Infection Control Unit

Paris, France

Infection Control Unit

Paris, France
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Marra A.R.,Hospital Israelita Albert Einstein | Guastelli L.R.,Hospital Israelita Albert Einstein | De Araujo C.M.P.,Hospital Israelita Albert Einstein | Dos Santos J.L.S.,Hospital Israelita Albert Einstein | And 8 more authors.
Infection Control and Hospital Epidemiology | Year: 2010

objective. To evaluate the effectiveness of a positive deviance strategy for the improvement of hand hygiene compliance in 2 adult step-down units. design. A 9-month, controlled trial comparing the effect of positive deviance on compliance with hand hygiene. setting. Two 20-bed step-down units at a tertiary care private hospital. methods. The first phase of our study was a 3-month baseline period (from April to June 2008) in which hand hygiene episodes were counted by use of electronic handwashing counters. From July to September 2008 (ie, the second phase), a positive deviance strategy was implemented in the east unit; the west unit was the control unit. During the period from October to December 2008 (ie, the third phase), positive deviance was applied in both units. results. During the first phase, there was no statistically significant difference between the 2 step-down units in the number of episodes of hand hygiene per 1,000 patient-days or in the incidence density of healthcare-associated infections (HAIs) per 1,000 patient-days. During the second phase, there were 62,000 hand hygiene episodes per 1,000 patient-days in the east unit and 33,570 hand hygiene episodes per 1,000 patient-days in the west unit ( ). The incidence density of HAIs per 1,000 patient-days was 6.5 in the east unit and 12.7 P ! .01 in the west unit (Pp.04). During the third phase, there was no statistically significant difference in hand hygiene episodes per 1,000 patientdays (Pp.16) or in incidence density of HAIs per 1,000 patient-days. conclusion. A positive deviance strategy yielded a significant improvement in hand hygiene, which was associated with a decrease in the overall incidence of HAIs. © 2009 by The Society for Healthcare Epidemiology of America.

Park S.A.,Infection Control Unit | Lee S.J.,Research Planning and Management Team | Choi G.U.,National Cancer Center
Asian Pacific Journal of Cancer Prevention | Year: 2011

Objective: To describe the nurse's perception of hospital organization related to cultural issues on the safety of the patient and reporting medical errors. In addition, to identify factors associated with the safety of the patient and the nurse. Methods: A survey conducted during December 2008-Jannuary 2009, with 126 nurses using the Korean version of the AHRQ patient safety survey, a self-report 5-point Likert scale. Stata 10.0 was used for descriptive analysis, ANOVA (Analysis of variance) and logistic regression. Setting: National cancer center in Korea. Results: The means for a working environment related to patient safety was 3.4 (±0.62). The associated factors of duration were at a present hospital, a special area, and direct contact with patients. Among organizational culture factors related to patient safety, the means were 3.81(±0.54) for the boss/manager's perception of patient safety and 3.37(±0.49) for the cooperation/collaboration between units. The frequent number of errors reported by nurses were 1~2(22.2%) times over the past 12 months. For incidence reporting, the items that the 'nurses perceived for communication among clinicians as fair' had a means of 3.23(±0.40) and the 'overall evaluation of patient safety was a good' 3.34(±0.73). Conclusions: The nurse's perception of cooperation and collaboration between units were associated with the direct contact between the patient and the nurse. The frequency of incidence reporting was associated with the duration of working hours at the present hospital and also their work experience. The nurse's perception of hospital environment, organizational culture, and incidence reporting was above average and mostly associated with organizational culture.

