Indicators for comparing and understanding differences in antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) for benchmarking are essential to identify priorities for hospitals. We measured the incidence of hospital-acquired or resistant Gram-negative bacilli bloodstream infections (GNB-BSI) in a large public healthcare consortium in the Parisian areas of France. Within each hospital, there was a strong positive correlation betweenthe incidence of GNB-BSI due to resistant GNB, and that of hospital-acquired GNB-BSI. Two scores measuring AMR and HAI rates by combining different GNB-BSI incidence rates were developed as indicators. These scores were highly variable within our hospital consortium. In multivariate analysis, AMR and HAI scores were significantly associated with the proportion of surgical beds, staff absenteeism and the consumption of alcohol-based hand rub, the last two of these characteristics being amenable to interventions. Carbapenem use was also linked to AMR but this may because carbapenems are the preferred drug for treating resistant infections. These results shed light on the incidence of HAIs and AMR in our hospitals and suggest possibilities for targeted interventions at healthcare facility level.
Amarsy R, Granger B, Fournier S, et al. J Hosp Infect 2023:S0195-6701(23)00332-8. Doi : 10.1016/j.jhin.2023.09.022. Online ahead of print.