Information concerning multidrug-resistant bacterial colonization or infection in the medical transfer letter.

OBJECTIVES: The aim of this study was to evaluate the proportion of transfer letters that contained information relative to infection or colonization by multidrug-resistant (MDR) bacteria and factors associated with the presence of that information. PATIENTS AND METHODS: Patients for whom at least one of these selected MDR bacteria (methicillin-resistant Staphylococcus aureus, extended-spectrum ß-lactamase-producing Enterobacteriaceae, or MDR Pseudomonas aeruginosa) was isolated during their hospitalization and who were transferred to another health care facility between 2009 and 2012 were included. Information of the MDR bacterium and the mention of isolation precautions were evaluated in the electronic medical record. RESULTS: Information (mention of MDR bacterium or isolation precaution) was present in 57% [52; 65] of records. Full information (genus and species, concept of MDR bacterium and mention of isolation precaution) was found in 20% [16; 25]. The presence of a dedicated item in the standard medical discharge letter was associated with more frequent information. Less information was retrieved with P. aeruginosa cases than with the other 2 MDR bacteria. CONCLUSION: The presence of the information has improved, but it is still insufficiently reported. Measures to improve information are needed. Indeed, information on MDR bacterial colonization or infection is the first step for isolation precautions. An item could be added to all standard medical discharge letters. An item could also be added to the indicators used to assess quality and safety in healthcare facilities.

Case fatality rates of Ebola virus diseases: a meta-analysis of World Health Organization data.

OBJECTIVE: Our objective was to estimate the case fatality rates of Zaire, Sudan, and Bundibugyo Ebola species, responsible for sometimes-lethal hemorrhagic fevers. METHODS: We performed a meta-analysis of World Health Organization data on outbreaks of infections due to theses species. RESULTS: Twenty outbreaks, including the current one, were studied. The estimated case fatality rate was 65.4% (CI 95% [54.6%; 75.5%]) and varied among the outbreaks. A species effect was identified, with a higher case fatality rate for the Zaire species than for Sudan and Bundibugyo species. The case fatality rate of the Zaire species tended to decrease with time. CONCLUSION: The case fatality rates associated with these 3 species was high. A great variability was observed. It could be explained partly by a species effect and by the decrease of Zaire species case fatality rate, with time.