The stakes of multi-resistant bacteria in hospitals. Technological innovations, public policies, experiences of hospital workers

Given the increasing prevalence of antibiotic "multi" or "extremely" resistant bacteria, the implementation of efficient infection prevention and control (IPAC) measures in hospitals is strongly recommended by public health authorities. There are diverse strategies, including the use of new diagnostic practices such as point-of-care diagnostic tests. This article presents anthropological research about the implementation of new diagnostic technology in hospitals in the province of Quebec. The article highlights the multiple issues and challenges that arise by implementing these rapid point-of-care diagnostic tests as an IPAC measure. In a political context of austerity in which hospitals' medical laboratories are merged in larger, central laboratories, these tests could not only provide faster and more appropriate care to patients suffering from a hospital cross infection, but also help to reduce mortality rates and hospitalisation costs. The adoption of point-of-care diagnostic tests aims to meet health, political, economic, technical and scientific objectives. However, it presents significant organizational, normative and even interpersonal challenges for potential users (nurses and laboratory professionals). In a changing health system and in a restrictive economic context, we are interested in the professionals' experiences. In other words, we have used a phenomenological approach to study the implementation of the technology in hospitals and also take into account the political dimension.