How to measure hospital antibiotic consumption: comparison of two methods from data surveillance in France.

Background: Antibiotic use (ABU) surveillance in healthcare facilities (HCFs) is essential to guide stewardship. Two methods are recommended: antibiotic consumption (ABC), expressed as the number of DDD/1000 patient-days; and prevalence of antibiotic prescription (ABP) measured through point prevalence surveys. However, no evidence is provided about whether they lead to similar conclusions.

[Accidents exposing to blood in France].

Occupational blood and body fluids exposure. Occupational blood and body fluids exposure (BBFE) is a serious daily risk to healthcare workers (HCW) wherever they work (i.e.

[Safety-engineered devices in medical office].

Safety-engineered devices in medical office. Safety-engineered devices are designed to inactivate the needle or the blade after completion of an invasive procedure and before device disposal, in order to prevent needlestick injuries. Safety-engineered devices include manual (bi or uni manual) activation devices, semi-automatic, and automatic activation devices with an increasing security level provided against needlestick injuries risk.

ICU-acquired candidaemia in France: Epidemiology and temporal trends, 2004-2013 - A study from the REA-RAISIN network.

Objective: Candidaemia is a life-threatening infectious disease, associated with septic shock, multiple organ failure, and a high mortality rate. In France, reported data on the incidence of ICU-acquired candidaemia and the causative Candida species are scarce. The objective of this study was to determine temporal trends in epidemiology and risk factors of intensive care unit-acquired candidaemia (ICU-Cand) and ICU mortality among a very large population of ICU patients.

Clinical, virological, and biological parameters associated with outcomes of Ebola virus infection in Macenta, Guinea.

The pathogenesis of Ebola virus (EBOV) disease (EVD) is poorly characterized. The establishment of well-equipped diagnostic laboratories close to Ebola treatment centers (ETCs) has made it possible to obtain relevant virological and biological data during the course of EVD and to assess their association with the clinical course and different outcomes of the disease. We were responsible for diagnosing EBOV infection in patients admitted to two ETCs in forested areas of Guinea.

[The register of activity at the Ebola treatment center in Forecariah (Guinea) from april 23 to june 5, 2015: analysis and thoughts].

The register of activity at the Ebola Treatment Center (ETC) in Forecariah (Guinea), from April 23 to June 5, 2015 is presented for analysis. The viral load of each patient is evaluated by the cycle threshold (Ct). One hundred and thirty patients were seen in Triage at the ETC, of which 24 (18.

[Input of a laboratory in the management of patients with Ebola virus disease and in the training of health personnel: experience of the Forecariah Ebola treatment centre (Guinea) in 2015].

Ebola virus disease (EVD) is associated with a high lethality rate even when the afflicted are provided with good support in an Ebola treatment center (ETC). Basic laboratory tests can help to better understand the pathophysiology of the disease, to guide treatment and to establish simple protocols and procedures tailored to the practice of medicine in the context of such precarious environment for caregivers. Based on a few clinical cases of patients treated in the ETC of Forecariah, Guinea, run by the French Red Cross, this article describes the difficult conditions associated with the provision of medical practice in this challenging environment, aiming to minimize the casualties in the EVD patient and to train the health staff.

Surgical site infection after valvular or coronary artery bypass surgery: 2008-2011 French SSI national ISO-RAISIN surveillance.

Background: Multisite information regarding surgical site infection (SSI) rates for cardiac surgery programmes is not widely available. Ward characteristics that may affect outcomes have not been analysed previously.

Aim: To determine individual- and ward-level factors associated with SSI occurrence after coronary artery bypass grafting (CABG) and valvular surgery.

Sharp Decrease of Reported Occupational Blood and Body Fluid Exposures in French Hospitals, 2003-2012: Results of the French National Network Survey, AES-RAISIN.

Objective: To assess the temporal trend of reported occupational blood and body fluid exposures (BBFE) in French healthcare facilities.

Method: Retrospective follow-up of reported BBFE in French healthcare facilities on a voluntary basis from 2003 to 2012 with a focus on those enrolled every year from 2008 to 2012 (stable cohort 2008-12).

Findings: Reported BBFE incidence rate per 100 beds decreased from 7.

Staphylococcus aureus healthcare associated bacteraemia: An indicator of catheter related infections.

Purpose: Surveillance of preventable healthcare associated infections and feedback of the results to clinicians is central in the efforts to improve performance. We assessed Staphylococcus aureus healthcare associated bloodstream infection (HA-BSI) as an indicator of healthcare quality.

