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hal.structure.identifierPharmaco-Épidémiologie des Produits de Santé [PEPS]
dc.contributor.authorBOYER, Alexandre
hal.structure.identifierInstitut de Mathématiques de Bordeaux [IMB]
dc.contributor.authorCOUALLIER, Vincent
hal.structure.identifierCHU Bordeaux
dc.contributor.authorCLOUZEAU, Benjamin
hal.structure.identifierCHU Bordeaux
dc.contributor.authorLASHERAS, Agnes
hal.structure.identifierMicrobiologie Fondamentale et Pathogénicité [MFP]
dc.contributor.authorM'ZALI, Fatima
hal.structure.identifierMicrobiologie Fondamentale et Pathogénicité [MFP]
dc.contributor.authorKANN, Michael
hal.structure.identifierPharmaco-Épidémiologie des Produits de Santé [PEPS]
dc.contributor.authorROGUES, Anne-Marie
hal.structure.identifierMicrobiologie Fondamentale et Pathogénicité [MFP]
dc.contributor.authorGRUSON, Didier
dc.date.accessioned2024-04-04T02:32:25Z
dc.date.available2024-04-04T02:32:25Z
dc.date.issued2015-12-01
dc.identifier.issn0196-6553
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/190385
dc.description.abstractEnThis study was undertaken to determine the temporal relationship between implementation of different interventions in an intensive care unit (ICU) and control of endemic nosocomial acquisition of extended-spectrum β-lactamase Enterobacteriaceae (ESBLE). This was a prospective observational study with time-series analysis of the monthly incidence of ESBLE and its predictors. In November 2007, after a 14-month baseline period, an intervention consisting of restriction of third-generation cephalosporins (3 GC) and increased use of alcohol-based hand rubs was implemented. In January 2008, an increased health care worker (HCW):patient ratio was also implemented. In March 2010, the ICU was closed, and patients were moved to a clean ICU. The first intervention resulted in global reduction in 3 GC and increased use of alcohol-based hand rub. A significant change in ESBLE incidence was observed in a full segmented univariate regression analysis (mean change in level, -0.91 ± 0.19; P < .0001). After ICU closure, there was a dramatic reduction in ESBLE acquisition. According to the multivariate model, the ICU closure was the main protective factor. Before ICU closure, an increase in the HCW:patient ratio of 0.1 point tended to be associated with a decreased risk of ESBLE acquisition (relative risk, 0.28; 95% confidence interval, 0.06-1.25; P = .09). This study shows that ICU closure was associated with, but not necessarily the reason for, control of ESBLE cross-transmission in a nonoutbreak setting. Environmental ESBE sources may play a role in cross-transmission.
dc.language.isoen
dc.publisherElsevier
dc.subject.enCross Infection
dc.subject.enEnterobacteriaceae
dc.subject.enEnterobacteriaceae Infections
dc.subject.enHumans
dc.subject.enInfection Control
dc.subject.enIntensive Care Units
dc.subject.enMiddle Aged
dc.subject.enProspective Studies
dc.subject.enRegression Analysis
dc.subject.enbeta-Lactamases
dc.title.enControl of extended-spectrum β-lactamase-producing Enterobacteriaceae nosocomial acquisition in an intensive care unit: A time series regression analysis.
dc.typeArticle de revue
dc.identifier.doi10.1016/j.ajic.2015.07.026
dc.subject.halSciences du Vivant [q-bio]/Microbiologie et Parasitologie
bordeaux.journalAmerican Journal of Infection Control
bordeaux.page1296-301
bordeaux.volume43
bordeaux.hal.laboratoriesInstitut de Mathématiques de Bordeaux (IMB) - UMR 5251*
bordeaux.issue12
bordeaux.institutionUniversité de Bordeaux
bordeaux.institutionBordeaux INP
bordeaux.institutionCNRS
bordeaux.peerReviewedoui
hal.identifierhal-04297344
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-04297344v1
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