Wastewater treatment plants release large amounts of extended-spectrum β-lactamase-producing Escherichia coli into the environment.

Background: The determinants of the spread of extended-spectrum β-lactamase-producing Escherichia coli (ESBLEC) in the community remain unclear. To evaluate its dissemination in the environment, we analyzed the ESBLEC population throughout an urban wastewater network.

Methods: Samples were collected weekly, over a 10-week period, from 11 sites throughout the wastewater network of Besançon city (France).

Influenza outbreaks management in a French psychiatric hospital from 2004 to 2012.

Objective: Influenza epidemics can have consequences in terms of morbidity and mortality for the patients. This work assesses influenza outbreaks in order to validate and optimize alert and control measures in a psychiatric hospital.

Method: The prospective monitoring of influenza episodes was conducted for 8 years in 19 units of a mental health hospital.

Tracking down antibiotic-resistant Pseudomonas aeruginosa isolates in a wastewater network.

The Pseudomonas aeruginosa-containing wastewater released by hospitals is treated by wastewater treatment plants (WWTPs), generating sludge, which is used as a fertilizer, and effluent, which is discharged into rivers. We evaluated the risk of dissemination of antibiotic-resistant P. aeruginosa (AR-PA) from the hospital to the environment via the wastewater network.

Evaluation of the number of opportunities for hand hygiene in hospital: a new methodological approach.

Objective: To assess the number of alcohol-based hand rubbing (ABHR) opportunities in different wards of a university hospital.

Materials And Methods: The amount of care procedures was measured in nine wards (4 medical wards, 4 surgical wards, 1 intensive care unit) over a two-year period. We converted the number of care procedures into a number of ABHR opportunities using the definition provided by the World Health Organization that takes in account the nature of the care procedure and the number of healthcare workers involved in.

Impact of a region wide antimicrobial stewardship guideline on urinary tract infection prescription patterns.

Background: Fluoroquinolones are frequently prescribed for non complicated urinary tract infection treatments and have a negative ecological impact. We aimed to substitute them by antibiotics with narrower activity spectrum in order to preserve fluoroquinolone activity in complicated hospital infections.

Objective: To assess the impact of a multi-modal approach that combines the dispatching of antibiotic prescription guidelines and voluntary attendance at educational sessions on general practitioners' (GP) antibiotic prescription habits.

Methicillin-susceptible ST398 Staphylococcus aureus responsible for bloodstream infections: an emerging human-adapted subclone?

In the course of an annual 3-month bloodstream infections (BSI) survey conducted during a four-year period in 31 healthcare institutions located in three noncontiguous French regions, we report 18 ST398 Staphylococcus aureus BSI. ST398 BSI incidence showed a seven-fold increase during the study period (0.002 per 1,000 patient days in 2007 vs.

Most multidrug-resistant Pseudomonas aeruginosa isolates from hospitals in eastern France belong to a few clonal types.

This study aimed to determine the genetic diversity of clinical multidrug-resistant Pseudomonas aeruginosa. We used pulsed-field gel electrophoresis and multilocus sequence typing to analyze 187 strains isolated in different French hospitals. To illustrate the diversity of resistance mechanisms to antibiotics in a given clone, we identified β-lactamases with an extended spectrum by using phenotypic and genotypic methods.

Impact of barrier precautions and antibiotic consumption on the incidence rate of acquired cases of infection or colonization with Acinetobacter baumannii: a 10-year multi-department study.

Following a previous investigation, this ecological study assessed the impact of barrier precautions and various factors on the annual incidence rate of acquired Acinetobacter baumannii cases in each of the 32 departments of the University Hospital of Besançon from 2000 to 2009. Ultimately, our study confirms the effectiveness of barrier precautions in addition to standard precautions for controlling A baumannii within our hospital departments. In comparison with the previous research, it emphasizes the significant role of fluoroquinolones in the emergence and the spread of this microorganism.

Nationwide investigation of extended-spectrum beta-lactamases, metallo-beta-lactamases, and extended-spectrum oxacillinases produced by ceftazidime-resistant Pseudomonas aeruginosa strains in France.

A nationwide study aimed to identify the extended-spectrum beta-lactamases (ESBLs), metallo-beta-lactamases (MBLs), and extended-spectrum oxacillinases (ES-OXAs) in a French collection of 140 clinical Pseudomonas aeruginosa isolates highly resistant to ceftazidime. Six ESBLs (PER-1, n=3; SHV-2a, n=2; VEB-1a, n=1), four MBLs (VIM-2, n=3; IMP-18, n=1), and five ES-OXAs (OXA-19, n=4; OXA-28, n=1) were identified in 13 isolates (9.3% of the collection).

