Time is Money! Influence on Operating Theater and Sterilization Times of Patient-specific Cutting Guides and Single-use Instrumentation for Total Knee Arthroplasty: A Full Factorial Design of 136 Patients.

Background: Patient-specific cutting guides (PSGs) and single-use disposable instrumentation (SUI) have emerged as potential beneficial innovations for total knee arthroplasty. The aim of this study was to evaluate the impact of PSG and SUI for total knee arthroplasty on operating room (OR) and sterilization times.

Methods: A monocentric, prospective, interventional, full factorial design study, including 136 patients, compared patient-specific (PSG, n = 68) to conventional cutting guides (n = 68) and SUI (n = 68) to conventional instrumentation (CVI, n = 68).

Burden of gastroenteritis outbreaks: specific epidemiology in a cohort of institutions caring for dependent people.

Background: In institutions caring for dependent people, viral gastroenteritis occurs frequently and is highly contagious. In elderly persons, these episodes can lead to hospitalization and occasionally death.

Aim: To study the impact of gastroenteritis outbreaks (GOs) in institutions caring for dependent people.

Acquisition of carbapenem-resistant Gram-negative bacilli in intensive care unit: predictors and molecular epidemiology.

Objectives: We had for aim to determine the risk factors for acquiring carbapenem-intermediate or -resistant Gram-negative bacilli (CR-GNB) in an intensive care unit (ICU) and to identify the resistance mechanisms involved.

Patients And Methods: We conducted an observational prospective cohort study during 6 months in medical and surgical ICUs of the Besançon Teaching Hospital. Patients with acquired CR-GNB were patients whose cultures (screening or diagnosis) became positive more than 48h after admission to the ICU.

Risk factors for Pseudomonas aeruginosa acquisition in intensive care units: a prospective multicentre study.

Background: Pseudomonas aeruginosa is a major nosocomial pathogen in intensive care units (ICUs); however, endogenous versus exogenous origin of contamination remains unclear.

Aim: To identify individual and environmental ICU risk factors for P. aeruginosa acquisition.

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.

Hospital cross-transmission of extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae.

Objectives: We had for objective to measure the incidence and the clonal diversity of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases (ESBL) in order to assess the role of patient stay in amplification of the phenomenon, in our teaching hospital.

Material And Methods: We measured the quarterly incidence rates of E. coli and K.

[Fungal and bacterial contamination of 30 general practitioners' consultation room in Franche-Comté (eastern France)].

Objective: To evaluate the level of microbial contamination of general pratice environment.

Methods: Ten points, including air, water and surfaces were sampled in general practitioner's consultation room of 30 general practices in Franche-Comté region (eastern France). For each sample, a global microbial count was assessed as well as the presence of potential pathogen microorganisms: Aspergillus fumigatus, Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae.

Antibiotic prescription in nursing homes for dependent elderly people: a cross-sectional study in Franche-Comté.

Objectives: We had for objective to determine the rate of patients treated with antibiotics and the determinants of antibiotic stewardship in nursing homes for dependent elderly people (French acronym EHPAD), of a French region (Franche-Comté).

Patients And Methods: A representative sample of EHPAD, in Franche-Comté, was included in a cross-sectional study made between April and June 2012. An external auditor and the EHPAD head physician collected data on the facility and on residents receiving antibiotics on the study day.

Alternatives to carbapenems in ESBL-producing Escherichia coli infections.

Objectives: The authors had for objective to assess the activity of a wide panel of antibiotics on extended-spectrum-β-lactamase producing Escherichia coli isolates (ESBL-Ec), because of the sharp increase of their frequency, leading to an increased use of carbapenems.

Material And Methods: We selected 100 ESBL-Ec in which ESBLs were identified by PCR and sequencing, between 2009 and 2010. We determined the MICs of amoxicillin-clavulanate, piperacillin-tazobactam, temocillin, mecillinam, cefoxitin, cefotaxime, ceftazidime, aztreonam, tigecycline, nitrofurantoin, and fosfomycin using reference methods.

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.

[Chronic wound care leads to the bacterial contamination of the environment].

Aim: The aim of this study was to determine levels of bacterial contamination of the environment during chronic wound dressing changes.

Methods: Sampling of chronic wounds and of the environment (air and surfaces) was performed during changing of chronic wound dressing. A series of samples was defined as the entire sample for a given day for a given patient.

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.

Temporal effects of infection control practices and the use of antibiotics on the incidence of MRSA.

Background: Meticillin-resistant Staphylococcus aureus (MRSA) has spread throughout the world and has become highly endemic worldwide. The need for implementing MRSA control strategies is no longer a matter of debate.

Aim: To determine the temporal association between various infection control practices, the use of antibiotics and the incidence of MRSA in a 1200-bed French university hospital.

Bacterial contamination of the hospital environment during wound dressing change.

Introduction: The hospital environment plays a role in the cross-transmission of multidrug-resistant bacteria. The aim of this study was to evaluate the bacterial contamination of the hospital environment during chronic wound dressing change.

Patients And Methods: This study was performed from July 2010 to May 2011.

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.

Mupirocin resistance is not an inevitable consequence of mupirocin use.

The rate of mupirocin resistance in meticillin-resistant Staphylococcus aureus (MRSA) in Besançon University Hospital is low with a decreasing trend, from 10% in 2004 to 3% in 2009. This trend in resistance paralleled mupirocin consumption. Genotyping results showed that this decrease was not linked to a change in MRSA clones.

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.

Relationship between prevalence of device-associated infections and alcohol-based hand-rub consumption: a multi-level approach.

Using a multi-level logistic regression model, we determined whether there was any relationship between alcohol-based hand-rub consumption and prevalence of device-associated infections (DAIs) in French healthcare facilities (HCFs). Two national databases were used: the 2006 French prevalence survey of nosocomial infections, and the 2006 French infection control indicator database which includes alcohol-based hand-rub consumption as an indicator (ICSHA: indicateur de consommation de solution hydro-alcoolique). Only patients with at least one medical device (urinary catheter, vascular catheter or tracheal tube) who were present in an HCF for at least two days were included in the analysis.