Deaths Related to Healthcare-Associated Infections: 2008–2017 Overview of External Reports in France—Focus on Staphylococcus aureus Bacteremia

The purpose of external reporting of healthcare-associated infections (HAIs) is to identify situations involving a risk of infection that require the implementation of control measures. One of the criteria is death attributable to a HAI. The objective of this study is to describe the reports submitted for a HAI that resulted in death. All reports of deaths related to a HAI received over a 10-year period (2008–2017) were analyzed according to their spatial and temporal distribution, as well as the characteristics of the infections and microorganisms. A textual analysis of the information accompanying reports of Staphylococcus aureus bacteremia was conducted, including an investigation into the causes of bacteremia and death. During the study period, 986 reports of HAI resulting in death were recorded. The annual proportion of these cases among all reports decreased from 11% to 4%, but two distinct periods can be observed. Between 2008 and 2012, there was an average of 103 annual reports of HAI resulting in death; subsequently, over the following period, there was a decrease of nearly 30%, with an annual average of 80 reports. These 986 reports originated primarily from intensive care units (37%), internal medicine (28%), surgery (23%), and neonatology (10%). The main infections were bacteremia (43%), pneumonia (27%), gastrointestinal infections (18%), and surgical site infections (SSI) (12%). The main microorganisms involved are Staphylococcus aureus (25%), Clostridium difficile (11%), and Pseudomonas aeruginosa (11%). Antibiotic resistance was observed in 24% of cases. Staphylococcus aureus bacteremias account for 16% (159) of these 986 reports. For these infections, textual analysis of the main contextual factors reveals the presence of a catheter (31%), endocarditis (8%), or prosthetic heart valves (6%). The analysis of reports for SSI cases resulting in death highlights Staphylococcus aureus bacteremias, particularly in neonatal units. Prevention efforts, particularly regarding catheter-related infections in vulnerable populations, must be continued.

Author(s): Deniau Nicolas, Poujol de Molliens Isabelle, Soing-Altrach Sophan, Maugat Sylvie, Berger-Carbonne Anne

Publishing year: 2020

Pages: 305-313

Weekly Epidemiological Bulletin, 2020, n° 15, p. 305-313

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