Curbing methicillin-resistant Staphylococcus aureus in 38 French hospitals through a 15-year institutional control program

BACKGROUND: The Assistance Publique-Hôpitaux de Paris (AP-HP) institution administers 38 teaching hospitals (23 acute care and 15 rehabilitation and long-term care hospitals; total, 23 000 beds) scattered across Paris and surrounding suburbs in France. In the late 1980s, the proportion of methicillin resistance among clinical strains of Staphylococcus aureus (MRSA) reached approximately 40% at AP-HP.METHODS: A program aimed at curbing the MRSA burden was launched in 1993, based on passive and active surveillance, barrier precautions, training, and feedback. This program, supported by the strong commitment of the institution, was reinforced in 2001 by a campaign promoting the use of alcohol-based hand-rub solutions. An observational study on MRSA rate was prospectively carried out from 1993 onwards. RESULTS: There was a significant progressive decrease in MRSA burden (-35%) from 1993 to 2007, whether recorded as the proportion (expressed as percentage) of MRSA among S aureus strains (41.0% down to 26.6% overall; 45.3% to 24.2% in blood cultures) or incidence of MRSA cases (0.86 down to 0.56 per 1000 hospital days). The MRSA burden decreased more markedly in intensive care units (-59%) than in surgical (-44%) and medical (-32%) wards. The use of ABHR solutions (in liters per 1000 hospital days) increased steadily from 2 L to 21 L (to 26 L in acute care hospitals and to 10 L in rehabilitation and long-term care hospitals) following the campaign. CONCLUSION: A sustained reduction of MRSA burden can be obtained at the scale of a large hospital institution with high endemic MRSA rates, providing that an intensive program is maintained for a long period

Scarabaeoidea (Insecta : Coleoptera) in the Brazilian Cerrado : current state of knowledge

Besouros pertencentes à superfamília Scarabaeoidea ocupam habitats variados, possuem hábitos alimentares diversifi cados, desempenham importante papel ecológico e diversas espécies apresentam importância agrícola. No entanto, estudos com esse grupo na região do Cerrado são escassos. Nesta revisão realizou-se um levantamento dos artigos publicados nos últimos 30 anos a respeito dos Scarabaeoidea no Cerrado. Foram recuperados 64 artigos, realizados em nove unidades da federação, que focavam quatro temas principais espécies praga, aspectos bioecológicos, biodiversidade e importância ecológica, e técnicas e metodologias de coleta de Scarabaeoidea. Os resultados desta revisão indicam que poucos estudos foram realizados com os Scarabaeoidea no Cerrado brasileiro nas últimas décadas frente à importância e diversidade desse grupo de insetos.Beetles belonging to the superfamily Scarabaeoidea occupy different habitats, present feeding habits diversifi ed, play an important ecological role and several species have agricultural importance. However, studies with this group in the Brazilian Cerrado are scarce. In this review we carried out a survey of scientifi c articles published in the past 30 years concerning Scarabaeoidea in the Cerrado. Were found 64 studies in nine Brazilian states. The studies focused on four main topics: pest species, bioecology, biodiversity and ecological importance, techniques and methodologies for collecting Scarabaeoidea. The results of this review indicate that few studies have been conducted with Scarabaeoidea in the Cerrado in recent decades compared to the importance and diversity of this group of insects