Nosocomial infections and hospital mortality: a multicentre epidemiological study

Kaoutar, B.; Joly, C.; L’Hériteau, F.; Barbut, Frédéric; Robert, Jérôme; Michel, Denis; Espinasse, F.; Merrer, Jacques; Doit, C.; Costa, Yannick; Daumal, F.; Blanchard, H; Eveillard, Mathieu; Botherel, A.H; Brücker, Gilles; Astagneau, Pascal

doi:10.1016/j.jhin.2004.06.006

Cited by 52 publications

(32 citation statements)

References 22 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The only relevant French multicenter study 4 was descriptive. This study analyzed, in 2001,1945 deaths in 16 university or regional institutions.…”

Section: Discussionmentioning

confidence: 99%

“…This hospital has 833 acute care beds, including 39 analysis that used patient records to attribute death to NI 4 in the intensive care unit (ICU), 399 in the medical unit, 223 (such studies, however, are often retrospective and lack proper in the surgery unit, 54 in the obstetrics and gynecology unit, controls); (2) comparative analysis that determined mortality and 118 in the psychiatry unit; 268 long-term care beds, due to NI by adjusting for or matching for other risk factors including beds in the physical medicine and rehabilitation (such studies, however, most often involve only one type of units; and 483 beds in the skilled nursing unit. Every year, approximately 40,000 patients are admitted to the hospital.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Mortality Attributable to Nosocomial Infection: A Cohort of Patients With and Without Nosocomial Infection in a French University Hospital

Fabbro‐Peray

Sotto

Defez

et al. 2007

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

OBJECTIVE To assess nosocomial infection (NI) as a risk factor for death and to estimate the population-attributable risk of death from NI. DESIGN. A prospective cohort study of patients with and without NI.SETTING. Nimes University Hospital, Nimes, France.PATIENTS. Patients were recruited from May 7, 2001, to January 10, 2003. Patients in acute care and long-term care units who had NI were enrolled, and patients without NI were randomly selected and matched with patients with NI for age, sex, type of care (acute care vs. long-term care) and length of stay in hospital at study inclusion. OUTCOME MEASURES. Vital status within 60 days after study inclusion was assessed. We used conditional logistic regression to estimate the relative death risk from NI after adjusting for comorbidities, severity of the underlying disease, and all other confounding factors. The adjusted population-attributable risk was assessed using the Mantel-Haenszel method.RESULTS. We recruited 1,914 patients with NI and 5,172 patients without NI. The median age of the patients with NI was 73 years; 1,045 (54.6%) were female. NI was associated with death within 60 days (adjusted odds ratio, 1.7 [95% confidence interval {CI}, 1.4-;2.2]; P<.001). The adjusted population-attributable risk of death for all sites of infection was 1.7% (95% CI, 1.4-2.1). If we consider the NI incidence to be 3%-6% in French hospitals, the population-attributable risk of death from NI would range from 2.1% (95% CI, 1.7%-2.5%) to 4.0% (95% CI, 3.3%-4.9%).CONCLUSION. In this study, NI appeared to have a significant impact on mortality. Multicenter studies will be needed to confirm these results.

show abstract

“…The only relevant French multicenter study 4 was descriptive. This study analyzed, in 2001,1945 deaths in 16 university or regional institutions.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Mortality Attributable to Nosocomial Infection: A Cohort of Patients With and Without Nosocomial Infection in a French University Hospital

Fabbro‐Peray

Sotto

Defez

et al. 2007

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Infections occurring more than 48 hours after admission are usually considered nosocomial [85][86]. They represent a problem associated with excess morbidity and mortality, extended hospitalisations and increased costs [85,87].…”

Section: Nosocomial Infectionsmentioning

confidence: 99%

Epidemiological and molecular biological studies of multi-resistant methicillin-susceptible Staphylococcus aureus

Lindqvist¹

2014

View full text Add to dashboard Cite

Antibiotic resistance is increasingly recognised as a major problem and threat. During the last decades Gram-positive bacteria in general, and methicillin-resistant Staphylococcus aureus (MRSA) in particular, have been in focus both concerning matters of antibiotic resistance and as pathogens causing health care-associated (nosocomial) infections. In contrast to MRSA, studies on clonal distribution of methicillin-susceptible S. aureus (MSSA) are scarce.However, interest in MSSA has increased since it was shown that MRSA emerges from susceptible backgrounds by acquisition of a staphylococcal cassette chromosome element, carrying the mecA gene encoding methicillin-resistance (SCCmec).In an outbreak investigation of MRSA in Östergötland County, Sweden, in 2005, a high incidence of MSSA isolates with concomitant resistance to erythromycin, clindamycin and tobramycin (ECT-R) was detected. Analysis showed that 91 % of the investigated isolates were genetically related (clonal). The ECT-R clone was divided into four different but closely related patterns with pulsed-field gel electrophoresis (PFGE), and was designated spa type t002. Whole genome sequencing revealed that the ECT-R clone carried a pseudo-SCC element estimated to be 12 kb in size, showing a resemblance of more than 99 % with the SCCmec type II element of MRSA strain N315 (New York/Japan clone). This suggested a probable derivation from a highly successful MRSA strain, which had partially excised its SCCmec. The clonal outbreak was concentrated in eight hospital departments and two primary care centres, all located in the city of Linköping. Despite a high exchange of patients with the hospitals in the neighbouring counties in southeast Sweden (Jönköping-and Kalmar County), the ECT-R clone seemed to be limited to Östergötland County. However, a tobramycin-resistant clone predominated by isolates of spa type t084 was found in all three counties in southeast Sweden, and in particular among newborns, suggesting inter-hospital transmission.The ECT-R clone has survived as an abundant MSSA clone for a decade in Östergötland County, which indicates an insufficiency in the maintenance of basic hygiene guidelines, and that the clone probably possesses mechanisms of virulence and transmission that are yet to be discovered. Sammanfattning på svenska

show abstract

“…Le second point, dont la mesure précise reste un exercice délicat, est celui de la mortalité directement liée aux infections nosocomiales. En effet en France chaque année, 6,6 % des décès qui surviennent à l'hôpital ou au décours d'une hospitalisation seraient associés à une infection nosocomiale [2]. Au total, les infections nosocomiales seraient donc en cause dans 9 000 décès par an dont 4 200 concernent des patients dont le pronostic vital n'était pas engagé à court terme.…”

Section: Les Faitsunclassified

Lutte contre les infections nosocomiales en France

Zahar

2007

Med Sci (Paris)

View full text Add to dashboard Cite

Nosocomial infections and hospital mortality: a multicentre epidemiological study

Cited by 52 publications

References 22 publications

Mortality Attributable to Nosocomial Infection: A Cohort of Patients With and Without Nosocomial Infection in a French University Hospital

Mortality Attributable to Nosocomial Infection: A Cohort of Patients With and Without Nosocomial Infection in a French University Hospital

Epidemiological and molecular biological studies of multi-resistant methicillin-susceptible Staphylococcus aureus

Lutte contre les infections nosocomiales en France

Contact Info

Product

Resources

About