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OBJECTIVES: Our aim is to compare the course of the disease between healthcare workers (HCWs) and non-HCWs suffering from covid-19 and eligible for outpatient management. METHODS: Single-center prospective cohort of outpatients with covid-19, diagnosed between the 10th March and the 2nd April, 2020 with a daily collection of symptoms by an on-line auto-questionnaire. RESULTS: A total of 186 patients were included (median age, 41 years [interquartile range, 19-78 years]; 74.2% female), of whom 132 (71%) were HCWs. The median follow-up after symptom onset was 14 (min 4-max 24) days. HCWs were significantly younger than non-HCWs (median age 40.3 years vs. 47.2 years [P<0.005]), and 81.8% were women. Four patients (2.2%) were hospitalized including one HCW. The median time to recovery was 9 days after symptom onset (95% CI 8-11) in the global population and respectively 8 (95% CI 8-9) and 13 (95% CI 11-15) days in HCWs and in non-HCWs (P<0.005). After adjusting for age, co-morbidities, and gender, the instantaneous risk ratio for symptom absence in HCWs was 1.76 compared with non-HCWs (95% CI [1.16-2.67], P=0.037). CONCLUSION: HCWs suffering from covid-19 had favorable outcomes and had a shorter time to recovery than non HCWs.
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COVID-19/epidemiología , Personal de Salud/estadística & datos numéricos , Pacientes Ambulatorios/estadística & datos numéricos , Evaluación de Síntomas , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Recuperación de la Función , SARS-CoV-2 , Encuestas y CuestionariosRESUMEN
Recruitment in preventive vaccine trials (PVT) is challenging due to common barriers to clinical research and lack of vaccine confidence. Identifying determinants of participation can help to improve recruitment. A prospective survey was conducted in 5 French clinical investigational sites. People asked to participate in a PVT were given a questionnaire whether they decided to participate or not in the trial. A total of 341 people answered the survey: 210 accepting and 131 declining to participate in a PVT. Acceptors were significantly younger (38.5 vs 54.9â¯years old), more likely to be involved in early phase trials, had a higher level of education (pâ¯<â¯0.005) and a significantly better general opinion concerning vaccines (92.3% versus 72.3%, pâ¯<â¯0.005) compared with those who declined. Factors associated with acceptance or refusal were evaluated in 224 people in the 4 sites where both groups were included. In a multivariate analysis, three factors: older age, having heard about PVT through multiple sources and financial incentives were significantly associated with refusal to participate in the PVT. A generally favourable opinion of vaccines was associated with acceptance. The main motivation for participation was altruism (93.2%) whereas fear of side effects was at the forefront of the barriers (36.6%). Information given by the physician was a key point for decision-making in 70.2% of those who accepted. In brief, vaccine hesitancy may decrease recruitment in PVTs; reinforcing altruism and quality of information given are key points in acceptance of participation in PVT.
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Ensayos Clínicos como Asunto , Motivación , Selección de Paciente , Vacunas , Adulto , Anciano , Ensayos Clínicos como Asunto/psicología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Vacunas/administración & dosificación , Vacunas/inmunologíaRESUMEN
BACKGROUND: Acute kidney injury (AKI) is associated with high case fatality in infective endocarditis (IE), but epidemiological data on the frequency of AKI during IE is scarce. We aimed to describe the frequency and risk factors for AKI during the course of IE using Kidney Disease: Improving Global Outcomes consensual criteria. METHODS: Using the French hospital discharge database (French acronym PMSI), we retrospectively reviewed the charts of 112 patients presenting with a first episode of probable or definite IE between January 2010 and May 2015. RESULTS: Seventy-seven patients (68.8%) developed AKI. In univariate analysis, risk factors for AKI were cardiac surgery for IE (n=29, 37.7% vs. n=4, 1.4%, P<0.0005), cardiac failure (n=29, 36.7% vs. n=1, 2.9%, P<0.0005), diabetes mellitus (n=14, 18.2% vs. n=1, 0.9%, P=0.034), and prosthetic valve IEs (n=24, 31.2% vs. n=4, 11.4%). No differences were observed for gentamicin exposure (n=57, 64% vs. n=32, 86.5%, P=0.286). Prosthetic valve IE, cardiac failure, and vancomycin exposure were independently associated with AKI with respective odds ratio of 5.49 (95% CI 1.92-17.9), 4.37 (95% CI 4.37-465.7), and 1.084 (1.084-16.2). Mean length of hospital stay was significantly longer in patients presenting with AKI than in controls (respectively 52.4±22.1 days vs. 39.6±12.6, P<0.005). CONCLUSION: AKI is very frequent during IE, particularly in patients with prosthetic valve IE, cardiac failure, and those receiving vancomycin.
