title: National point prevalence survey of healthcare-associated infections and antimicrobial use in French home care settings, May to June 2012.
abstract: In May and June 2012, a national point prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use was conducted among French patients under home-based hospital care (HBHC). Data from 5,954 patients in 179 volunteer HBHC providers were collected. Prevalence of patients with at least one active HAI was 6.8% (95% confidence interval (CI): 6.1–7.4). Prevalence of those receiving at least one antimicrobial agent was 15.2% (95% CI: 14.3–16.1). More than a third (35.5%) of HAIs were HBHC-associated, 56% were imported from a healthcare facility and 8.5% of indeterminate origin. The main infection sites were urinary tract (26.6%), skin and soft tissue (17.6%), surgical site (15%), and pneumonia or other respiratory tract infections (13.5%). In multivariate analysis, three risk factors were associated with HBHC-associated infections: urinary catheter, at least one vascular catheter and a McCabe score 1 or 2. The most frequently isolated microorganism was Staphylococcus aureus (20.7%), 28.1% of them meticillin-resistant. Non-susceptibility to third-generation cephalosporins was reported in 25.3% of Enterobacteriaceae, of which 16.1% were extended spectrum beta-lactamase-producing strains. The most prescribed antimicrobials were fluoroquinolones (16.1%), and third-generation cephalosporins (14.5%). PPS may be a good start in HBHC to obtain information on epidemiology of HAIs and antimicrobial use.
authors.affiliation: Regional Coordinating Centre for Nosocomial Infection Control (CClin Paris - Nord), Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Miliani
authors.forename: B
authors.initials: B
authors.lastname: Migueres
authors.forename: D
authors.initials: D
authors.lastname: Verjat-Trannoy
authors.forename: J M
authors.initials: JM
authors.lastname: Thiolet
authors.forename: S
authors.initials: S
authors.lastname: Vaux
authors.forename: P
authors.initials: P
authors.lastname: Astagneau
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D062885:Urinary Catheters / Q000382:microbiology
chemical_list: D000890:Anti-Infective Agents