Helene Boulestreau - Academia.edu (original) (raw)
Uploads
Papers by Helene Boulestreau
Journal of Hospital Infection, 2008
results was probably confounded by serial TST and previous BCG vaccination with the possibility o... more results was probably confounded by serial TST and previous BCG vaccination with the possibility of false positive results secondary to cross-reaction with BCG or booster phenomenon. In fact, seven HCWs (18%) had skin induration to PPD 10 mm but did not reach the criterion for recent LTBI and therefore therapy of LTBI was not recommended. From these seven HCWs, only two (29%) resulted positive for QTBG test. We tested HCWs with QTBG test only once; thus we were unable to identify recent MTB infection by serial g-interferon measurement in previously QTBG-negative HCWs. Prospective studies of larger samples with QTBG test should help to define the criterion for QuantiFERON conversion and reversion and the incidence of booster phenomenon of QTBG induced by previous TST, allowing a better understanding of the potential role of QTBG in the screening of HCWs exposed to nosocomial risk of TB infection.
International Journal of Antimicrobial Agents, 2007
Patterns and determinants of antibiotic usage S299 19 hospitals (35%) had trouble finding equival... more Patterns and determinants of antibiotic usage S299 19 hospitals (35%) had trouble finding equivalent drugs for substitution. Only 10 hospitals reported that they had always been adequately informed by the producer or distributor about the shortage. Conclusions: A substantial number of hospital pharmacies in Europe have experienced antimicrobial drug shortages within the last 12 months. Shortage of meropenem, mupirocin and cefepime were considered to have the largest impact on patient care. Shortage-triggered policy changes may negatively affect antimicrobial prescribing patterns and expenses. This survey provides important information that will guide further ESGAP initiatives to document and ultimately prevent shortages. P1106 Hospital consumption of antibacterials for systemic use in Slovenia in 2005 M. Cizman on behalf of the Slovenian ESAC group Objective: To collect data on Hospital consumption (HC) of antibiotics in all Slovenian hospitals and departments aggregated at national level in the year 2005. Methods: Consumption data of systemic antibiotics in anatomical therapeutic chemical (ATC) (WHO version 2006) class J01 were collected, expressed in Defined Daily Doses (DDD). The consumption was expressed in DDD per 100 bed-days. Hospital pharmacist provided the data in the number of packages. The coverage of bed days were in all three years 100%. Results: The results are shown in Tables 1 and 2.
European Journal of Clinical Microbiology and Infectious Diseases, 2002
In 1999, over a 3-week period, Alcaligenes xylosoxydans subsp. xylosoxydans was isolated from fiv... more In 1999, over a 3-week period, Alcaligenes xylosoxydans subsp. xylosoxydans was isolated from five blood cultures and one cerebrospinal fluid specimen from five children hospitalized in a pediatric hematology ward as well as from two respiratory therapy devices of two children hospitalized in an intensive care unit. The infection control unit of the hospital conducted an epidemiological investigation and identified a detergent-disinfectant solution as the source of contamination. Conventional biochemical tests, antimicrobial susceptibility tests and random amplified polymorphic DNA (RAPD) fingerprinting were used to compare clinical and environmental isolates. RAPD analysis proved to be more discriminant than biotyping or antibiotyping in this context and identified the common source of the outbreak.
American Journal of Infection Control, 2006
The reservoir for hospital-acquired Legionnaires' disease has been shown to be the potable water ... more The reservoir for hospital-acquired Legionnaires' disease has been shown to be the potable water distribution system. The objectives of the present study were as follows: (1) to examine the possible relationship between physical-chemical characteristics of water such as temperature, pH, hardness, conductivity, and residual chlorine and the presence of amoebae as growth-promoting factors for Legionella species and (2) to determine eradication measures for water distribution systems to seek ways of reducing the risk of legionellosis. Ten hospitals in southwest France took part in this study. Water samples were collected from 106 hot water faucets, showers, hot water tanks, and cooling towers. Two analyses were performed to analyze the association between water characteristics and (1) the presence of Legionella species and (2) the proliferation of Legionella species. Of the 106 water samples examined, 67 (63.2%) were positive for Legionella species. Amoebae were detected in 73 of 106 (68.9%) samples and in 56 of 67 (86.6%) Legionella species-positive samples (P , 10 26). In these positive samples, conductivity was lower than 500 mV 21 Ácm 21 in 58.2% (P 5 .026), temperature was below 50°C in 80.6% (P 5 .004), and hardness was significantly higher (P 5 002) than in Legionella species-negative samples. Neither Legionella species nor amoebae were isolated from any sampling point in which the water temperature was above 58.8°C. Multivariate analysis shows that high hardness and presence of amoebae were strongly correlated statistically with the presence of Legionella when showers, tanks, pH, and temperature promoted their proliferation. This study shows the importance of water quality evaluation in assessing environmental risk factors and in selecting the most appropriate prevention and control measures in hospital water systems.