Otter J.A.,King's College London | Otter J.A.,Bioquell UK Ltd andover | Yezli S.,Bioquell UK Ltd andover | Perl T.M.,Johns Hopkins University | And 3 more authors.
Journal of Hospital Infection | Year: 2013

Background: Surface contamination in hospitals is involved in the transmission of pathogens in a proportion of healthcare-associated infections. Admission to a room previously occupied by a patient colonized or infected with certain nosocomial pathogens increases the risk of acquisition by subsequent occupants; thus, there is a need to improve terminal disinfection of these patient rooms. Conventional disinfection methods may be limited by reliance on the operator to ensure appropriate selection, formulation, distribution and contact time of the agent. These problems can be reduced by the use of 'no-touch' automated room disinfection (NTD) systems. Aim: To summarize published data related to NTD systems. Methods: Pubmed searches for relevant articles. Findings: A number of NTD systems have emerged, which remove or reduce reliance on the operator to ensure distribution, contact time and process repeatability, and aim to improve the level of disinfection and thus mitigate the increased risk from the prior room occupant. Available NTD systems include hydrogen peroxide (H2O2) vapour systems, aerosolized hydrogen peroxide (aHP) and ultraviolet radiation. These systems have important differences in their active agent, delivery mechanism, efficacy, process time and ease of use. Typically, there is a trade-off between time and effectiveness among NTD systems. The choice of NTD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation and cost constraints. Conclusion: NTD systems are gaining acceptance as a useful tool for infection prevention and control. © 2012 The Healthcare Infection Society.

Memish Z.A.,National Guard Affairs | Memish Z.A.,Infection Control Unit | Dbaibo G.,American University of Beirut | Montellano M.,Mary Chiles Hospital | And 7 more authors.
Pediatric Infectious Disease Journal | Year: 2011

Background: Meningococcal disease remains an important cause of invasive bacterial infections in children less than 5 years of age. Immunogenicity and safety of the investigational ACWY vaccine conjugated with tetanus toxoid (ACWY-TT, GlaxoSmithKline Biologicals) were evaluated in 1501 healthy 2- to 10-year-old children in the Philippines, India, Lebanon, and Saudi Arabia. Methods: Children were randomized (3:1) to receive ACWY-TT or licensed tetravalent meningococcal polysaccharide vaccine (Mencevax, GlaxoSmithKline, Men-PS). Diary cards were used to collect solicited symptoms for 4 days after vaccination. Serious adverse events were reported for 6 months. Serum bactericidal activity (rSBA, rabbit complement) was measured before and 1 month after vaccination in the first 75% of subjects enrolled in each country. Results: The statistical criteria for noninferiority in terms of rSBA vaccine responses were reached. Exploratory analyses showed that postvaccination rSBA titers ≥ 1:8 and ≥ 1:128 were significantly higher after ACWY-TT than Men-PS for serogroups C, W-135, and Y, and rSBA vaccine responses and geometric mean antibody titers were significantly higher for all 4 serogroups after administration of ACWY-TT. Noninferiority in terms of incidences of grade 3 general symptoms was not demonstrated. ACWY-TT was well tolerated with grade 3 events reported in < 1% of subjects per group. No serious adverse events were considered related to vaccination. Conclusion: ACWY-TT was immunogenic in children between 2 to 10 years of age with a clinically acceptable safety profile that resembled licensed Men-PS. These data support a positive benefit/risk ratio for the ACWY-TT vaccine. Copyright © 2011 by Lippincott Williams & Wilkins.

Birgand G.,Imperial College London | Birgand G.,French Institute of Health and Medical Research | Birgand G.,Infection Control Unit | Johansson A.,Umeå University | And 3 more authors.
Clinical Microbiology and Infection | Year: 2015

Reasons for a successful or unsuccessful implementation of infection prevention and control (IPC) guidelines are often multiple and interconnected. This article reviews key elements from the national to the individual level that contribute to the success of the implementation of IPC measures and gives perspectives for improvement. Governance approaches, modes of communication and formats of guidelines are discussed with a view to improve collaboration and transparency among actors. The culture of IPC influences practices and varies according to countries, specialties and healthcare providers. We describe important contextual aspects, such as relationships between actors and resources and behavioural features including professional background or experience. Behaviour change techniques providing goal-setting, feedback and action planning have proved effective in mobilizing participants and may be key to trigger social movements of implementation. The leadership of international societies in coordinating actions at international, national and institutional levels using multidisciplinary approaches and fostering collaboration among clinical microbiology, infectious diseases and IPC will be essential for success. © 2015 European Society of Clinical Microbiology and Infectious Diseases.