Patients And Method: Between 2002 and 2012, we carried out a ten-year prospective bedside surveillance of S.

Management of nurse shortage and its impact on pathogen dissemination in the intensive care unit.

Introduction: Studies provide evidence that reduced nurse staffing resources are associated to an increase in health care-associated infections in intensive care units, but tools to assess the contribution of the mechanisms driving these relations are still lacking. We present an agent-based model of pathogen spread that can be used to evaluate the impact on nosocomial risk of alternative management decisions adopted to deal with transitory nurse shortage.

Materials And Methods: We constructed a model simulating contact-mediated dissemination of pathogens in an intensive-care unit with explicit staffing where nurse availability could be temporarily reduced while maintaining requisites of patient care.

Improving prediction of surgical site infection risk with multilevel modeling.

Background: Surgical site infection (SSI) surveillance is a key factor in the elaboration of strategies to reduce SSI occurrence and in providing surgeons with appropriate data feedback (risk indicators, clinical prediction rule).

Aim: To improve the predictive performance of an individual-based SSI risk model by considering a multilevel hierarchical structure.

Patients And Methods: Data were collected anonymously by the French SSI active surveillance system in 2011.

Antibiotics involved in the occurrence of antibiotic-resistant bacteria: a nationwide multilevel study suggests differences within antibiotic classes.

Objectives: To identify the antibiotics potentially the most involved in the occurrence of antibiotic-resistant bacteria from an ecological perspective in French healthcare facilities (HCFs).

Methods: This study was based on data from the French antimicrobial surveillance network (ATB-RAISIN, 2007-09). Antibiotics were expressed in defined daily doses per 1000 patient-days.

[NEOCAT, surveillance network of catheter-related bloodstream infections in neonates: 2010 data].

The NEOCAT surveillance network was implemented in 2006 in order to address catheter-associated bloodstream infections (BSIs) in neonates. The results for 2010 surveillance are presented herein. Neonatal intensive care units (NICUs) participated in the study on a voluntary basis.

A multicentre analysis of catheter-related infection based on a hierarchical model.

Purpose: To decrease intensive care unit (ICU)-acquired catheter-related infections (CRI), it is essential that healthcare workers receive training and that quality improvement programmes are in place. The aim of our study was to evaluate risk factors for catheter colonisation and infection, focussing specifically on local care bundles.

Methods: Data were collected prospectively in 51 ICUs [7,188 patients, 8,626 central venous catheters (CVCs)] during two 6-month periods in 2007 and 2008, using a standardized questionnaire on catheter insertion, care and removal.

Nosocomial urinary tract infection in the intensive care unit: when should Pseudomonas aeruginosa be suspected? Experience of the French national surveillance of nosocomial infections in the intensive care unit, Rea-Raisin.

Individual and ward risk factors for P. aeruginosa-induced urinary tract infection in the case of nosocomial urinary tract infection in the intensive care unit were determined with hierarchical (multilevel) logistic regression. The 2004-2006 prospective French national intensive care unit nosocomial infection surveillance dataset was used and 3252 patients with urinary tract infection were included; 16% were infected by P.

Identifying new risk factors for Pseudomonas aeruginosa pneumonia in intensive care units: experience of the French national surveillance, REA-RAISIN.

Pseudomonas aeruginosa is an important pathogen of complicated pneumonia in intensive care units (ICUs). Our objective was to determine 'patient' and 'ward' risk factors for P. aeruginosa pneumonia among patients with nosocomial pneumonia in ICU.

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.

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.

Prospective assessment of hospital-acquired bloosdstream infections: how many may be preventable?

Objective: To determine the proportion of preventable hospital-acquired bloodstream infections (HA-BSIs), the authors prospectively examined consecutive cases in a large university hospital over an 18-month period.

Patients And Methods: Medical charts were assessed with the physician in charge of the patient within 4 days after HA-BSI diagnosis to determine whether the infection was healthcare-related. Preventability was assessed using a validated tool.

Surveillance of surgical-site infections: impact on quality of care and reporting dilemmas.

Purpose Of Review: Among a wide range of publications on surgical-site infections (SSIs), many issues are still controversial, especially those concerning their monitoring and feedback. This review focuses on recent advances in surveillance as a tool for improving healthcare quality performance in surgery.

Recent Findings: Recent data were obtained from many reference surveillance systems which tend to demonstrate significant decrease in SSI incidence rates over a several-year period.