Infection Control and Hospital Epidemiology, 2003
Médecine et maladies infectieuses, 2006
The authors had for aim to study reservoirs and transmission of Pseudomonas aeruginosa in an inte... more The authors had for aim to study reservoirs and transmission of Pseudomonas aeruginosa in an intensive care unit. A 6-month prospective descriptive study was made on water samples, samples from hands of health care workers, and clinical samples. P. aeruginosa strains were compared by pulsed-field gel electrophoresis. Among the 211 patients hospitalized during the study, 14 (6.6%) were infected by P. aeruginosa. Out of 494 water samples, 80 were contaminated by P. aeruginosa. The regularly disinfected water taps were more rarely contaminated than the others (P<10(-5)). Out of 140 hand samples, one showed contamination from an infected patient. aeruginosa cross transmission was observed during this study. We should follow strict hygienic precautions such as wearing gloves and performing thorough alcoholic rub disinfection. Water taps are often contaminated and require regular disinfection.
This study examined tap water as a source of Pseudomonas aeruginosa in a medical intensive care s... more This study examined tap water as a source of Pseudomonas aeruginosa in a medical intensive care setting. We prospectively screened specimens of patients, tap water and hands of healthcare workers (HCWs) over a six-month period in a 16-bed medical intensive care unit. Molecular relatedness of P. aeruginosa strains was investigated by pulsed-field gel electrophoresis. A total of 657 tap water samples were collected from 39 faucets and 127 hands of HCWs were sampled. P. aeruginosa was found in 11.4% of 484 tap water samples taken from patients' rooms and in 5.3% of 189 other tap water samples (P<0.01). P. aeruginosa was isolated from 38 patients. Typing of 73 non-replicate isolates (water samples, hands of HCWs and patients) revealed 32 major DNA patterns. Eleven (52.4%) of the 21 faucets were contaminated with a patient strain, found before isolation from tap water in the corresponding room in nine cases, or from the neighbouring room in two cases. Among seven P. aeruginosa str...
Journal of Hospital Infection, 2001
Stenotrophomonas maltophilia (S. maltophilia) is an important cause of nosocomial infection among... more Stenotrophomonas maltophilia (S. maltophilia) is an important cause of nosocomial infection among ventilated and immunocompromised patients, and among patients receiving broad-spectrum antimicrobials. We report a cluster of patients in a surgical intensive care unit who were colonized or infected with S. maltophilia. An epidemiological investigation was initiated after surveillance data revealed that eight patients were culture-positive from sputum for S. maltophilia in the preceding month. Review of respiratory care procedures revealed that when mechanical ventilators were serviced between patients, the electronic temperature probes used with servo-controlled humidifiers were wiped with inadequate disinfection. We collected cultures of case-patient room surfaces, sinks and ventilator equipment. S. maltophilia was recovered from room surfaces, ventilator expiratory circuits and a temperature sensor which had been kept in ambient air after disinfection. Patients and environmental isolates were examined by RAPD-PCR. Three clinical isolates and one environmental isolate had the same profile, which suggests cross-contamination or common source exposure. The outbreak was controlled by adequate disinfection of the temperature sensors. No single epidemic strain was identified but several observations support the conclusion that the temperature probes contributed to the outbreak.
Clinical Nutrition, 2002
The microbiological quality of a 1-l closed enteral feeding system (CS) was prospectively monitor... more The microbiological quality of a 1-l closed enteral feeding system (CS) was prospectively monitored under clinical conditions simulating cyclic feeding over a 24-h period in geriatric patients. Method: The set was connected after diet sampling (T0). After 5-h feeding, the set was disconnected and a sample taken (T5). Diet was sampled after12 h before (T12A) and after a10 ml diet-flush of the set (T12B), after 24-h (T24) and in the pouch (P24). Concentrations of microorganisms were considered significant when above 10 4 colony-forming units per millilitre. Results:Twenty-one CS were examined.T0 samples were all sterile; 10 out of 21T5 were contaminated.The microbiological content of the diet was lower inT12B, compared toT12A (P = 0.002). None of the P24 samples was contaminated; 19 were sterile and two contained low levels of microorganisms that had been previously found in the sets. Conclusion: The CS was sterile before connecting to the patient. Retrograde contamination of the set was observed without contamination of the pouch after 24-h hanging time. Performing a diet-flush decreased the rate of diet contamination at the distal extremity of the set. Thus, cyclic enteral nutrition using the same pouch during a 24-h period seems to be safe in geriatric patients.