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Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/microbiología , Endocarditis/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Travelers may be responsible for the spread of vaccine-preventable diseases upon return. Travel physicians and family physicians may play a role in checking and updating vaccinations before traveling. Our aim was to evaluate the vaccine coverage for mandatory and recommended vaccination in travelers attending a travel medicine clinic (TMC). METHODS: Vaccine coverage was measured using the current French immunization schedule as reference for correct immunization, in travelers providing a vaccination certificate during the TMC visit (university hospital of Saint-Étienne), between August 1, 2013 and July 31, 2014. RESULTS: In total, 2336 travelers came to the TMC during the study period. Among the 2019 study participants, only 1216 (60.3%) provided a vaccination certificate. Travelers who provided a vaccination certificate were significantly younger than travelers who did not (mean age: 34.8±17.8 vs. 46±18.4 years, P<0.005) and were less likely to be Hajj pilgrims. Vaccine coverage against Tetanus, Diphtheria, and Poliomyelitis (Td/IPV vaccine) was 91.8%, 78.6% against Measles, Mumps, and Rubella (MMR), and 59.4% against Viral Hepatitis B (HBV). BCG vaccine coverage was 71.9%. Older travelers were less likely to be correctly vaccinated, except against HBV as vaccinated travelers were significantly older than unvaccinated travelers. CONCLUSION: Obtaining information about immunization in travelers is difficult. Coverage for routine vaccines should be improved in this population. Travel medicine consultations could be the opportunity to vaccinate against MMR, HBV, and Td/IPV.
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Mejoramiento de la Calidad , Derivación y Consulta , Medicina del Viajero , Cobertura de Vacunación , Adolescente , Adulto , Anciano , Certificación , Niño , Estudios Transversales , Femenino , Francia/epidemiología , Humanos , Esquemas de Inmunización , Masculino , Registros Médicos/normas , Registros Médicos/estadística & datos numéricos , Persona de Mediana Edad , Mejoramiento de la Calidad/normas , Derivación y Consulta/normas , Derivación y Consulta/estadística & datos numéricos , Viaje/estadística & datos numéricos , Medicina del Viajero/métodos , Medicina del Viajero/organización & administración , Medicina del Viajero/normas , Medicina del Viajero/estadística & datos numéricos , Cobertura de Vacunación/organización & administración , Cobertura de Vacunación/normas , Cobertura de Vacunación/estadística & datos numéricos , Adulto JovenRESUMEN
OBJECTIVE: To estimate the benefits of iterative prevalence surveys in detecting trends of hospital-acquired infections (HAIs). METHODS: On the basis of the French protocol for national prevalence studies, HAI data of 15 consecutive annual surveys performed at the same period by the same group of investigators was gathered in a single database to describe the trend of HAIs in a University Hospital over a 15-year period. RESULTS: A total of 20,401 patients were included. Overall, the prevalence of patients presenting with at least one HAI acquired in our University Hospital was 5.1% [95% CI, 4.8-5.4%]. The prevalence of HAIs and antimicrobial drug use significantly decreased over time (P<0.01). CONCLUSION: Despite limitations, repeated prevalence surveys can be a useful tool for promoting control measures to better prevent HAIs.
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Infección Hospitalaria/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Niño , Preescolar , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/prevención & control , Estudios Transversales , Utilización de Medicamentos/tendencias , Femenino , Francia/epidemiología , Encuestas Epidemiológicas , Hospitales Universitarios , Humanos , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Tiempo , Adulto JovenRESUMEN
This paper is about a Brugada syndrome (BS) of accidental discovery in a patient from Benin during an intestinal shigellosis episode in the infectiology department of university hospital of Saint-Etienne, France. Authors establish a link between these two diseases. After a literature's review, they underline that BS is under-diagnosed in Africa. Furthermore, they highlight socio-cultural characteristics of sudden deaths in West Africa including BS.
