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Surveillance of occupational blood and body fluids exposures

Abstract number: 1732_10

Parneix P., Vincent A., L'Hériteau F., Floret N., Sénéchal H., Abiteboul D., Reyreaud E., Coignard B., Alert the National Nosocomial Infection, Network Investigation & Surveillance

Background: National surveillance of occupational blood and body fluids exposures (BBFE) in France is conducted since 2002 through the Nosocomial Infection Early Warning, Investigation and Surveillance Network (Raisin) in collaboration with Geres (Groupe d'Etude sur le Risque d'Exposition des Soignants aux Agents Infectieux).

Methods: Participation of healthcare facilities (HCF) is voluntary and anonymous. BBFE occurring from 01/01/04 to 31/12/04 were documented using a standardised questionnaire documenting the nature, circumstances (mechanism, type of device, infectious status of the source) and follow-up of each BBFE. Incidence of BBFE is reported per 100 hospitalisation beds, by type of personnel per 100 full time equivalents (FTE), or by type of material per 100,000 devices.

Results: In 2004, 13,041 BBFE were documented in 371 participating HCF, which accounted for 15% of HCF and 29% of hospitalisation beds in France. BBFE overall incidence was 8.9 per 100 beds. Considering that all French hospitals account for 465,494 beds, 41,276 [95% CI: 40,896–41,656] BBFE could have occurred in France in 2004. HCV or HIV status of the source was not known for more than 20% of documented BBFE. Post-exposure prophylaxis (PEP) was prescribed to 4.5% of exposed personnel (vs. 5.8% in 2003 and 6.3% in 2002); this decrease may reflect the impact of April 2003 French recommendations, which reduced PEP indications. For the first time in 2004, sutures were the most frequent cause of BBFE associated with needles (more than subcutaneous injections) and accounted for 1,103 (11%) of all BBFE; one third occurred among residents, and 20% in ICU or emergency rooms (beyond surgery or obstetrics). Prevention through education and use of safety devices (such as blunt suture needles) may thus be a priority. Data from a cohort of 173 HCF which participated in 2003 and 2004 also were compared and demonstrate significant progresses. Compliance to glove use increased from 58.6% in 2003 to 62.3% in 2004, and BBFE incidence among nurse assistants fell from 2.3 in 2003 to 2.1 per 100 FTE in 2004. Last, BBFE incidence fell from 17.2 to 13.7 per 100,000 catheters, and from 71.6 to 43.2 per 100,000 implantable venous access systems.

Conclusion: AES-Raisin is one of the biggest BBFE surveillance network and results demonstrate an increase in observance to standard precautions and a significant decrease in the incidence of some types of BBFE. They also point out future priorities for improvement.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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