Journal of Hospital Infection, 2008
results was probably confounded by serial TST and previous BCG vaccination with the possibility o... more results was probably confounded by serial TST and previous BCG vaccination with the possibility of false positive results secondary to cross-reaction with BCG or booster phenomenon. In fact, seven HCWs (18%) had skin induration to PPD 10 mm but did not reach the criterion for recent LTBI and therefore therapy of LTBI was not recommended. From these seven HCWs, only two (29%) resulted positive for QTBG test. We tested HCWs with QTBG test only once; thus we were unable to identify recent MTB infection by serial g-interferon measurement in previously QTBG-negative HCWs. Prospective studies of larger samples with QTBG test should help to define the criterion for QuantiFERON conversion and reversion and the incidence of booster phenomenon of QTBG induced by previous TST, allowing a better understanding of the potential role of QTBG in the screening of HCWs exposed to nosocomial risk of TB infection.
International Journal of Antimicrobial Agents, 2007
Patterns and determinants of antibiotic usage S299 19 hospitals (35%) had trouble finding equival... more Patterns and determinants of antibiotic usage S299 19 hospitals (35%) had trouble finding equivalent drugs for substitution. Only 10 hospitals reported that they had always been adequately informed by the producer or distributor about the shortage. Conclusions: A substantial number of hospital pharmacies in Europe have experienced antimicrobial drug shortages within the last 12 months. Shortage of meropenem, mupirocin and cefepime were considered to have the largest impact on patient care. Shortage-triggered policy changes may negatively affect antimicrobial prescribing patterns and expenses. This survey provides important information that will guide further ESGAP initiatives to document and ultimately prevent shortages. P1106 Hospital consumption of antibacterials for systemic use in Slovenia in 2005 M. Cizman on behalf of the Slovenian ESAC group Objective: To collect data on Hospital consumption (HC) of antibiotics in all Slovenian hospitals and departments aggregated at national level in the year 2005. Methods: Consumption data of systemic antibiotics in anatomical therapeutic chemical (ATC) (WHO version 2006) class J01 were collected, expressed in Defined Daily Doses (DDD). The consumption was expressed in DDD per 100 bed-days. Hospital pharmacist provided the data in the number of packages. The coverage of bed days were in all three years 100%. Results: The results are shown in Tables 1 and 2.
European Journal of Clinical Microbiology and Infectious Diseases, 2002
In 1999, over a 3-week period, Alcaligenes xylosoxydans subsp. xylosoxydans was isolated from fiv... more In 1999, over a 3-week period, Alcaligenes xylosoxydans subsp. xylosoxydans was isolated from five blood cultures and one cerebrospinal fluid specimen from five children hospitalized in a pediatric hematology ward as well as from two respiratory therapy devices of two children hospitalized in an intensive care unit. The infection control unit of the hospital conducted an epidemiological investigation and identified a detergent-disinfectant solution as the source of contamination. Conventional biochemical tests, antimicrobial susceptibility tests and random amplified polymorphic DNA (RAPD) fingerprinting were used to compare clinical and environmental isolates. RAPD analysis proved to be more discriminant than biotyping or antibiotyping in this context and identified the common source of the outbreak.
American Journal of Infection Control, 2006
The reservoir for hospital-acquired Legionnaires' disease has been shown to be the potable water ... more The reservoir for hospital-acquired Legionnaires' disease has been shown to be the potable water distribution system. The objectives of the present study were as follows: (1) to examine the possible relationship between physical-chemical characteristics of water such as temperature, pH, hardness, conductivity, and residual chlorine and the presence of amoebae as growth-promoting factors for Legionella species and (2) to determine eradication measures for water distribution systems to seek ways of reducing the risk of legionellosis. Ten hospitals in southwest France took part in this study. Water samples were collected from 106 hot water faucets, showers, hot water tanks, and cooling towers. Two analyses were performed to analyze the association between water characteristics and (1) the presence of Legionella species and (2) the proliferation of Legionella species. Of the 106 water samples examined, 67 (63.2%) were positive for Legionella species. Amoebae were detected in 73 of 106 (68.9%) samples and in 56 of 67 (86.6%) Legionella species-positive samples (P , 10 26). In these positive samples, conductivity was lower than 500 mV 21 Ácm 21 in 58.2% (P 5 .026), temperature was below 50°C in 80.6% (P 5 .004), and hardness was significantly higher (P 5 002) than in Legionella species-negative samples. Neither Legionella species nor amoebae were isolated from any sampling point in which the water temperature was above 58.8°C. Multivariate analysis shows that high hardness and presence of amoebae were strongly correlated statistically with the presence of Legionella when showers, tanks, pH, and temperature promoted their proliferation. This study shows the importance of water quality evaluation in assessing environmental risk factors and in selecting the most appropriate prevention and control measures in hospital water systems.
