures. American Journal of Infection Control, 49(6), 759-763.

Laupland, K. & Leal, J. (2020). Defining microbial invasion of the bloodstream: A structured review. Infectious Diseases, 52(6), 391-395.

Pfister, T., Rennert-May, E., Ellison, J., Bush, K., & Leal, J. (2020). Clostridioides difficile infections in Alberta: The validity of administrative data using ICD-10 diagnostic codes for CDI surveillance versus clinical infection surveillance. American Journal of Infection Control.

Sharma, A., Leal, J., Kim, J., Pearce, C., Pillai, D. R., & Hollis, A. (2020) The cost of contact precautions: a systematic analysis. Canadian Journal of Infection Control, Winter2020, 35(4), 163-169

Sharma, A., Pillai, D. R., Lu, M., Doolan, C., Leal, J., Kim, J., & Hollis, A. (2020). Impact of isolation precautions on quality of life: A meta-analysis. Journal of Hospital Infection, 105(1), 35-42.


Published Literature

Bush, K., Ellison, J., Hearn, K., Pfister, T., & Taylor, G. (2019). A comparison of extended-spectrum beta-lactamase (ESBL) – producing Escherichia coli and Klebsiella pneumoniae bloodstream infections in Alberta using a provincial surveillance system. Infection Control and Hospital Epidemiology, 40(3), 388.

Leal, J., Ronksley, P., Henderson, E. A., Conly, J., & Manns, B. (2019). Predictors of mortality and length of stay in patients with hospital-acquired Clostridioides difficile infection: A population-based study in Alberta, Canada. Journal of Hospital Infection, 103(1):85-91.

Leal, J. R., Conly, J., Weaver, R., Wick, J., Henderson, E. A., Manns, B., & Ronksley, P. (2019). Attributable costs and length of stay of hospital-acquired Clostridioides difficile: A population-based matched cohort study in Alberta, Canada. Infection Control and Hospital Epidemiology, 40(10), 1135-1143.

Martin, P., Nour Abou Chakra, C., Williams, V., Bush, K., Dyck, M., Hirji, Z., Kiss, A., Larios, O. E., McGeer, A., Moore, C., Weiss, K., & Simor, A. E. (2019). Prevalence of antibiotic-resistant organisms in Canadian hospitals: Comparison of point-prevalence survey results from 2010, 2012, and 2016. Infection Control and Hospital Epidemiology, 40(1), 53-59.

Mitchell, R., Taylor, G., Rudnick, W., Alexandre, S., Bush, K., Forrester, L., Frenette, C., Granfield, B., Gravel-Tropper, D., Happe, J., John, M., Lavallee, C., McGeer, A., Mertz, D., Pelude, L., Science, M., Simor, A., Smith, S., Suh, K.N., … Amaratunga, K. (2019). Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys. Canadian Medical Association Journal, 191(36), E981-E988.


Published Literature

Rennert-May, E., Conly, J.M., Leal, J., Smith, S., Manns, B. (2018). Economic evaluations and their use in infection prevention and control: a narrative review. Antimicrobial Resistance and Infection Control, 7(31), 1-6.

Rennert-May, E.D., Manns, B., Smith, S., Puloski, S., Henderson, E., Au MA, F. … Conly, J. (2018). Validity of administrative data in identifying complex surgical site infections from a population-based cohort after primary hip and knee arthroplasty in Alberta, Canada. American Journal of Infection Control, 40 (10), 1123-1126.



Best Practices for Surveillance of Health Care-associated Infections in Patient and Resident Populations Provincial Infectious Disease Advisory Committees (PIDAC, Ontario), 2014

Canadian Institute for Health Information, The CIHI Data Quality Framework, 2009. Ottawa, ON; CIHI, 2009

Canadian Nosocomial Infection Surveillance Program (CNISP) Monitors healthcare-associated infections at Canadian healthcare facilities and publishes infection control guidelines.

CDC/NHSN Surveillance Definitions for Specific Types of Infections Center for Disease Control, 2017

Centers for Disease Control and Prevention. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working group. Morb Mortal Wkly Rep 2001; 50:14-24

Recommended practices for surveillance: Association for Professionals in Infection Control and Epidemiology Am J Infect Control 2007;35:427-40