La tunisie Medicale - 2021 ; Vol 99 ( n°012 ) : 1148-1155
[ Vu 2403 fois ]
Résumé

Introduction : Les infections associées aux soins (IAS) représentent une menace réelle pour la sécurité des patients et leur prévention devrait être une priorité pour tout système de santé. Les enquêtes de prévalence constituent l'une des méthodes les plus courantes de surveillance épidémiologique des IAS dans le but de déterminer le fardeau de ce problème.
Objectif : Déterminer la prévalence de l'IAS et ses facteurs de risque associés.
Méthodes : Il s'agit d'une étude transversale descriptive, réalisée au CHU Farhat Hached en 2019, sur une période de 9 jours incluant tous les patients hospitalisés depuis au moins 48 heures, dans 21 services cliniques de notre hôpital. Un seul passage a été effectué par service. Résultats : Sur 373 patients inclus, un total de 66 patients ont présenté une IAS, avec une prévalence moyenne de 17,7 %, quatre patients ont présenté plus qu’une IAS. La prévalence moyenne des IAS au CHU Farhat Hached était de 19 %. Les infections associées aux cathéters veineux périphériques (41,5%) représentaient l’IAS la plus fréquente. Les patients admis dans un service chirurgical étaient 4,6 fois plus susceptibles de contracter une IAS. Les patients hospitalisés pour plus de 7 jours étaient 4,57 fois plus à risque de développer une IAS. L'exposition au cathéter veineux périohérique, au cathéter veineux central et à la ventilation mécanique étaient parmi les facteurs de risque indépendants de l'IAS avec un OR ajusté, respectivement de 4,90; 10,65 et 11,99.
Conclusion : La prévalence de l'IAS est élevée dans notre CHU. Une stratégie nationale pour la prévention des IAS doit être instaurée pour un meilleur contrôle de ce problème de santé.

Mots Clés
Article
Références
  1. 1. Allegranzi B, Nejad SB, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. The Lancet 2011;377(9761):228-41. 2. Zimlichman E, Henderson D, Tamir O, Franz C, Song P, Yamin CK, et al. Health Care–Associated Infections: A Meta-analysis of Costs and Financial Impact on the US Health Care System. JAMA Intern Med 2013;173(22):2039. 3. Safdar N, Abad C. Educational interventions for prevention of healthcare-associated infection: A systematic review: Crit Care Med 2008;36(3):933-40. 4. Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections – an overview. Infect Drug Resist 2018;11:2321-33. 5. Caparros AC, Wyckoff M. Infection Control Interventions to Improve Hospital-Acquired Infection Rates in Adult- Geriatric Patients. J Prev Infect Control 2020;6(2). 6. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011;32(2):101-14. 7. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet Lond Engl 2011;377(9761):228-41. 8. Rosenthal V D , Maki D, Graves N. The International Nosocomial Infection Control Consortium (INICC): goals and objectives, description of surveillance methods, and operational activities. Am J Infect Control 2008; 36. [cited 2020 Nov 23]. Available from: https://pubmed.ncbi.nlm.nih.gov/18992646/ 9. Mitchell R, Taylor G, Rudnick W, Alexandre S, Bush K, Forrester L, et al. Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys. Can Med Assoc J 2019;191(36):E981-8. 10. ECDC updated tools for point prevalence surveys of healthcare-associated infections and antimicrobial use in European acute care hospitals and long-term care facilities. Hygienes 2016 [cited 2020 Dec 5]. Available from: https://www.hygienes.net/ecdc/ecdc-updated-tools-for-point-prevalence-surveys-of-healthcare-associated-infections-and-antimicrobial-use-in-european-acute-care-hospitals-and-long-term-care-facilities/ 11. Ontario, Provincial Infectious Diseases Advisory Committee, Public Health Ontario. Best practices for surveillance of health care-associated infections in patient and resident populations. Toronto: Public Health Ontario 2014. 