ABSTRACT
A nurse hygienist, a senior health care manager within her hospital, describes the V2014 certification quality policy. The Hygiene, Epidemiology, Infection vigilance and Prevention theme forms part of the hospital's priorities.
Subject(s)
Guideline Adherence , Health Facilities , Quality of Health Care/legislation & jurisprudence , Certification , France , Health Facilities/legislation & jurisprudence , Health Facilities/standards , Health Plan Implementation/organization & administration , Health Plan Implementation/standards , Humans , Quality Improvement , Quality of Health Care/organization & administrationABSTRACT
Between 2013 and 2014 a Vancomycin-resistant Enterococci (VRE) outbreak occurred in a teaching hospital in France. The outbreak was significant possibly due to the lack of implementation of recommended control measures. The aim of this study was to identify the effect of the lack of adherence to control measures for prevention of VRE acquisition in contact patients taking into account individual risk factors. Contact patients (first two months of the outbreak) with VRE acquisition were compared to patients without VRE acquisition (univariate and logistic regression), in terms of institutional characteristics (unit of hospitalization and isolation measures) and risk factors. Between December 2013 and February 2014, 282 contact patients were included in the study. The prevalence of VRE acquisition was 6.4% (18/282). Significant risk factors for VRE acquisition according to logistic regression analysis were; lack of isolation, hospitalization in the same hospital unit as a VRE carrier patient and lack of isolation (RR=856.8, p=0.001), hospitalization in a specific unit (RR=927.4, p=0.002), McCabe score equal to 2 (RR=5233.6, p=0.008), age (RR=1.2 by year, p=0.011), hemodialysis (RR=36.1, p=0.011), central venous catheter (RR=25.4, p=0.021) and surgery (RR=0.012, p=0.007). Antibiotic use was a significant risk factor for VRE acquisition using univariate analysis (p<10-3). The findings confirm that the factors focused on by the study (lack of isolation and dedicated unit) had a significant effect on VRE acquisition as patient associated factors. It highlights the importance of observance of the guidelines.
Subject(s)
Carrier State/epidemiology , Cross Infection/epidemiology , Disease Outbreaks , Gram-Positive Bacterial Infections/epidemiology , Vancomycin-Resistant Enterococci/isolation & purification , Aged , Carrier State/microbiology , Case-Control Studies , Cross Infection/microbiology , Female , France/epidemiology , Gram-Positive Bacterial Infections/microbiology , Hospitals, Teaching , Humans , Infection Control/methods , Male , Prevalence , Retrospective Studies , Risk FactorsABSTRACT
Intensive care unit patients exposed to multiple devices but free of hospital-acquired infection (HAI) until discharge were identified through a surveillance network of HAIs in Lyon, France, between 2003 and 2011. Multiexposed patients were defined according to the tenth deciles of length of stay and exposures to invasive devices. Overall, 982 (5.0%) multiexposed patients were identified; 154 (15.7%) remained uninfected. Multiexposed infected patients differed from noninfected patients regarding length of exposures and mortality.