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Síndrome de Brugada/complicaciones , Síndrome de Brugada/diagnóstico , Disentería Bacilar/complicaciones , Disentería Bacilar/diagnóstico , Benin , Diagnóstico Diferencial , Disentería Bacilar/patología , Hospitales Universitarios , Humanos , Hallazgos Incidentales , Masculino , Anamnesis , Persona de Mediana EdadRESUMEN
OBJECTIVES: To evaluate concordance between glomerular filtration rate (GFR) estimates (Cockcroft and Gault, modification of diet in renal diseases, chronic kidney disease epidemiology study group equations) for drug dosing in HIV-infected patients. PATIENTS AND METHODS: We performed a monocentric study. GFR was measured using the gold standard method (plasma clearance of iohexol) in 230 HIV-infected patients. Concordance rate was evaluated between measured GFR (mGFR) and estimated GFR (eGFR) for different GFR categories (GFR>90 mL/min, GFR<90 mL/min, GFR>70 mL/min, and GFR<70 mL/min). MDRD and CKD-EPI were used with and without indexation to body surface area (BSA). RESULTS: Mean age was 48±10 years, mean mGFR was 101±26 mL/min. Concordance between mGFR and eGFR estimated with CG, CKD-EPI (indexed and not indexed to BSA), or MDRD equations (not indexed to BSA) was similar (73%, 73%, 74%, and 73% respectively) for a breakpoint value of 90 mL/min for GFR. At this value, the concordance rate between mGFR and MDRD indexed to BSA was significantly lower (65%, P<0.05). Using 70 mL/min of GFR as the breakpoint value, all equations had similar concordance rates with mGFR (with or without indexation to BSA). CONCLUSION: CKD-EPI equation has the same concordance with GFR and with CG when used for drug dosing.
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Algoritmos , Fármacos Anti-VIH/administración & dosificación , Tasa de Filtración Glomerular , Infecciones por VIH/complicaciones , Pruebas de Función Renal/métodos , Insuficiencia Renal Crónica/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Fármacos Anti-VIH/farmacocinética , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Comorbilidad , Factores de Confusión Epidemiológicos , Creatinina/sangre , Errores Diagnósticos , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Yohexol/análisis , Pruebas de Función Renal/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/complicaciones , Carga Viral , Adulto JovenRESUMEN
OBJECTIVE: The management of infective endocarditis (IE) may differ from international guidelines, even in reference centres. This is probably because most recommendations are not based on hard evidence, so the consensus obtained for the guidelines does not represent actual practices. For this reason, we aimed to evaluate this question in the particular field of antibiotic therapy. METHODS: Thirteen international centres specialized in the management of IE were selected, according to their reputation, clinical results, original research publications and quotations. They were asked to detail their actual practice in terms of IE antibiotic treatment in various bacteriological and clinical situations. They were also asked to declare their IE-related in-hospital mortality for the year 2015. RESULTS: The global compliance with guidelines concerning antibiotic therapy was 58%, revealing the differences between theoretical 'consensus', local recommendations and actual practice. Some conflicts of interest were also probably expressed. The adherence to guidelines was 100% when the protocol was simple, and decreased with the seriousness of the situation (Staphylococus spp. 54%-62%) or in blood-culture-negative endocarditis (0%-15%) that requires adaptation to clinical and epidemiological data. CONCLUSION: Worldwide experts in IE management, although the majority of them were involved and co-signed the guidelines, do not follow international consensus guidelines on the particular point of the use of antibiotics.
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Antibacterianos/uso terapéutico , Endocarditis/tratamiento farmacológico , Adhesión a Directriz , Endocarditis/mortalidad , Mortalidad Hospitalaria , Humanos , Análisis de SupervivenciaRESUMEN
INTRODUCTION: The recruitment of volunteers in preventive vaccine trials (PVT) is a challenge, since vaccine hesitancy and debates on vaccines are combined to usual difficulties of enrollment in clinical trials. Areas covered: Current knowledge of the reasons leading to the volunteers' participation or non-participation in PVT mainly focuses on data from preventive HIV vaccine trials. A systematic PubMed search was conducted using PRISMA guidelines to identify articles or reviews that reported barriers and motivations to participation in PVT regardless of the targeted disease or population. Expert commentary: In view of the barriers and motivations reviewed here, improvements in recruitment could be made through a better explanation of the prevented disease, of the expected individual and collective benefit and of all ethical protective principles associated to the trials. Use of decision aids as well as patient and public involvement may improve given information and may enhance comprehension of participants and their participation in PVT. Further prospective and interventional studies are needed to analyze if these leads may improve acceptation level in PVT.
