[What is the place of a geriatric follow-up ambulatory care unit in the structures developed by the 2008/2012 Alzheimer Plan?]. / Quelle est la place d’un hôpital de jour de suivi gériatrique au sein des structures développées par le Plan Alzheimer 2008/2012'.

UNLABELLED: The French 2008/2012 Alzheimer Plan is designed to improve the support given to elderly patients and their families. Objective: To describe the typology of the patients managed in a Geriatric multidimensional rehabilitation ambulatory care unit between 2008 and 2012. METHODS: Programme de médicalisation des systèmes d'information database concerning the number of concomitant diseases and several specific indicators. RESULTS: The number of patients increased between 2008 (109) and 2009 (293) but then remained stable (about 300). The differences between 2008 and subsequent years were statically significant for the number of concomitant diseases (p < 0.001) and the number of days/patients (p < 0.01), but not for 2009-2012. CONCLUSION: The variations seem to be related to implementation of the Alzheimer Plan and a change in the organization of French gerontology health networks.

Impact of an Antimicrobial Stewardship Program on Resistance to Fluoroquinolones of Urinary Enterobacteriaceae Isolated From Nursing Home Residents: A Retrospective Cohort Study.

OBJECTIVES: This study investigated the impact of an antimicrobial stewardship program on fluoroquinolone (FLQ) resistance in urinary Enterobacteriaceae isolated from residents of 3 French nursing homes. DESIGN: A multicentric retrospective before-and-after study was conducted. SETTING AND PARTICIPANTS: All the first urinary Enterobacteriaceae isolates obtained from nursing home residents were included. Two time frames were analyzed: 2013-2015 and 2016-2017. METHODS: The antimicrobial stewardship program started in 2015 and was based on (1) 1-day training for use of an "antimicrobial stewardship kit for nursing homes;" and (2) daily support and training of the coordinating physician by an antibiotic mobile team (AMT) in 2 of 3 nursing homes. RESULTS: Overall, 338 urinary isolates were analyzed. Escherichia coli was the most frequent species (212/338, 63%). A significant reduction of resistance to ofloxacin was observed between 2013-2015 and 2016-2017 in general (Δ = -16%, P = .004) and among isolates obtained from patients hospitalized in the county nursing home with AMT support (Δ = -28%, P < .01). A nonstatistically significant reduction in ofloxacin resistance was also observed in the hospital nursing home with AMT support (Δ = -18%, P = .06). CONCLUSIONS AND IMPLICATIONS: Our antimicrobial stewardship program resulted in a decrease in resistance to FLQ among urinary Enterobacteriaceae isolated from nursing home residents. The support of an AMT along with continuous training of the coordinating physician seems to be an important component to ensure efficacy of the intervention.