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

BESPRECHUNGEN COMPTES RENDUS - REVIEWS

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72613/1/j.1467-6435.1957.tb00243.x.pd

Design of a new strategy for the control of the refrigeration process: fruit and vegetables conditioned in a pallet

A heat and mass transfer numerical model is developed to describe the refrigeration process between the air and agricultural products packed in bins piled on a pallet. The model includes the local overall average heat transfer coefficients and fitted wall with experimental results. A sensivity parameter study suggests that the air temperature is one of the factors which allows strong variation of the cooling kinetics. The model profiles the local heterogeneity of cooling in terms of a "coldest point" and a "hottest point" inside the bins for the same air flow conditions. This study permits the determination of the best location of sensors in order to prevent the over-treatment of products. Finally this work shows that the use of the model could be integrated in a control strategy for the refrigeration process. / Un modèle de transfert de chaleur et de matière a été mis au point. Il permet de décrire le procédé de réfrigération entre l'air et des produits conditionnés en palette. Le modèle tient compte du coefficient local de transfert de chaleur. Il permet de prédire de l'hétérogénéité en termes du point le "plus chaud" et du point le "plus froid". Ce travail montre que le modèle peut-être intégré dans une stratégie de contrôle du procédé de réfrigération

Evolution des technologies alimentaires

International audienc

Dossier céréales. Cuisson des produits céréaliers

National audienc

Automatique et industries alimentaires : Quelques avancées, perspectives et limites

10 graph. Numéro spécial : AutomatiqueNational audienc

Protection of vitamin E in high-pressureinduced β-lactoglobulin aggregate

International audienc

Individual choices influence on value chain sustainability

International audienc

Contrôle de procédés alimentaires batch basé sur la connaissance humaine

International audienceBatch-to-batch methodologies use the repetitive nature of batch processes in order to determine the optimal operating policy in the presence of uncertainty. In this paper, a general and flexible framework for batch-to-batch control alone or combined with feedback control is proposed: it constitutes a novel multivariable technique for batch processes implemented to obtain a product having a predetermined set of characteristics at the end of the run. This control technique relies on human knowledge used as a tool for evaluating product quality and controlling processes. It was used to control two food processing operations: the chopping operation for manufacturing meat emulsion and the ripening operation applied to obtain the dry sausage. An experimental validation is introduced: the results show that the algorithm is likely to control the process so as to obtain the desired sensory characteristics