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Since March 2017, a portal for reporting adverse health events (signal-sante.gouv.fr) is accessible to health professionals and users. Ultimately, it should be the only reporting platform for health professionals, says Professor Jérôme Salomon, Director General of Health (DGS), in the editorial of the "Weekly Epidemiological Bulletin" ("BEH") of 17 July, dedicated to the reporting of infections badociated with care.
The creation of this portal responds to a double regret: a too poor overall readability and lack of ergonomics systems monitoring and health safety, built in silo, and a culture of insufficient reporting in France.
Since its launch, the portal that allows you to report any adverse health event related to a product or practice, has collected more than 40,000 reports. Health professionals report pharmacovigilance cases (40%), serious events badociated with care (28%) and cases of vigilance, while users focus on pharmacovigilance (90%). With peaks in media business (like changing the Levothyrox formula).
This portal is intended to cover all health security, including surveillance; health professionals will soon be able to report health-related infections, clustered episodes of respiratory infections and acute gastroenteritis, and in the future, all notifiable diseases, says the DGS.
23,000 reports of nosocomial infections since 2001
The "BEH" reviews the dynamics of nosocomial infection reporting (SIN), mandatory for all health facilities since 2001 – afterwards have delivered a photograph in early June, on the figures of 2017.
Between 2001 and 2017, 23 012 SIN were received, affecting 100 658 patients – and more and more institutions complied with the game (73 in 2001 to 620 in 2017, ie 91% of French ES).
The reported anatomical sites are the digestive tract (in 39% of the INS), the lungs (20%) and the urinary tract infections (12%).
Multi-resistant and highly resistant bacteria in progress
Public Health France observed a sharp increase in infections involving a multi-resistant bacterium (BMR), a highly resistant bacterium emerging (BHRe) – whose curve has soared – or a Clostridium difficile, that end up accounting for 46% of nosocomial infections ( vs. 2.5% in 2001). Respectively, the BMR constitute 13% of the SIN, the BHRe, 25%, and CD, 7%.
Such an increase testifies, according to the agency, of the sensitization of the teams of hospital hygiene for their control. But also the circulation in the ES EPC strains (enterobacteria producing carbapenemase), the family of BHRe, directly related to foreign or indigenous. Public Health France reminds that to respond to this pre-epidemic situation, a specific tool for the reporting of these episodes has been available since September 2017 – which simplifies the capture of information and educates health institutions to the management measures of patients with BHRe . Finally, the widening of the reporting of infections badociated with care in medical and social institutions and the city, should allow to have a more global vision of these issues in the near future.
Nine cases of bacteremia in neonatalogy not elucidated with AP-HP
Article by Sandra Fournier (operational hygiene team, management of the medical organization, AP-HP) et al. reviews the nine cases of bacteremia in Bacillus cereus that occurred between August and December 2016 in five neonatal resuscitation units at the Paris Public Assistance Hospital. At the time, the delivery of milk from the Ile-de-France lactarium had been suspended after the contamination of three very premature babies. The retrospective investigation within AP-HP showed that the incidence of bacteremia at B. cereus had increased from 0.005 to 0.33 for 100 neonatal resuscitation admissions between 2014 and 2016, but could not be explained. No hypothesis seems obvious: contamination of batches of milk is hampered by the fact that two of the nine cases did not consume lactarian milk; a contamination of SMOFlipid, lipid emulsion administered parenterally in all cases, is unlikely in view of the large number of newborns receiving this product in France; chance does not explain the increase in incidence; another common source not yet identified can not be eliminated. This alert was an opportunity to implement improvements around the lactarium milk circuit and in hospitals, conclude the authors.
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