Politique de maîtrise de la diffusion des bactéries multirésistantes aux antibiotiques dans la région Nord–Pas de Calais: état des lieux

Abstract

Objective – To evaluate the resources in personnel and equipment dedicated to nosocomial infection control and the policies used to control multidrug resistance. 62 institutions (21,631 hospital beds) were included in the study. Material and methods – A multicentric survey was performed, using guidelines, developed in order to control the spreading of multidrug resistant bacteria in the Nord-Pas de Calais region, as reference. The 6 infection control units that were identified concerned 17 institutions, either uniquely or by inter-hospital agreement. Results – Infection control personnel (in full time equivalent, FTE) included 5.3 physicians (i.e. 1 per 4,081 acute care beds) and 35.1 nurses (i.e. 1 per 600 acute care beds). Only 1 institution met national recommendations regarding the infection control physician/bed ratio while 12 institutions met the recommendations regarding the infection control nurse /bed ratio. The estimation in FTE showed that the whole region lacked 21.7 physicians and 19 nurses. 81% of the institutions indicated the presence of “hygiene links” in clinical units. The proportion of single rooms was 58%, that of fully equipped sinks with non-medicated soap was 45% and 38% with antiseptic soap. 12.5% of the clinical units identified correctly patients with multidrug resistant organisms. In 55% of the institutions, no unit had the necessary equipment to correctly implement isolation precautions. 77% of the units modified the organization of care in case of patients with multidrug resistant organisms. Written procedures for handwashing and isolation precautions were available in 74% of the units.