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Ensayos Clínicos como Asunto , Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud , Vacunas/administración & dosificación , Vacunas/inmunología , Voluntarios , HumanosRESUMEN
OBJECTIVE: We aimed to describe the management of a carbapenemase-producing Acinetobacter baumannii (CP-AB) outbreak using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement. We also aimed to evaluate the cost of the outbreak and simulate costs if a dedicated unit to manage such outbreak had been set-up. METHODS: We performed a prospective epidemiological study. Multiple interventions were implemented including cohorting measures and limitation of admissions. Cost estimation was performed using administrative local data. RESULTS: Five patients were colonized with CP-AB and hospitalized in the neurosurgery ward. The index case was a patient who had been previously hospitalized in Portugal. Four secondary colonized patients were further observed within the unit. The strains of A. baumannii were shown to belong to the same clone and all of them produced an OXA-23 carbapenemase. The closure of the ward associated with the discharge of the five patients in a cohorting area of the Infectious Diseases Unit with dedicated staff put a stop to the outbreak. The estimated cost of this 17-week outbreak was $474,474. If patients had been managed in a dedicated unit - including specific area for cohorting of patients and dedicated staff - at the beginning of the outbreak, the estimated cost would have been $189,046. CONCLUSION: Controlling hospital outbreaks involving multidrug-resistant bacteria requires a rapid cohorting of patients. Using simulation, we highlighted cost gain when using a dedicated cohorting unit strategy for such an outbreak.
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Infecciones por Acinetobacter/microbiología , Acinetobacter baumannii/enzimología , Proteínas Bacterianas/análisis , Infección Hospitalaria/microbiología , Brotes de Enfermedades , Farmacorresistencia Bacteriana Múltiple , Resistencia betalactámica , beta-Lactamasas/análisis , Infecciones por Acinetobacter/economía , Infecciones por Acinetobacter/epidemiología , Acinetobacter baumannii/efectos de los fármacos , Anciano , Anciano de 80 o más Años , Infección Hospitalaria/economía , Infección Hospitalaria/epidemiología , Francia/epidemiología , Gastos en Salud/estadística & datos numéricos , Costos de Hospital/estadística & datos numéricos , Departamentos de Hospitales , Unidades Hospitalarias/economía , Hospitales Universitarios/economía , Humanos , Infectología , Masculino , Persona de Mediana Edad , Neurocirugia , Aislamiento de Pacientes/economía , Estudios Prospectivos , Centros de Atención Terciaria/economíaRESUMEN
Staphylococcus aureus nasal colonization is a well-known independent risk factor for infection caused by this bacterium. Screening and decolonization of carriers have been proven effective in reducing S. aureus infections in some populations. However, a gap remains between what has been proven effective and what is currently done. We aimed to summarize recommendations and current knowledge of S. aureus decolonization to answer the following questions: Why? For whom? How? When? And what are the perspectives?
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Portador Sano/microbiología , Portador Sano/prevención & control , Infecciones Estafilocócicas/prevención & control , Staphylococcus aureus/aislamiento & purificación , Portador Sano/diagnóstico , Humanos , Guías de Práctica Clínica como Asunto , Infecciones Estafilocócicas/diagnósticoRESUMEN
To gain knowledge about vaccine hesitancy among general practitioners (GPs), we conducted a survey to compare their vaccination attitudes for themselves, their children and their patients. A questionnaire survey was sent to GPs working in private practice in the Rhône-Alpes region, France, between October 2013 and January 2014. GPs' immunisation practices for diphtheria-tetanus-poliomyelitis (DTP), measles-mumps-rubella (MMR), pneumococcal, pertussis, hepatitis B (hepB), human papillomavirus (HPV), seasonal and H1N1 influenza and meningococcal C (menC) vaccines were considered. Divergence was defined by the presence of at least one different immunisation practice between their patients and their children. A total of 693 GPs answered the questionnaire. When considering all investigated vaccines, 45.7 % of divergence was found. Individually, divergence was highest for the newest and more controversial, i.e. HPV (11.8 %), hepB (13.1 %), menC (23.7 %) and pneumococcal (19.8 %) vaccines. Only 73.9 % of GPs declared that they recommended HPV vaccine for their daughters. After multivariate analysis, older age was associated with higher risk of divergence. According to the French 2012 recommendations, GPs were insufficiently immunised, with 88 % for DTP and 72 % for pertussis. GPs declared to recommend vaccination against DTP, pertussis and MMR for their patients and their children in more than 95 % of cases. The declared rates of recommendation were lower than 90 % for other vaccines. These results bring new insight about vaccine hesitancy. GPs have divergent immunisation attitudes toward their relatives and their patients, especially when considering the newest and most controversial vaccines, with HPV vaccine being the main focus of controversies.
