Genomics With Regard to Epidemiological and Clinical Investigations Conducted for an Open Chest Postsurgical Infection Outbreak.

Background: Postsurgical infections due to appeared as a novel nosocomial threat in 2015, with a worldwide outbreak due to contaminated heater-cooler units used in open chest surgery. We report the results of investigations conducted in France including whole-genome sequencing comparison of patient and heater-cooler unit isolates.

Methods: We sought infection cases from 2010 onwards through national epidemiological investigations in health care facilities performing cardiopulmonary bypass, together with a survey on good practices and systematic heater-cooler unit microbial analyses.

Prolonged delay for controlling KPC-2-producing Klebsiella pneumoniae outbreak: the role of clinical management.

Background: Carbapenemase-producing Enterobacteriaceae (CPE) are becoming of immediate concern for infection control policies. Prompt detection of CPE on health care setting admission is crucial to halt the spread of an outbreak. We report a cluster of 13 Klebsiella pneumoniae carbapenemase (KPC)-2-producing K pneumoniae cases in a tertiary care hospital.

Horizontal transmission of Streptococcus pneumoniae in the surgical ward: a rare source of nosocomial wound infection.

Streptococcus pneumoniae is rarely isolated from nosocomial infections. We report an outbreak of 4 nosocomial-acquired surgical site infections due to S pneumoniae after retropubic simple prostatectomy. The likely source was detected in the rhinopharynx of the surgeon.

[Non-tuberculous mycobacterial infections related to esthetic care in France, 2001-2010].

Non-tuberculous mycobacteria (NTM) infections usually occur in immunocompromised patients but also in immunocompetent patients following invasive procedures, especially for esthetic purposes. Since 2001, 20 episodes (57 cases) of NTM infections, seven of which (43 cases) were related to esthetic care, have been reported to the regional infection control coordinating centers (RICCC), the local health authorities (LHA), and the national institute for public health surveillance. Four notifications (40 cases) were related to non-surgical procedures performed by general practitioners in private settings: mesotherapy, carboxytherapy, and sclerosis of microvaricosities.

Imipenem and ciprofloxacin consumption as factors associated with high incidence rates of resistant Pseudomonas aeruginosa in hospitals in northern France.

In France, Pseudomonas aeruginosa is the third most common isolate from nosocomial infections. To determine whether high consumption rates of some antibiotics are risk factors for resistance to ceftazidime, imipenem, ciprofloxacin and amikacin in P. aeruginosa, we conducted a study based on data from the Antimicrobial Surveillance Network in northern France and the French public reporting system of infection control indicators.

Control of a multi-hospital outbreak of KPC-producing Klebsiella pneumoniae type 2 in France, September to October 2009.

An outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae type 2 was detected in September 2009 in two hospitals in a suburb south of Paris, France. In total, 13 KPC-producing K. pneumoniae type 2 cases (four with infections and nine with digestive-tract colonisations) were identified, including a source case transferred from a Greek hospital.

Extended measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003-2004.

We report the successful control of an outbreak caused by imipenem-resistant VIM-1-producing Klebsiella pneumoniae (IR-Kp) in France. This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per year. The index case was a patient with acute liver failure transferred from a hospital in Greece for urgent liver transplantation who was carrying IR-Kp at admission as revealed by routine culture of a rectal swab.

[Description and investigation of an outbreak of extended-spectrum beta-lactamase producing Escherichia coli strain in a neonatal unit].

An outbreak of colonization and infection with an Escherichia coli strain producing extended-spectrum beta-lactamase (ESBL) occurred in a neonatal unit : a high rate of cases was observed, 27/59 neonates were colonized : one of them developed meningitis with favourable outcome and another baby developed conjunctivitis. Despite intensive efforts to control the outbreak by standard methods of hand hygiene, patients screening and isolation, the spread was uncontrolled and the unit was closed to all admission in order to stop the outbreak. The investigation was not able to identify a single outbreak's source.

Investigation of a large outbreak of Clostridium difficile PCR-ribotype 027 infections in northern France, 2006-2007 and associated clusters in 2008-2009.

In 2006 and 2007, a large outbreak of Clostridium difficile infections (CDIs) with PCR-ribotype 027 was identified in northern France. Overall, 38 healthcare facilities notified 529 CDIs over a 22-month period, including 281 laboratory-confirmed CDI 027 and 248 non-confirmed CDI 027 cases (incidence rate per 10,000 elective bed days: 1.63, range: 0.

Antibiotic use in 530 French hospitals: results from a surveillance network at hospital and ward levels in 2007.

Objectives: Antibiotic use in French hospitals is among the highest in Europe. A study was carried out to describe antibiotic consumption for inpatients at hospital and at ward levels.