Usefulness of weekly methicillin-resistant Staphylococcus aureus screening.

We evaluated the usefulness of adding weekly methicillin-resistant Staphylococcus aureus (MRSA) screening to our established admission screening and clinical sampling in 4 acute care units of a university hospital. Our results suggest that weekly MRSA screening allows the detection of 56.1% of all cases of hospital-acquired MRSA carriage.

Usefulness of antimicrobial resistance pattern for detecting PVL- or TSST-1-producing meticillin-resistant Staphylococcus aureus in a French university hospital.

Several recent reports have suggested that community-associated meticillin-resistant Staphylococcus aureus (MRSA) clones, particularly those harbouring genes for Panton-Valentine leukocidin (PVL) or toxic shock syndrome toxin 1 (TSST-1), are increasingly responsible for infections in hospitals. Here, a retrospective study was carried out to investigate whether antimicrobial resistance patterns could be used to detect these pathogens in a French university hospital. Isolates were characterized by antimicrobial susceptibility testing, PCR profiling (PVL genes and tst), PFGE typing and multilocus sequence typing.

Ecological study of the effectiveness of isolation precautions in the management of hospitalized patients colonized or infected with Acinetobacter baumannii.

Objective: To assess the impact of isolation precautions on the incidence of patients colonized or infected with Acinetobacter baumannii (case patients) in a university hospital during the period from 1999 to 2006.

Design: Ecological study.

Setting: The Besançon University Hospital in France, a 1,200-bed acute care hospital with approximately 50,000 admissions per year.

The role of water fittings in intensive care rooms as reservoirs for the colonization of patients with Pseudomonas aeruginosa.

Objective: To assess the role of the water environment in the Pseudomonas aeruginosa colonization of patients in intensive care units in the absence of a recognized outbreak.

Design And Setting: Prospective, single-centre study over an 8-week period in two adult ICUs at a university hospital. Environmental samples were taken from the water fittings of rooms once per week, during a 8-week period.

Relationship between antibiotic use and incidence of MexXY-OprM overproducers among clinical isolates of Pseudomonas aeruginosa.

In a university hospital, time-series analysis revealed a significant relationship between antibiotic (aminoglycoside, fluoroquinolone, and cefepime) use and incidence of MexXY-OprM-overproducing Pseudomonas aeruginosa. In vitro experiments confirm that such mutants were readily selected from both PAO1 and clinical strains when grown in the presence of these antibiotics.

[Air cleanliness in operating rooms: on-site controls and biological testing].

Air cleanliness control in operating rooms is based on air filtration, and targets the lowest density of particules and bacteria. Legally, the equipment must be periodically verified during periods of inactivity. Most airborne bacteria are of human origin.

Effect of individual- and group-level antibiotic exposure on MRSA isolation: a multilevel analysis.

Objectives: To observe the relative role of individual and group-level antimicrobial selective pressure on subsequent methicillin-resistant Staphylococcus aureus (MRSA) isolation in a university hospital.

Methods: For this purpose, 18 596 patients were included in a retrospective statistical analysis, applying multilevel modelling with discrete time intervals at the lowest level. Individual-level and hospital group variables on antimicrobial exposure and MRSA colonization pressure were collected from computerized databases.

Discrepancies between prescribed daily doses and WHO defined daily doses of antibacterials at a university hospital.

Aims: The defined daily doses (DDD) defined by the WHO are widely used as an indicator to measure antibiotic use in the hospital setting. However, discrepancies exist between countries in terms of antibiotic dosage. The aim of the present study was to compare, for each antibacterial agent available at our university hospital, the prescribed daily doses (PDD) with the DDD.

Use of intranasal mupirocin to prevent methicillin-resistant Staphylococcus aureus infection in intensive care units.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) causes severe morbidity and mortality in intensive care units (ICUs) worldwide. The purpose of this study was to determine whether intranasal mupirocin prophylaxis is useful to prevent ICU-acquired infections with MRSA.

Materials And Methods: We conducted a 4-year observational retrospective study in a 15-bed adult medical ICU.

Estimation of the cumulative incidence of hospital-acquired bacteremia from prevalence data: a formula.

We evaluated the validity of the formula of Rhame and Sudderth to estimate the cumulative incidence of nosocomial bacteremia from prevalence studies. The observed cumulative incidence was threefold higher than the calculated cumulative incidence. We do not recommend converting prevalence into incidence data for nosocomial bloodstream infections.