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Actitud del Personal de Salud , Médicos Generales/psicología , Pautas de la Práctica en Medicina , Vacunación/psicología , Vacunas/administración & dosificación , Adulto , Factores de Edad , Anciano , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
Complement system is a part of innate immunity, its main function is to protect human from bacterial infection. As genetic disorders, complement deficiencies are often diagnosed in pediatric population. However, complement deficiencies can also be revealed in adults but have been poorly investigated. Herein, we describe a case series of infections revealing complement deficiency in adults to study clinical spectrum and management of complement deficiencies.A nationwide retrospective study was conducted in French university and general hospitals in departments of internal medicine, infectious diseases enrolling patients older than 15 years old who had presented at least one infection leading to a complement deficiency diagnosis.Forty-one patients included between 2002 and 2015 in 19 different departments were enrolled in this study. The male-to-female ratio was 1.3 and the mean age at diagnosis was 28â±â14 (15-67) years. The main clinical feature was Neisseria meningitidis meningitis 75% (nâ=â31/41) often involving rare serotype: Y (nâ=â9) and W 135 (nâ=â7). The main complement deficiency observed was the common final pathway deficiency 83% (nâ=â34/41). Half of the cohort displayed severe sepsis or septic shock at diagnosis (nâ=â22/41) but no patient died. No patient had family history of complement deficiency. The mean follow-up was 1.15â±â1.95 (0.1-10) years. Half of the patients had already suffered from at least one infection before diagnosis of complement deficiency: meningitis (nâ=â13), pneumonia (nâ=â4), fulminans purpura (nâ=â1), or recurrent otitis (nâ=â1). Near one-third (nâ=â10/39) had received prophylactic antibiotics (cotrimoxazole or penicillin) after diagnosis of complement deficiency. The vaccination coverage rate, at the end of the follow-up, for N meningitidis, Streptococcus pneumonia, and Haemophilius influenzae were, respectively, 90% (nâ=â33/37), 47% (nâ=â17/36), and 35% (nâ=â14/34).This large study emphasizes that complement deficiencies can be revealed in adults by infectious episodes. Most of them were meningococcal infections revealing common final pathway deficiency. To avoid undiagnosis or late diagnosis, adult displaying first episode of N meningitidis infection should be tested for complement deficiency.
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Infecciones Bacterianas/inmunología , Proteínas del Sistema Complemento/deficiencia , Diagnóstico Tardío , Adolescente , Adulto , Factores de Edad , Anciano , Infecciones Bacterianas/tratamiento farmacológico , Complejo de Ataque a Membrana del Sistema Complemento/deficiencia , Femenino , Francia , Humanos , Masculino , Meningitis Meningocócica/inmunología , Meningitis Meningocócica/microbiología , Persona de Mediana Edad , Neisseria meningitidis , Otitis Media/inmunología , Neumonía/inmunología , Púrpura Fulminante/inmunología , Estudios Retrospectivos , Sepsis/inmunología , Choque Séptico/inmunología , Adulto JovenRESUMEN
Mobile phones (MPs) are potential reservoirs of nosocomial bacteria, but few data are available concerning viruses. We aimed to evaluate the presence of virus RNA from epidemic viruses including metapneumovirus, respiratory syncytial virus, influenza viruses, rotavirus (RV) and norovirus on the MPs used by healthcare workers (HCWs) and to relate it to hygiene measures. An anonymous behavioural questionnaire about MP use at hospital was administered to the HCWs of four adult and paediatric departments of a university hospital. After sampling personal (PMP) and/or professional MPs (digital enhanced cordless telephone, DECT), virus RNAs were extracted and amplified by one-step real-time reverse transcription-quantitative PCR. The molecular results were analysed in a masked manner in relation to the behavioural survey. Questionnaires from 114 HCWs (25 [corrected] senior physicians, 30 residents, 32 nurses, 27 nurses' assistants) working either in adult (n = 58) or paediatric (n = 56) departments were analysed. Medical personnel used their PMP more frequently than paramedical HCWs (33/65 vs. 10/59, p <0.001). MPs were used during care more frequently in adult wards than in paediatric ones (46/58 vs. 27/56, p <0.001). Virus RNA was detected on 42/109 (38.5%) collected MPs, with RV found on 39, respiratory syncytial virus on three and metapneumovirus on one. The presence of virus RNA was significantly associated with MPs from the paediatric HCWs (p <0.001). MPs routinely used in hospital, even during care, can host virus RNA, especially RV. Promotion of frequent hand hygiene before and after MP use, along with frequent cleaning of MPs, should be encouraged.
