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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

Flu outbreaks usually reveal that practices and knowledge about the diagnosis of influenza, its treatment and infection control measures must be improved. A serious game, “Flu.0”, was created to teach the 8 key points to know and do when facing one or more patient infected by influenza.

Blood and Body Fluid Exposures (BFFEs) involve a complex sequence of events combining technical, human and organizational factors. Performing root cause analysis (RCA) of these events is promoted to improve safety. We conducted a RCA of a BBFE in a radiology unit using a recently developed French method called Orion.

Introduction L’antibioprophylaxie chirurgicale (ABP) fait partie des mesures de prevention des infections du site operatoire (ISO). Depuis 2014, un module optionnel sur l’ABP est associe a la surveillance nationale des ISO, afin d’evaluer si l’incidence des ISO varie selon que l’ABP est administree ou non en conformite avec les recommandations de la societe francaise d’anesthesie et de reanimation (SFAR). Materiels et methodes L’etude utilisait les donnees 2014 et 2015 de la surveillance nationale des ISO (interventions jugees prioritaires). L’incidence des ISO a ete comparee, en analyse univariee et par discipline chirurgicale, d’une part selon que l’ABP recommandee etait realisee ou non, et d’autre part suivant que l’administration ABP etait conforme au referentiel 2010 de la SFAR ou non. Resultats En 2014 et 2015, 353 services (23,5 % des services participant a la surveillance) ont participe au module ABP. Parmi les 12 109 interventions de gynecologie-obstetrique, l’incidence des ISO etait plus elevee pour les interventions avec ABP recommandee et non realisee que pour les interventions avec ABP recommandee et realisee : OR = 2,14, IC95 % [1,31–3,48], p = 0,002. Sur les ABP recommandees et realisees, 55,9 % etaient conformes au referentiel. Parmi les 1928 interventions de neurochirurgie, l’incidence des ISO etait plus elevee pour les interventions avec ABP recommandee et non realisee que pour les interventions avec ABP recommandee et realisee : OR = 4,70, IC95 % [1,56–14,20], p = 0,006. Sur les ABP recommandees et realisees, 35,7 % etaient conformes au referentiel. Les ABP non-conformes l’etaient en raison du delai d’administration majoritairement trop tot ; 90,5 % des administrations en chirurgie gynecologie-obstetrique et 93,3 % des administrations en neurochirurgie. Conclusion L’introduction, dans la surveillance ISO, d’un module ABP a permis de montrer que la non-conformite de l’ABP, facteur de risque d’ISO connu, est associe a une incidence plus elevee des ISO dans certaines specialites. Ces resultats, qui soulignent l’interet de coupler evaluation de pratiques et surveillance epidemiologique, ont amene le comite de pilotage de la surveillance a integre un representant de la SFAR parmi ses membres.

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.

Healthcare associated infections surveillance is a priority in intensive care units (ICUs). Since 2004, French national surveillance in adult ICUs (REA-RAISIN network) has targeted device-associated infections, for which control measures are essential.

Introduction – objectifs Realiser un etat des lieux des ressources humaines pour le bon usage des antibiotiques (BUA) dans les ES de l’inter region Sud-Ouest en 2012. Materiels et methodes Enquete adressee aux 450 ES de l’inter region. Autoquestionnaire base sur la circulaire de 2002 et sur les criteres de l’indicateur de BUA : ICATB, du bilan 2012 des activites de lutte contre les infections nosocomiales. Resultats 250 ES repondants soit 59 % des ES sollicites (3 CHU, 58 CH, 69 MCO, 67 ESSR, 26 hopitaux locaux). Au total, 365 referents etaient recenses dans 223 ES ; 89 % des ES avait designe un referent et 38 % en avait plus d’un (moins souvent pour les hopitaux locaux). Moins de la moitie des referents disposaient d’un diplome cite dans la circulaire du 2 mai 2002 ; ils etaient le plus souvent pharmaciens (18,4 %), infectiologues (18,1 %) ou anesthesistes- reanimateurs (17,3 %). L’objectif cible en termes d’ETP etait atteint pour 1/3 CHU, 63 % des CH, 76 % des MCO, 83 % des ESSR. Dans 194 ES (87 %), le referent etait interne a l’etablissement (sinon reseau interetablissements) et integre dans une « equipe chargee du bon usage des antiinfectieux » dans 57 % des cas. L’equipe comportait : pharmacien (90 % des cas), hygieniste (65 %), biologiste (59 %), infectiologue (7 %). Dans 80 ES ayant donne l’information, le temps hebdomadaire median consacre par ses membres a cette equipe etait de 3 heures (minimum : 0,5 h, maximum 35 h). Le temps pharmaceutique hebdomadaire median consacre a la dispensation des antibiotiques etait de 2 h/100 lits. Conclusion Les ressources humaines consacrees au BUA en 2012 l’enquete variaient selon le type d’ES. Meme si une majorite des ES avait nomme un referent, sa formation et le temps dedie etaient a ameliorer. Le nouvel indicateur ICATB2 devrait promouvoir des progressions, notamment en termes d’organisation pluridisciplinaire et d’attribution de temps dedie au BUA.

The need for, and benefits of, hand hygiene technique training have been identified. However, it usually requires actions which are often logistically challenging and time-consuming. For the 2012 French hand hygiene day, which was in November due to political schedule, an edutainment concept was created: the hand rub dance.