Fournier S.,Central Infection Control Team | Lepainteur M.,Central Infection Control Team | Kassis-Chikhani N.,Infection Control Unit | Huang M.,Central Infection Control Team | And 5 more authors.
Journal of Travel Medicine | Year: 2012

Assistance Publique-Hôpitaux de Paris launched a specific strategy to survey and control the spread of emerging multidrug-resistant bacteria such as carbapenemase-producing Enterobacteria (CPE). Among the 63 CPE events that occurred between 2004 and 2011, 87% involved patients with a link with cross-border exchanges, justifying the recommendation to screen and isolate such patients. © 2012 International Society of Travel Medicine.

Talaat M.,Infection Control Unit | Hafez S.,Alexandria University | Saied T.,Infection Control Unit | Elfeky R.,Alexandria University | And 2 more authors.
American Journal of Infection Control | Year: 2010

Background: We sought to measure the incidence rate of catheter-associated urinary tract infections (CAUTIs), identify risk factors associated with acquiring the infections; and identify the etiologic and antibiotic resistant patterns associated with CAUTIs in the intensive care units (ICUs) of a large University Hospital in Alexandria, Egypt. Methods: Prospective active surveillance of CAUTIs was conducted in 4 ICUs during a 13-month period from January 1, 2007 through January 31, 2008 in Alexandria University Hospital using the standard Centers for Disease Control National Nosocomial Infection Surveillance (NNIS) case definitions. Rates were expressed as the number of infections per 1000 catheter days. Results: During the study period, 757 patients were monitored after ICU admission, with either existing indwelling urinary catheters (239), or got catheters inserted after ICU admission (518), for a total duration of 16301 patient days, and 10260 patient catheter days. A total of 161 episodes of infection were diagnosed, for an overall rate of 15.7 CAUTIs per 1000 catheter days. Important risk factors associated with acquiring CAUTI were female gender (Relative risk (RR), 1.7; 95% confidence interval (CI); 1.7-4.3), and previous catheterization within the same hospital admission (RR, 1.6; 95% CI; 1.3-1.96). Patients admitted to the chest unit, patients =40 years, patients with prolonged duration of catheterization, prolonged hospital and ICU stay had a significantly higher risk of acquiring CAUTIs. Out of 195 patients who had their urine cultured, 188 pathogens were identified for 161 infected patients; 96 (51%) were Candida, 63 (33.5%) gram negatives, 29 (15.4%) gram positives. The prevalence of ESBL producers among K. pneumoniae and E. coli isolates was 56% (14/25) and 78.6% (11/14), respectively. Conclusion: Despite infection control policies and procedures, CAUTI rates remain a significant problem in Alexandria University hospital. Using the identified risk factors, tailored intervention strategies are now being implemented to reduce the rates of CAUTIs in these 4 ICUs. © 2010 Association for Professionals in Infection Control and Epidemiology, Inc.

Lucet J.-C.,Infection Control Unit | Regnier B.,University Paris Diderot
Clinical Infectious Diseases | Year: 2010

Methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) have few structural differences, but their epidemiologies differ profoundly in terms of colonization, infection, and transmission.We compare strategies for controlling hospital infection due to MSSA and MRSA. Despite the straightforward epidemiology of MSSA, the effectiveness of screening and decolonization was established only recently. The optimal strategy for controlling MRSA spread and infection remains debated. Many data need to be acquired, given the complexity of MRSA epidemiology, the entanglement between collective and individual objectives, and the challenges faced when adjusting for confounders. However, studies have consistently demonstrated that screening is useful in high-risk units to identify the reservoir and to initiate contact precautions. In an endemic setting, the contribution of MRSA decolonization to cross-transmission limitation is probably small in comparison to the impact of precautions. Screening and decolonization may be effective in decreasing the MRSA infectionrisk in carriers. © 2010 by the Infectious Diseases Society of America.