Methods: Data were voluntarily collected retrospectively by 530 hospitals accounting for approximately 40 million patient-days (PD) on the following: antibacterials for systemic use [J01 class of the WHO Anatomical Therapeutic Chemical (ATC) classification, defined daily doses (DDD) system, 2007], rifampicin and oral imidazole derivatives, expressed in number of DDD and number of PD in 2007.

[Tuberculosis among healthcare workers in Northern France (2002-2007): descriptive analysis of notified cases and contact tracing].

Unlabelled: The regional centre for infection control in northern France (CCLIN Nord) has received 28 notifications of pulmonary tuberculosis cases (PTC) in healthcare workers (HCWs), in 30 healthcare institutions, since the implementation of the French notification system for nosocomial infections.

Method: A descriptive analysis of PTC investigations in healthcare workers was performed over a five-year period using a standardized form.

Results: Smear and culture of bronchial samples were positive for 22 PTC and 15 presented radiological cavities.

Curbing methicillin-resistant Staphylococcus aureus in 38 French hospitals through a 15-year institutional control program.

Background: The Assistance Publique-Hôpitaux de Paris (AP-HP) institution administers 38 teaching hospitals (23 acute care and 15 rehabilitation and long-term care hospitals; total, 23 000 beds) scattered across Paris and surrounding suburbs in France. In the late 1980s, the proportion of methicillin resistance among clinical strains of Staphylococcus aureus (MRSA) reached approximately 40% at AP-HP.

Methods: A program aimed at curbing the MRSA burden was launched in 1993, based on passive and active surveillance, barrier precautions, training, and feedback.

Is high consumption of antibiotics associated with Clostridium difficile polymerase chain reaction-ribotype 027 infections in France?

We compared antibiotic consumption between hospitals affected by a strain of Clostridium difficile designated as polymerase chain reaction-ribotype 027 (CD-027) and those unaffected during an outbreak in northern France. The mean consumption of several beta-lactams, amikacin, and fluoroquinolones was high in affected hospitals (P < .05).

Clinical management of rapidly growing mycobacterial cutaneous infections in patients after mesotherapy.

Background: Increasing numbers of patients are expressing an interest in mesotherapy as a method of reducing body fat. Cutaneous infections due to rapidly growing mycobacteria are a common complication of such procedures.

Methods: We followed up patients who had developed cutaneous infections after undergoing mesotherapy during the period October 2006-January 2007.

Outbreak of nontuberculous mycobacterial subcutaneous infections related to multiple mesotherapy injections.

We describe an outbreak of severe subcutaneous infections due to nontuberculous mycobacteria following mesotherapy. Epidemiological studies and molecular comparisons of Mycobacterium chelonae strains from different patients and the environment suggested that contamination may be associated with inappropriate cleaning of the multiple-injection device with tap water.

Specific control measures for antibiotic prescription are related to lower consumption in hospitals: results from a French multicentre pilot study.

Background: In France, antibiotic consumption (ABC) is dramatically high in parallel with the high rate of multidrug-resistant bacteria. For the last few years, a nationwide policy has been implemented at the national level to control and monitor ABC. Since 2002, surveillance networks have been set up with voluntary hospitals to evaluate the antibiotic policy and consumption.

[Evaluation of practices involving a cross infection risk in anaesthesia].

Objective: The practice of anaesthesiology has the potential for transmitting a number of infectious agents to the patient. In France, several recent cases have been identified, so that a wide survey on anaesthesiology practice has been enhanced.

Methods: An anonymous questionnaire, based on the recommendations of the French Society of Anaesthesiology and Intensive Care (Sfar), was send to 8,771 anaesthesiologists and intensive care practitioners and to 2,070 nurses practicing anaesthesiology.

VEB-1 Extended-spectrum beta-lactamase-producing Acinetobacter baumannii, France.

VEB-1 extended-spectrum beta-lactamase-producing Acinetobacter baumannii was responsible for an outbreak in hospitals in France. A national alert was triggered in September 2003 when 4 hospitals reported clusters of A. baumannii infection with similar susceptibility profiles.

[How to reduce the risk of Legionnaires' disease?].

Legionella pneumophila is a microorganism present in water and able to develop pneumoniae through inhalation of contaminated aerosols. Legionnaires'disease is rare (1000 cases per year in France) concerning particularly people with risk factors, but potentially with severe prognosis (lethality 15-20%). The diagnosis was recently facilitated by the introduction of urinary antigen test.

Patient-to-patient transmission of hepatitis C virus through the use of multidose vials during general anesthesia.

A cluster of four patients with hepatitis C virus (HCV) infection was identified in a surgery clinic. Molecular characterization revealed close homology between viruses. This cluster was related to unsafe injection practices through multidose vials and reused materials.