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Relationship between the Prevalence of Methicillin-Resistant Staphylococcus aureus Infection and Indicators of Nosocomial Infection Control Measures A Population-Based Study in French Hospitals

Published online by Cambridge University Press:  02 January 2015

Leslie Grammatico-Guillon ,
Jean-Michel Thiolet ,
Pascale Bernillon ,
Bruno Coignard ,
Babak Khoshnood  and
Jean-Claude Desenclos
Leslie Grammatico-Guillon*
Affiliation:
Institut de Veille Sanitaire, Paris University Hospital, Tours, France
Jean-Michel Thiolet
Affiliation:
Institut de Veille Sanitaire, Paris
Pascale Bernillon
Affiliation:
Institut de Veille Sanitaire, Paris
Bruno Coignard
Affiliation:
Institut de Veille Sanitaire, Paris
Babak Khoshnood
Affiliation:
Université Pierre et Marie Curie, Paris Epidemiological Research Unit on Perinatal and Women's Health, Villejuif, France
Jean-Claude Desenclos
Affiliation:
Institut de Veille Sanitaire, Paris
*
Leslie Grammatico-Guillon, MD, Service de médecine interne et maladies infectieuses, Centre hospitalier universitaire de Tours, 2, bid Tonnellé, 37 000 Tours, France( [email protected])
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Abstract

Objective.

To assess whether infection control indicators are associated with the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection in French hospitals.

Methods.

We linked the database for the 2006 national prevalence survey of nosocomial infection with the database of infection control indicators (comprised of ICALIN, an indicator of infection control organization, resources, and action, and ICSHA, an indicator of alcohol-based handrub consumption) recorded from hospitals by the Ministry of Health. Data on MRSA infection were obtained from the national prevalence survey database and included the site and origin of infection, the microorganism responsible, and its drug resistance profile. Because the prevalence of MRSA infection was low and often nil, especially in small hospitals, we restricted our analysis to hospitals with at least 300 Patients. We used a multilevel logistic regression model to assess the joint effects of patient-level variables (eg, age, sex, or infection) and hospital-level variables (infection control indicators).

Results.

Two hundred two hospitals had at least 300 patients, for a total of 128,631 Patients. The overall prevalence of MRSA infection was 0.34% (95% confidence interval [CI], 0.29%-0.39%). The mean value for ICSHA was 7.8 L per 1,000 patient-days (median, 6.1 L per 1,000 patient-days; range, 0-33 L per 1,000 patient-days). The mean value for ICALIN was 92 of a possible 100 points (median, 94.5;range, 67-100). Multilevel analyses showed that ICALIN scores were associated with the prevalence of MRSA infection (odds ratio for a score change of 1 standard deviation, 0.80;95% CI, 0.69-0.93). We found no association between prevalence of MRSA infection and ICSHA. Other variables significantly associated with the prevalence of MRSA infection were sex, vascular or urinary catheter, previous surgery, and the McCabe score.

Conclusions.

We found a significant association between the prevalence of MRSA infection and ICALIN that suggested that a higher ICALIN score may be predictive of a lower prevalence of MRSA infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 9 , September 2009 , pp. 861 - 869
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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