Infection Control and Hospital Epidemiology, 2003
Médecine et maladies infectieuses, 2006
The authors had for aim to study reservoirs and transmission of Pseudomonas aeruginosa in an inte... more The authors had for aim to study reservoirs and transmission of Pseudomonas aeruginosa in an intensive care unit. A 6-month prospective descriptive study was made on water samples, samples from hands of health care workers, and clinical samples. P. aeruginosa strains were compared by pulsed-field gel electrophoresis. Among the 211 patients hospitalized during the study, 14 (6.6%) were infected by P. aeruginosa. Out of 494 water samples, 80 were contaminated by P. aeruginosa. The regularly disinfected water taps were more rarely contaminated than the others (P<10(-5)). Out of 140 hand samples, one showed contamination from an infected patient. aeruginosa cross transmission was observed during this study. We should follow strict hygienic precautions such as wearing gloves and performing thorough alcoholic rub disinfection. Water taps are often contaminated and require regular disinfection.
This study examined tap water as a source of Pseudomonas aeruginosa in a medical intensive care s... more This study examined tap water as a source of Pseudomonas aeruginosa in a medical intensive care setting. We prospectively screened specimens of patients, tap water and hands of healthcare workers (HCWs) over a six-month period in a 16-bed medical intensive care unit. Molecular relatedness of P. aeruginosa strains was investigated by pulsed-field gel electrophoresis. A total of 657 tap water samples were collected from 39 faucets and 127 hands of HCWs were sampled. P. aeruginosa was found in 11.4% of 484 tap water samples taken from patients' rooms and in 5.3% of 189 other tap water samples (P<0.01). P. aeruginosa was isolated from 38 patients. Typing of 73 non-replicate isolates (water samples, hands of HCWs and patients) revealed 32 major DNA patterns. Eleven (52.4%) of the 21 faucets were contaminated with a patient strain, found before isolation from tap water in the corresponding room in nine cases, or from the neighbouring room in two cases. Among seven P. aeruginosa str...
Journal of Hospital Infection, 2001
Stenotrophomonas maltophilia (S. maltophilia) is an important cause of nosocomial infection among... more Stenotrophomonas maltophilia (S. maltophilia) is an important cause of nosocomial infection among ventilated and immunocompromised patients, and among patients receiving broad-spectrum antimicrobials. We report a cluster of patients in a surgical intensive care unit who were colonized or infected with S. maltophilia. An epidemiological investigation was initiated after surveillance data revealed that eight patients were culture-positive from sputum for S. maltophilia in the preceding month. Review of respiratory care procedures revealed that when mechanical ventilators were serviced between patients, the electronic temperature probes used with servo-controlled humidifiers were wiped with inadequate disinfection. We collected cultures of case-patient room surfaces, sinks and ventilator equipment. S. maltophilia was recovered from room surfaces, ventilator expiratory circuits and a temperature sensor which had been kept in ambient air after disinfection. Patients and environmental isolates were examined by RAPD-PCR. Three clinical isolates and one environmental isolate had the same profile, which suggests cross-contamination or common source exposure. The outbreak was controlled by adequate disinfection of the temperature sensors. No single epidemic strain was identified but several observations support the conclusion that the temperature probes contributed to the outbreak.
Clinical Nutrition, 2002
The microbiological quality of a 1-l closed enteral feeding system (CS) was prospectively monitor... more The microbiological quality of a 1-l closed enteral feeding system (CS) was prospectively monitored under clinical conditions simulating cyclic feeding over a 24-h period in geriatric patients. Method: The set was connected after diet sampling (T0). After 5-h feeding, the set was disconnected and a sample taken (T5). Diet was sampled after12 h before (T12A) and after a10 ml diet-flush of the set (T12B), after 24-h (T24) and in the pouch (P24). Concentrations of microorganisms were considered significant when above 10 4 colony-forming units per millilitre. Results:Twenty-one CS were examined.T0 samples were all sterile; 10 out of 21T5 were contaminated.The microbiological content of the diet was lower inT12B, compared toT12A (P = 0.002). None of the P24 samples was contaminated; 19 were sterile and two contained low levels of microorganisms that had been previously found in the sets. Conclusion: The CS was sterile before connecting to the patient. Retrograde contamination of the set was observed without contamination of the pouch after 24-h hanging time. Performing a diet-flush decreased the rate of diet contamination at the distal extremity of the set. Thus, cyclic enteral nutrition using the same pouch during a 24-h period seems to be safe in geriatric patients.