Research Article
Relevance of a French National Database Dedicated to
Infection Prevention and Control (NosoBase®): A Three-Step Quality Evaluation
of a Specialized Bibliographic Database
Kae Ting Trouilloud
Infection Control Pharmacist
Mobile Infection Prevention Team for Nursing Homes (EMHE)
Lyon University Hospital (HCL)
Lyon, France
Email: kae.trouilloud@chu-lyon.fr
Nathalie Sanlaville
Librarian
Healthcare-Associated
Infection Prevention and Control Regional Coordinating Centre for
Auvergne-Rhone-Alpes (CPIAS ARA)
Lyon, France
Email: nathalie.sanlaville@chu-lyon.fr
Sandrine Yvars
Head of Documentation Center for Professionals
National Police Academy (ENSP)
Saint-Cyr-au-Mont-d’Or, France
Email: yvars.sandrine@wanadoo.fr
Anne Savey
Director (IPC)
Healthcare-Associated
Infection Prevention and Control Regional Coordinating Centre for
Auvergne-Rhone-Alpes (CPIAS ARA)
Lyon, France
Email: anne.savey@chu-lyon.fr
Received: 15 May 2018 Accepted: 16 Jan. 2019
2019 Ting Trouilloud, Sanlaville, Yvars, and Savey. This
is an Open Access article distributed under the terms of the Creative Commons‐Attribution‐Noncommercial‐Share Alike License 4.0
International (http://creativecommons.org/licenses/by-nc-sa/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly attributed, not used for commercial
purposes, and, if transformed, the resulting work is redistributed under the
same or similar license to this one.
DOI: 10.18438/eblip29448
Abstract
Objective
–
NosoBase® is a collection of documentation centres with a national
bibliographic database dedicated to infection prevention and control (IPC),
with over 20 years of experience in France. As a quality assurance activity,
this study was conducted in 2017 with a three-step approach to evaluate the
bibliographic database regarding (1) the availability and coverage of
citations; (2) the scope and relevance of content; and (3) the quality of the
documentation centre services.
Methods
– The three-step quality approach
involved (1) evaluating the availability and coverage of citations in NosoBase®
by searching for the bibliographic citations of three systematic reviews on hand
hygiene practices, published recently in three different peer-reviewed
international journals; (2) evaluating the scope and relevance of content in
NosoBase® by searching for all documents from 2015 indexed in NosoBase® under
hand hygiene related keywords, and analyzing according to publication language,
document type (e.g., legislation, research, or guidelines), and target
audience; and 3) evaluating the strengths, weaknesses, and opportunities of the
documentation centre services, with interviews involving the librarians.
Results
–
NosoBase® contained 70.8%-80.9% of references directly concerning hand hygiene
cited by the three systematic reviews. Of the 200 articles indexed in NosoBase®
under hand hygiene related keywords in 2015, 22.5% were French language based,
with a significant representation of French non-indexed literature. The
analysis of the documentation centre services highlighted future opportunities
for growth, building on the strengths of experience and collaborations, to
improve marketing and usability, targeting francophone IPC professionals.
Conclusion
–
Specialized bibliographic databases may be useful and time efficient for the
retrieval of relevant specialized content. NosoBase® has significant relevance
to French and francophone healthcare professionals in its representation of
French documentation and healthcare literature not otherwise indexed
internationally. NosoBase® needs to highlight its resources and adapt its
services to allow easier access to its content.
Introduction
With the growing emphasis on evidence based practice,
more databases and research content are now being made available. Yet it is
often difficult and time-consuming for clinicians and researchers to locate
relevant literature even if it is more accessible. Studies indicate that
searches only on Google Scholar may not be enough (Boeker, Vach, &
Motschall, 2013), and that searches on multiple databases are often necessary
for finding relevant bibliographic content (Rathbone, Carter, Hoffmann, &
Glasziou, 2016). One earlier study compared several health-related databases
(CINAHL, Cochrane Library, MEDLINE, PsycLIT, Sociofile, and Social Science
Citation Index), and found that PsycLIT was the most useful database for
information on the rehabilitation of people with severe mental illness in terms
of search efficiency and relevance in this topic area, highlighting the
importance of a specialized bibliographic database (Brettle & Long, 2001).
More recently, Rethlefsen, Murad, and Livingston (2014) proposed that human-indexed
databases allow faster, more comprehensive searching in terms of terminology
and controlled vocabulary structure than solely computer algorithm-indexed
databases such as Scopus and Google Scholar, despite search engines that search
full-text articles in the latter. The impact of trained searching and
assistance from trained information professionals and librarians has also been
underlined (Centre for Reviews and Dissemination, 2009). Librarian co-authors
correlated with higher quality reported search strategies in general internal
medicine systematic reviews, leading to a more comprehensive, true systematic
review (Rethlefsen, Farrell,
Osterhaus Trzasko, & Brigham, 2015).