12. Gravel D, Taylor G, Ofner M, Johnston L, Loeb M, Roth VR, et al. Point prevalence survey for healthcare-associated infections within Canadian adult acute-care hospitals. J Hosp Infect 2007;66(3):243-8. 13. Yallew WW, Kumie A, Yehuala FM. Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in Ethiopia. Drug Healthc Patient Saf 2016;8:71-6. 14. Annabi Attia Th, DhidahL, HamzaR, kibechM, Lepoutre-toulemon, A. The first national Tunisian nosocomial infection prevalence survey: main results. Hygienes 2007;15(2):144-9. 15. Chelly S, Rjaibi S, Letaif H, Bouguerra H, Hechaicha A, Saffar F, Cherif A, Missaoui Lamia, Bahrini A, Ben Alaya N. [Epidemiology of Nosocomial Infections in Aged Subjects: Results of the Nosotun National Survey 2012]. ME-JAA 2017;14(2). 16. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36(5):309-32. 17. Debbie Weston. Infection Prevention and Control: Theory and Clinical Practice for Healthcare Professionals | Wiley. Wiley.com. [cited 2020 Nov 30]. Available from: https://www.wiley.com/en-us/Infection+Prevention+and+Control%3A+Theory+and+Clinical+Practice+for+Healthcare+Professionals-p-9780470988091 18. Lyytikäinen O, Kanerva M , Agthe N, Möttönen T, Ruutu P, Finnish Prevalence Survey Study Group. Healthcare-associated infections in Finnish acute care hospitals: a national prevalence survey, 2005. J Hosp Infect 2008:69. 19. Daniau C, Léon L, Berger-Carbonne A. National survey of the prevalence of nosocomial infections and anti-infectious treatments in health care facilities, May-June 2017: regional summary of the results. 2019:270. [cited 2020 Dec 3]. Available from:: /import/enquete-nationale-de-prevalence-des-infections-nosocomiales-et-des-traitements-anti-infectieux-en-etablissements-de-sante-mai-juin-2017 20. Krieger E, Grjibovski A, Samodova O, Eriksen H. Healthcare-associated infections in Northern Russia: Results of ten point-prevalence surveys in 2006–2010. Medicina (Mex) 2015;37. 21. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA.Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014; 370:1198-1208. 22. Tao X-B, Qian L-H, Li Y, Wu Q, Ruan J-J, Cai D-Z, et al. Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients. Int J Infect Dis 2014;27:7-9. 23. Askarian M, Yadollahi M, Assadian O. Point prevalence and risk factors of hospital acquired infections in a cluster of university-affiliated hospitals in Shiraz, Iran. J Infect Public Health 2012;5(2):169-76. 24. Kumar A , Biswal M, Dhaliwal N, Mahesh R, Appannanavar S B, Gautam V et al. Point prevalence surveys of healthcare-associated infections and use of indwelling devices and antimicrobials over three years in a tertiary care hospital in India. J Hosp Infect 2014;86. 25. Balkhy HH, Cunningham G, Chew FK, Francis C, Al Nakhli DJ, Almuneef MA, et al. Hospital- and community-acquired infections: a point prevalence and risk factors survey in a tertiary care center in Saudi Arabia. Int J Infect Dis IJID Off Publ Int Soc Infect Dis 2006;10(4):326-33. 26. Faria S, Sodano L, Gjata A, Dauri M, Sabato AF, Bilaj A, et al. The first prevalence survey of nosocomial infections in the University Hospital Centre ‘Mother Teresa’ of Tirana, Albania. J Hosp Infect 2007;65(3):244-50. 