Improved quality of care for patients infected or colonised with ESBL-producing Enterobacteriaceae in a French teaching hospital: impact of an interventional prospective study and development of specific tools

  • Véronique Mondain
  • Florence Lieutier
  • Céline Pulcini
  • Nicolas Degand
  • Luce Landraud
  • Raymond Ruimy
  • Thierry Fosse
  • Pierre Marie Roger
Original Article

Abstract

The increasing incidence of ESBL-producing Enterobacteriaceae (ESBL-E) in France prompted the publication of national recommendations in 2010. Based on these, we developed a toolkit and a warning system to optimise management of ESBL-E infected or colonised patients in both community and hospital settings. The impact of this initiative on quality of care was assessed in a teaching hospital. The ESBL toolkit was developed in 2011 during multidisciplinary meetings involving a regional network of hospital, private clinic and laboratory staff in Southeastern France. It includes antibiotic treatment protocols, a check list, mail templates and a patient information sheet focusing on infection control. Upon identification of ESBL-E, the warning system involves alerting the attending physician and the infectious disease (ID) advisor, with immediate, advice-based implementation of the toolkit. The procedure and toolkit were tested in our teaching hospital. Patient management was compared before and after implementation of the toolkit over two 3-month periods (July–October 2010 and 2012). Implementation of the ESBL-E warning system and ESBL-E toolkit was tested for 87 patients in 2010 and 92 patients in 2012, resulting in improved patient management: expert advice sought and followed (16 vs 97%), information provided to the patient’s general practitioner (18 vs 63%) and coding of the condition in the patient’s medical file (17 vs 59%), respectively. Our multidisciplinary strategy improved quality of care for in-patients infected or colonised with ESBL-E, increasing compliance with national recommendations.

Notes

Acknowledgements

We thank Brigitte Dunais for her assistance in preparing this manuscript.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.InfectiologieCentre Hospitalo-Universitaire de NiceNiceFrance
  2. 2.PharmacieCentre Hospitalo-Universitaire de NiceNiceFrance
  3. 3.BactériologieCentre Hospitalo-Universitaire de NiceNiceFrance
  4. 4.HygièneCentre Hospitalo-Universitaire de NiceNiceFrance

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