[Analysis of the factors influencing the internal reporting of nosocomial infections. A review of 108 notifications].
BACKGROUND
Since July 26, 2001, the external reporting to the regional office of health and social affairs (Direction départementale des affaires sanitaires et sociales--Ddass) and the coordination centre (Comité de lutte contre les infections nosocomiales--Cclin) for the fight against nosocomial infections (NI) is mandatory. However, the modalities of internal reporting to the Clin are unknown.


METHODS
We performed a retrospective analysis of 108 cases of NI reported over 23 months in 4 medical-surgical departments (MSD) with 14 to 35 NI reported/MSD. The distribution of the bacteria responsible was compared with that of the local epidemiological state (chi2 test). A correlation analysis was performed between the number of NI reported in each MSD and the structural characteristics and activity index of these MSD (Spearmann's correlation test).


RESULTS
The NI were predominantly infections related to a catheter (43), lower respiratory tract (25) and infection of the site of surgery (19). Ninety were documented biologically, among which 10 implied multi-resistant bacteria. Ninety-four NI were associated with the prescription of an antibiotic. Compared with the local epidemiological state, the NI reported generally implied multi-resistant bacteria (p=0.009). The other microbiological data had little implication. In each of the MSD, the number of cases reported was independent of: the global activity, the number of interventions, the mean duration of hospitalisation, the number of beds, the number of clinicians, the number of new patients managed and the chemotherapy outpatient activity. Conversely, there was a strong correlation between the global consumption of antibiotics (r=0.78), and the number of the Clin members in each MSD DMC (r=0.82).


CONCLUSIONS
In each MSD, the internal reporting of NI relies on the discovery of multi-resistant bacteria, but above all on the implication of those involved in the fight against nosocomial infections.
Penel
N
N
Département de cancérologie générale, Centre Oscar Lambret, Lille. n-penel@o-lambret.fr
Fournier
C
C
Roussel-Delvallez
M
M
Deberles
M-F
MF
Buisset
E
E
Cazin
J-L
JL
Leclercq
B
B
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D018563:Disease Notification / Q000379:methods / Q000592:standards*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D024901:Drug Resistance, Multiple, Bacterial; D005602:France / Q000453:epidemiology; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods / Q000592:standards*; D007902:Length of Stay / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011159:Population Surveillance / Q000379:methods; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents