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Summary This study assessed the hand hygiene performance in French nursing homes using the consumption of alcohol-based hand rubs (AHRs) as a surrogate. Nursing homes from the 17 French regions were contacted to collect their AHR consumption and occupancy in 2018 and 2019. A total of 1290 nursing homes from 15 French regions participated in the survey. The estimated median number of hand hygiene actions per resident-day was 1.48 (interquartile range: 1.04–2.03) in 2018 and 1.60 (1.10–2.26) in 2019. A significantly higher AHR consumption was observed in public nursing homes with an infection control team or link nurse.

Introduction La surveillance nationale de la consommation hospitaliere d’antibiotiques permet le recueil et l’analyse des donnees par specialite clinique (outil ConsoRes). Cela permet des comparaisons entre meme types de services : medecine, chirurgie, reanimation, gynecologie, soins de longue duree (SLD), soins de suite et reeducation (SSR), psychiatrie. Afin de mieux cibler les actions de bon usage des antibiotiques, notre objectif est ici de decrire l’usage des antibiotiques a large spectre (ALS) par specialite clinique. Materiels et methodes Tous les antibiotiques systemiques (classe J01 de la classification Anatomical Therapeutic Chemical de l’OMS, ATC-DDD system, 2019) ont ete surveilles. Les consommations d’antibiotiques (C-ATB) exprimees en nombre de Doses Definies Journalieres pour 1000 journees d’hospitalisation (DDJ/1000 JH) ont ete recueillies pour 3812 services de 1630 etablissements de sante (ES) volontaires pour l’annee 2018. La proportion d’ALS consommes (glycopeptides [GP], cephalosporines de 3e et 4e generation, monobactames, carbapenemes [CBP], fluoroquinolones [FQ], polymyxines, piperacilline–tazobactam, linezolide [L], tedizolide [T] et daptomycine [D]) au sein de la consommation globale d’antibiotiques, indicateur propose par l’ECDC, etait calcule pour chaque service. Resultats La C-ATB totale variait entre 42 DDJ/1000 JH en psychiatrie et 1199 en reanimation. De meme, l’indicateur ECDC variait selon les services : 11 % en psychiatrie (n = 275) ; 12 % en gynecologie (n = 367) ; 25 % en SLD (n = 367) ; 33 % en chirurgie (n = 632) et en SSR (n = 1064) ; 35 % en medecine (n = 785) et 50 % en reanimation (n = 220). Parmi les ALS, la ceftriaxone seule correspondait a 41 % en SLD versus 8 % en reanimation a 26 % en gynecologie. La proportion en FQ variait de 15 % en reanimation a 74 % en psychiatrie ; les CBP representaient moins de 2 % en psychiatrie et gynecologie, 5 % en chirurgie et medecine, et 13 % (dont 40 % de meropeneme) en reanimation. Les antibiotiques anti-staphylocoques resistant a la meticilline (GP, L, T et D) representaient 16 et 17 % des ALS prescrits en chirurgie et en reanimation. Conclusion La consommation globale et la proportion d’ALS apportent des informations complementaires renseignant sur la pression de selection. De plus, une description detaillee de l’usage des ALS apporte des informations utiles afin de mieux cibler les actions correctives a mener (c.-a-d. sur les FQ en psychiatrie). Surveiller a l’echelle des services permet de mieux adapter les recommandations et les actions de bon usage des antibiotiques et d’evaluer l’impact d’actions ciblees sur certaines specialites cliniques. Cela permet aussi des comparaisons plus pertinentes qu’a l’echelle des hopitaux.

OBJECTIVETo assess the temporal trend of reported occupational blood and body fluid exposures (BBFE) in French healthcare facilities.METHODRetrospective 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).FINDINGSReported BBFE incidence rate per 100 beds decreased from 7.5% in 2003 to 6.3% in 2012 (minus 16%). Percutaneous injuries were the most frequent reported BBFE (84.0% in 2003 and 79.1% in 2012). Compliance with glove use (59.1% in 2003 to 67.0% in 2012) and sharps-disposal container accessibility (68.1% in 2003 to 73.4% in 2012) have both increased. A significant drop in preventable BBFE was observed (48.3% in 2003 to 30.9% in 2012). Finally, the use of safety-engineered devices increased from 2008 to 2012.CONCLUSIONOf the 415,209 hospital beds in France, 26,158 BBFE could have occurred in France in 2012, compared with 35,364 BBFE in 2003. Healthcare personnel safety has been sharply improved during the past 10 years in France.Infect. Control Hosp. Epidemiol. 2015;36(8):963–968

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. Methods A dataset from the French national SSI database ISO-RAISIN 2008–2011 was used. Only adult patients were included. A standardized questionnaire was completed for each patient who underwent surgery, and patients with and without SSI were characterized. Patients and ward risk factors for SSI were analysed using a multilevel logistic regression model with SSI as binary outcome (two levels: patient and ward). Results Out of 8569 patients from 39 wards, the SSI rate was 2.2%. Micro-organisms were isolated in 144 patients (74%): 35% coagulase-negative staphylococci (N = 51), 23% Staphylococcus aureus (N = 33), 6% Escherichia coli (N = 8). Higher probability of SSI was associated with the duration of preoperative hospitalization, the duration of follow-up, the duration of surgery >75th percentile and the SSI rate in the surgery ward. The residual heterogeneity between wards (median odds ratio: 1.53) was as relevant as duration of preoperative hospitalization (odds ratio: 1.57). Conclusion Although patient risk factors were more strongly associated with SSI occurrence, this study provided evidence for the existence of a ward-level effect. This should be taken into account when considering possible corrective interventions.