Comparative Analysis of Nosocomial Bacteremia in Adults in and Outside the ICU: 2012 National Prevalence Survey, France

Introduction: National surveillance of nosocomial bacteremia (NB) was restricted to intensive care units in 2005. In 2012, the National Prevalence Survey (ENP) of nosocomial infections reported a prevalence of NB of 0.5%. The objective of this study was to compare NB rates in intensive care units and outside of intensive care units. Method: Data were obtained from the 2012 ENP. Analyses focused on the prevalence of NB, their distribution by type of hospital stay, and their source. A multivariate analysis examined factors associated with NB. Results: Among the 216,387 patients included, 2.4% were hospitalized in the ICU, 65.9% in short-stay units, and 31.7% in follow-up and rehabilitation care (SSR). The prevalence of BN was 3.2%, 0.6%, and 0.2%, respectively. Only 14.9% of BIs were recorded in the ICU, compared with 74.8% in short-stay care. Catheter-related BIs accounted for 42.0% of BIs in the ICU, 44.7% in short-stay care, and 19.0% in SSR. Non-catheter-related NIs were more often secondary to pneumonia in the ICU (15.3%), to a urinary tract infection in short-stay care (25.4%), or in SSR (45.7%). The occurrence of an NI was associated with numerous patient-related factors, the main one being catheter exposure. After adjustment, the risk of developing a BN in the ICU did not differ significantly from that in the short-stay ward. Conclusion: In the 2012 ENP, while the prevalence of BNs was higher in the ICU, three-quarters of BNs occurred in the short-stay ward. The most common cause was catheter exposure, in both the short-stay ward and the ICU. Prevention and surveillance efforts should be expanded to include at-risk patients outside of the ICU, particularly those with catheters. (R.A.)

Author(s): Giard M, Machut A, Noel Lagnado D, Ayzac L, Vaux S, Coignard B, Savey A, Georges S, Leon L, Thiolet JM, Bernet C, Gautier C, Jarno P, Simon L, Migueres B, Miliani K, Verjat Trannoy D, Alfandari S, Bajolet O

Publishing year: 2014

Pages: 474-81

Weekly Epidemiological Bulletin, 2014, n° 29, p. 474-81

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