27. Ahoyo TA, Bankolé HS, Adéoti FM, Gbohoun AA, Assavèdo S, Guénou MA, et al Prevalence of nosocomial. infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012. Antimicrob Resist Infect Control 2014;3:17. 28. Öncül O, Keskin Ö, Acar HV, Küçükardalı Y, Evrenkaya R, Atasoyu EM, et al. Hospital-acquired infections following the 1999 Marmara earthquake. J Hosp Infect 2002;51(1):47‑51. 29. Jroundi I, Khoudri I, Azzouzi A, Zeggwagh A, Benbrahim N, Hassouni F, et al. Prevalence of hospital-acquired infection in a Moroccan university hospital. Am J Infect Control 2007;35:412-6. 30. Kallel H, Bahoul M, Ksibi H, Dammak H, Chelly H, Hamida CB, et al. Prevalence of hospital-acquired infection in a Tunisian hospital. J Hosp Infect 2005;59(4):343-7. 31. Mahjoub M, Bouafia N, Bannour W, Masmoudi T, Bouriga R, Hellali R, et al. Healthcare-associated infections in a tunisian university hospital: from analysis to action. Pan Afr Med J 2015;20:197 32. Liu JY, Wu YH, Cai M, Zhou CL. Point-prevalence survey of healthcare-associated infections in Beijing, China: a survey and analysis in 2014. J Hosp Infect 2016;93(3):271-9. 33. Lanini S, Jarvis WR, Nicastri E, Privitera G, Gesu G, Marchetti F, et al. Healthcare-Associated Infection in Italy: Annual Point-Prevalence Surveys, 2002-2004. Infect Control Hosp Epidemiol 2009;30(10):1029 34. Gravel D, Taylor G, Ofner M , Johnston L , Loeb M, Roth V.R, et al. Point prevalence survey for healthcare-associated infections within Canadian adult acute-care hospitals. J Hosp Infect 2007;66 : 243-48 35. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014;370(13):1198-208. 36. Klavs I, Bufon Luznik T, Skerl M, Grgic-Vitek M, Lejko Zupanc T, Dolinsek M, et al. Prevalance of and risk factors for hospital-acquired infections in Slovenia-results of the first national survey, 2001. J Hosp Infect 2003;54(2):149-57. 37. Dumpis U, Balode A, Vigante D, Narbute I, Valinteliene R, Pirags V, et al. Prevalence of nosocomial infections in two Latvian hospitals. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull 2003;8(3):73-8. 38. Rhazi KE, Nejjari C, Kanjaa N, Tachfouti N, Qarmiche N, Berraho M, et al. [Prevalence of nosocomial infections and its risk factors]. Maroc Méd 2008;30(1). 39. Yoo S, Ha M, Choi D, Pai H. Effectiveness of surveillance of central catheter-related bloodstream infection in an ICU in Korea. Infect Control Hosp Epidemiol 2001;22(7):433-6. 40. Mary Alexander Naomi P. O’Grady, Burns LA, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for the Prevention of Intravascular Catheter-Related Infections 2011. 41. Warren DK, Cosgrove SE, Diekema DJ, Zuccotti G, Climo MW, Bolon MK, et al. A multicenter intervention to prevent catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 2006;27(7):662-9. 42. Coopersmith CM, Rebmann TL, Zack JE, Ward MR, Corcoran RM, Schallom ME, et al. Effect of an education program on decreasing catheter-related bloodstream infections in the surgical intensive care unit. Crit Care Med 2002;30(1):59-64. 43. Mitchell B, Gardner A. A model for influences on reliable and valid health care-associated infection data. Am J Infect Control 2013;42.
Espace membre
E-mail :
Mot passe :
Mémoriser Mot de passe oublié S'inscrire
Archives
2022
Janvier
Février
Mars
Avril
Mai
Juin
Juillet
Août
Septembre
Octobre
Novembre
Décembre
Mots-clés
Enfant traitement Chirurgie pronostic diagnostic Tunisie Maladie de crohn dépistage Cancer du sein Cancer Coelioscopie Immunohistochimie mammographie Mortalité prévention
Newsletter
S'inscrire pour recevoir les newsletters
E-mail :
Partagez
Rejoignez-nous !