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Teléfono Celular , Personal de Salud , Virus ARN/aislamiento & purificación , ARN Viral/análisis , Adulto , Femenino , Hospitales Universitarios , Humanos , Masculino , Virus ARN/clasificación , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: Compliance with advanced isolation precautions (IPs) is crucial to reduce healthcare-associated infections. Our aim was to evaluate physician's knowledge and attitudes related to IPs. METHODS: An online questionnaire was sent to our hospital's physicians (attending physicians and residents). RESULTS: A total of 111 physicians completed the questionnaire: 60 (54%) attending physicians and 51 (46%) residents. Overall, respondents had a poor knowledge of the three types of IPs, especially droplet precautions (13 correct answers, 11.7%) and airborne IP (17 correct answers, 16.3%). We observed a statistically significant difference between attending physicians and residents for the type of IP to prescribe to a patient presenting with multidrug-resistant urinary infection: 44 residents (86%) gave the correct answer vs 42 attending physicians (70%), P=0.04. Physicians (both residents and attending physicians) who were already familiar with the dedicated webpage available on the hospital's intranet (n=40) obtained a score of 4.75/10 (±2.0) compared with 4.03/10 (±1.7) for those who had never used that tool (n=71). The difference was statistically significant (P=0.04). The average score for both residents and attending physicians was 4.3/10 (±1.9, range: 1-10). Attending physicians' and residents' scores were 4/10 (±1.8) and 4.5/10 (±1.9), respectively, but the difference was not statistically significant (P=0.14). CONCLUSION: Physicians' knowledge of IPs was insufficient. Improvement in medical training is needed. The use of a dedicated webpage on hospitals' intranet could help physicians acquire better knowledge on that matter.
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Infección Hospitalaria/prevención & control , Educación Médica Continua , Internado y Residencia , Cuerpo Médico de Hospitales/educación , Aislamiento de Pacientes/métodos , Aerosoles , Redes de Comunicación de Computadores , Infección Hospitalaria/transmisión , Evaluación Educacional , Francia , Adhesión a Directriz , Conocimientos, Actitudes y Práctica en Salud , Necesidades y Demandas de Servicios de Salud , Hospitales Universitarios , Humanos , Conducta en la Búsqueda de Información , Guías de Práctica Clínica como Asunto , Encuestas y Cuestionarios , Precauciones UniversalesAsunto(s)
Lesión Renal Aguda/etiología , Virus BK/aislamiento & purificación , Trasplante de Células Madre de Sangre del Cordón Umbilical/efectos adversos , Infecciones por Polyomavirus/complicaciones , Infecciones Tumorales por Virus/complicaciones , Antibacterianos/uso terapéutico , Virus BK/fisiología , Ciprofloxacina/uso terapéutico , Infecciones por Citomegalovirus/complicaciones , Enfermedad Injerto contra Huésped/complicaciones , Enfermedad Injerto contra Huésped/tratamiento farmacológico , Enfermedad Injerto contra Huésped/terapia , Humanos , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Isoxazoles/uso terapéutico , Leflunamida , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/complicaciones , Síndromes Mielodisplásicos/terapia , Plasmaféresis , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/virología , Carga Viral , Viremia/diagnóstico , Viremia/etiología , Activación ViralRESUMEN
During the 2012 Hajj season, the risk of acquisition of Staphylococcus aureus nasal carriage in a cohort of French pilgrims was 22.8%, and was statistically associated with the acquisition of viral respiratory pathogens (p 0.03). The carriage of S. aureus belonging to the emerging clonal complex 398 significantly increased following the pilgrimage (p < 0.05).