The methodology of surveillance for antimicrobial resistance and healthcare-associated infections in Europe (SUSPIRE): a systematic review of publicly available information.

OBJECTIVES: Surveillance is a key component of any control strategy for healthcare-associated infections (HAIs) and antimicrobial resistance (AMR), and public availability of methodologic aspects is crucial for the interpretation of the data. We sought to systematically review publicly available information for HAIs and/or AMR surveillance systems organized by public institutions or scientific societies in European countries. METHODS: A systematic review of scientific and grey literature following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was performed. Information on HAIs and/or AMR surveillance systems published until 31 October 2016 were included. RESULTS: A total of 112 surveillance systems were detected; 56 from 20 countries were finally included. Most exclusions were due to lack of publicly available information. Regarding AMR, the most frequent indicator was the proportion of resistant isolates (27 of 34 providing information, 79.42%); only 18 (52.9%) included incidence rates; the data were only laboratory based in 33 (78.5%) of the 42 providing this information. Regarding HAIs in intensive care units, all 22 of the systems providing data included central line-associated bloodstream infections, and 19 (86.3%) included ventilator-associated pneumonia and catheter-associated urinary tract infections; incidence density was the most frequent indicator. Regarding surgical site infections, the most frequent procedures included were hip prosthesis, colon surgery and caesarean section (21/22, 95.5%). CONCLUSIONS: Publicly available information about the methods and indicators of the surveillance system is frequently lacking. Despite the efforts of European Centre for Disease Control and Prevention (ECDC) and other organizations, wide heterogeneity in procedures and indicators still exists

Management of psychiatric complications in unrelated donor before unrelated peripheral hematopoietic stem cell collections

Olivier Hequet,1,2 Valerie Mialou,2 Francoise Audat,3 Eric Wattel,4 Valerie Chapel,4 Damiela Revesz,1 Jean-Piere Jouet,3 Brigitte Fisseaux,5 Mohamed Saoud,6 Mauricette Michallet4 1Apheresis Unit, 2Cell Therapy Laboratory, Etablissement Français du Sang (EFS) Rhône Alpes, Centre Hospitalier Lyon Sud, Pierre Bénite, 3Biomedicine Agency, Saint-Denis, 4Hematological Unit, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, 5Psychiatric Unit, Hospices Civils de Lyon, Centre Hospitalier, Bourgoin Jallieu, 6Psychiatric Unit, Hospices Civils de Lyon, Centre Hospitalier P Wertheimer, Lyon, France Abstract: Allogeneic hematopoietic stem cell transplantation can efficiently treat patients with severe hematological diseases. A human leukocyte antigen-compatible donor is required for performing transplantation. The occurrence of unexpected acute severe diseases in a donor can compromise the feasibility of allogeneic hematopoietic stem cell transplantation. However, when a severe health problem occurs in a donor while the recipient has already received a conditioning regimen, hematologists have to find the best solutions for the recipient, while the team in charge of the donor has to find the best medical solutions for the donor. We describe here the occurrence of psychiatric acute complications in an unrelated donor while the myeloablative conditioning regimen had already been given to the recipient. We report the successive decisions that were made in an emergency based upon the expertise of physicians specialized in hematology, apheresis, cell therapy, and psychiatry to preserve the donor’s health and recipient’s life. Keywords: hematopoietic stem cells, mobilization, harvest, psychiatric complication, CD34+ cells, unrelated dono

ADEME, 2018.Améliorer la qualité de l’air intérieur dans un bâtiment tertiaire – Impact énergétique d’un prototype d’épuration de l’air (techniques de filtration, d’adsorption et de photocatalyse)- CUBAIR :Confort des usagers des bâtiments tertiaires par l'usage de techniques de traitement de l'air. Rapport n°5, 20 pages.

RapportInternational audienc

Compliance to genomic test recommendations to guide adjuvant chemotherapy decision‐making in the case of hormone receptor‐positive, human epidermal growth factor receptor 2‐negative breast cancer, in real‐life settings

Abstract Background Genomic tests are a useful tool for adjuvant chemotherapy decision‐making in the case of hormone receptor‐positive (HR+), and human epidermal growth factor receptor 2‐negative (HER2−) breast cancer with intermediate prognostic factors. Real‐life data on the use of tests can help identify the target population for testing. Methods French multicentric study (8 centers) including patients, all candidates for adjuvant chemotherapy for HR‐positive, HER2‐negative early breast cancer. We describe the percentage of tests performed outside recommendations, according to the year of testing. We calculated a ratio defined as the number of tests required to avoid chemotherapy for one patient, and according to patient and cancer characteristics. We then performed a cost‐saving analysis using medical cost data over a period of 1 year from diagnosis, calculated from a previous study. Finally, we calculated the threshold of the ratio (number of tests required to avoid chemotherapy for one patient) below which the use of genomic tests was cost‐saving. Results A total of 2331 patients underwent a Prosigna test. The ratio (performed test/avoided chemotherapy) was 2.8 [95% CI: 2.7–2.9] in the whole population. In the group following recommendations for test indication, the ratio was 2.3 [95% CI: 2.2–2.4]. In the case of non‐abidance by recommendations, the ratio was 3 [95% CI: 2.8–3.2]. Chemotherapy was avoided in 841 patients (36%) following the results of the Prosigna test. The direct medical costs saved over 1 year of care were 3,878,798€ and 1,718,472€ in the group of patients following test recommendations. We calculated that the ratio (performed test/avoided chemotherapy) needed to be under 6.9 for testing to prove cost‐saving. Conclusion The use of genomic testing proved cost‐saving in this large multicentric real‐life analysis, even in certain cases when the test was performed outside recommendations