Healthcare workers' knowledge and perceptions of the risks associated with emerging extensively drug-resistant bacteria.

Objective: Guidelines have been issued in 2010 to prevent the spread of emerging extensively resistant bacteria (eXDR), but their implementation is difficult. We aimed to evaluate healthcare workers' (HCW) knowledge and their risk perception to identify barriers to the implementation of guidelines.

Methods: Semi-structured interviews were conducted at a University Hospital, where case patients are regularly admitted. The interviews focused on HCW's knowledge, risk perception, and challenges met. The evaluation of HCW's knowledge and contagiousness and perception of severity of eXDR carriage were analyzed statistically. Risk perception and opinion about guidelines were analyzed by qualitative description.

Results: One hundred and twenty-one HCWs were interviewed. The category of HCW, having searched for information on resistant bacteria, and having taken care of case patients were associated with better knowledge. The HCW category, age, type of unit, seniority, and having taken care of case patients were associated with risk perceptions. Qualitative analysis identified 61 themes. HCWs were extremely concerned by the spread of bacteria within the hospital. The main challenges identified were organizational and communication issues.

Conclusion: HCWs reported a lack of knowledge and a lack of resources to implement guidelines. Strategies to improve guidelines implementation must be based on a better availability of resources, better communication, and new educational methods.