Birgand G.,French Institute of Health and Medical Research | Birgand G.,University Paris Diderot | Birgand G.,Infection Control Unit | Saliou P.,Brest Teaching Hospital | And 3 more authors.
Infection Control and Hospital Epidemiology | Year: 2015

A systematic literature review was performed to assess the impact of surgical-staff behaviors on the risk of surgical site infections. Published data are limited, heterogeneous, and weakened by several methodological flaws, underlying the need for more studies with accurate tools Objective. To assess the current literature regarding the impact of surgical-staff behaviors on the risk of surgical-site infection (SSI) Design. Systematic literature review Methods. We searched the Medline, EMBASE, Ovid, Web of Science, and Cochrane databases for original articles about the impact of intraoperative behaviors on the risk of SSI published in English before September 2013 Results. We retrieved 27 original articles reporting data on number of people in the operating room (n = 14), door openings (n= 14; number [n= 6], frequency [n =7], reasons [n =4], or duration [n= 3]), surgical-team discipline (evidence of distraction; n=4), compliance with traffic measures (n= 6), or simulated behaviors (n =3). Most (59%) articles were published in 2009–2013. End points were the 30-day SSI rate (n = 8), air-particle count (n =2), or microbiological air counts (n =6); 11 studies were only descriptive. Number of people in the operating room and SSI rate or airborne contaminants (particle/bacteria) were correlated in 2 studies. Door openings and airborne bacteria counts were correlated in 2 observational studies and 1 experimental study. Two cohort studies showed a significant association between surgeon interruptions/distraction or noise and SSI rate. The level of evidence was low in all studies Conclusions. Published data about the impact of operating-room behaviors on the risk of infection are limited and heterogeneous. All studies exhibit major methodological flaws. More studies with accurate tools should be performed to address the influence of operating room behaviors on the infectious risk. © 2015 by The Society for Healthcare Epidemiology of America. All rights reserved.

El-Kholy A.,Cairo University | Saied T.,Infection Control Unit | Gaber M.,Cairo University | Younan M.A.,Cairo University | And 5 more authors.
American Journal of Infection Control | Year: 2012

Background: Device associated infections (DAIs) have major impact on patient morbidity and mortality. Methods: This study involved active prospective surveillance to measure the incidence of DAIs, evaluate microbiological profiles, and investigate excessive mortality in intensive care units (ICUs) in 3 hospitals of Cairo University applying the US Centers for Disease Control and Prevention's National Healthcare Safety Network case definitions for ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI), and central-line associated bloodstream infection (CLABSI). Data were collected between March 2009 and May 2010. Results: A total of 1,101 patients were hospitalized for a total of 10,869 days, had 4,734 device-days, and acquired 97 DAIs, with an overall rate of 20.5/1,000 ICU days. VAP was the most commonly identified infection (88.7%); followed by CLABSI (8.2%) and CAUTI (3.1%). Excess mortality was 48% (relative risk, 1.9; P <.001) for CAUTI, 12.9% (relative risk, 1.2; 95% confidence interval, 1.1-1.4; P <.05) for VAP, and 45.7% for CLABSI. Acinetobacter baumannii was the most frequently isolated pathogen (36.1%), followed by Klebsiella pneumoniae (29.2%) and Pseudomonas aeruginosa (22.2%). High antimicrobial resistance was identified, with 85% of A baumannii isolates resistant to ciprofloxacin and imipenem, 76% of K pneumoniae isolates were extended-spectrum β-lactamase producers, and 56.3% P aeruginosa isolates resistant to imipenem (56.3%). Conclusion: High rates of DAI and antimicrobial resistance require strengthening infection control, instituting surveillance systems, and implementing evidence-based preventive strategies. Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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