As a quality assurance activity, this study evaluated
NosoBase®. Created in 1996, NosoBase® is a national project focused on
infection prevention and control (IPC) in healthcare settings (Savey, Sanlaville,
& Fabry, 2000). It consists of five documentation centres,
with trained librarians located in different cities in France (Lyon, Paris,
Rennes, Bordeaux, and Nancy). It hosts a forum for IPC professionals and a
website with resources and tools. There are collaborations with national
medical or professional IPC learned societies, cooperation with other
libraries, and bibliographic support to the national public health agency.
Based in the French language, it manages a bibliographic database also known as
NosoBase®, indexing up to 180 journals in multiple languages. This study
describes a three-step quality assessment conducted in 2017 to evaluate the
content of the database (steps 1 and 2) and the documentation centre services
(step 3).
Literature
Review
Bibliographic databases came into being in the 19th
and 20th centuries in response to the proliferation of journals and other
publications, then went online in the late 20th century (Glasziou
& Aronson, 2017). Specialized (or subject-specific) bibliographic databases
are now available in diverse fields, from chemistry (Chemical Abstract Service)
to psychology, psychiatry, and neurology (PsycINFO); from nursing and caring
sciences (CINAHL) to geology (GeoBase) (Gasparyan et al., 2016). Many offer
access mainly through subscription or through membership in professional
associations. In France, bibliographic databases such as Pascal & Francis
and the public health database Banque de Données en Santé Publique (BDSP) were
developed in the 1970s and 1990s, respectively. It was noted that in the Pascal
database, around 12% of the journals indexed were French language based, and
55% of the journals indexed were not available in PubMed (Dufour, Mancini,
& Fieschi, 2009).
However, bibliographic databases and the documentation
centres that maintain them currently face growing costs for maintenance and
rising competition from multidisciplinary databases such as PubMed that provide
free online access. Researchers began to compare recall efficacy between
multidisciplinary databases and specialized databases. One case study used a
systematic review to investigate the performance of bibliographic databases in
identifying the included studies. Its results showed that the use of at least
two databases and reference checking were required to retrieve all included
studies (Beyer & Wright, 2013). Another study examined the yield of
MEDLINE, EMBASE, and CENTRAL to find randomized controlled trials within the
area of musculoskeletal disorders. It found that searching all three databases
was not sufficient for identifying all effect studies on musculoskeletal
disorders, though an additional 10 databases did only increase the median
recall by 2% (Aagaard, Lund, & Juhl, 2016).
In France, the National Conservatory of Arts and
Crafts and National Institute for Documentation Techniques (CNAM INTD, http://intd.cnam.fr/)
developed methodologies to evaluate documentation centre services. These
methodologies focused mainly on the organization of resources and processes and
evaluating the management of the information systems, with an emphasis on
quality assurance activity built into the process. Quality indicators and
action plans are identified to improve client satisfaction and overall
documentation quality and service quality.
In the 1990s, there was also a progression towards
practices based on evidence, or evidence based practice, and medicine was at
the origin of this movement (Goodman, 2002). Libraries and documentation
centres have joined the movement, examining the management of documents and
information based on evidence, an approach known as evidence based librarianship
(Booth & Brice, 2004). An example of this was a systematic review conducted
in 2010, which examined models of clinician services and evaluated the value of
their service towards clinicians. It described clinician libraries having a
positive impact on patient care, resulting in better informed decisions on
choices of drugs or therapy, and saving clinicians’ time (Brettle et al.,
2011).
However, during the same year, the dramatic evolution
of information technologies led to a reexamination of the librarian role and a
reevaluation of core competences by the Canadian Association of Research
Libraries (2010). With the rise of Google and internet access, studies also
described changes in scholar and student information-seeking behavior (Jamali
& Asadi, 2010). A recent study indicated that the coverage of Google Scholar is
improving (Gehanno, Rollin, & Darmoni, 2013). However, the findings of this
study have been disputed. Guistini and Kamel Boulos (2013) noted that Google
Scholar was still unreliable for searching systematic reviews due to its
constantly changing content, algorithms, and database structure. Other studies
found that Google Scholar missed important literature in evidence reviews and
grey literature searching (Haddaway, Collins, Coughlin, & Kirk, 2015) or
that it presented incomplete recall (Bramer, Giustini, Kramer, & Anderson,
2013).
In France, websites and portals in the French language
dedicated to health literature have been in place for some time, such as
CISMeF, Recomedical, BIU Santé Paris, and BDSP, a database for public health
hosted by the national public health higher learning institution Ecole des
Hautes Etudes en Santé Publique (EHESP) in Rennes. However, funding for BDSP
has been greatly limited recently.
Aims
After more than 20 years of experience, the librarians
of the documentation centre NosoBase® wanted to assess the quality and the
usefulness of the services and tools provided. This study was conducted in 2017
with a three-step process to evaluate the bibliographic database NosoBase®
regarding (1) the availability and coverage of citations and (2) the scope and
relevance of content, as well as (3) the quality of the NosoBase® documentation
centre services.
Methods
A three-step quality assessment was used in order to evaluate
the content of the database and the documentation centre services. Step 1
evaluated the availability and coverage of citations in NosoBase® through
searching for bibliographic citations of three systematic reviews on hand
hygiene practices, which were published recently in three different
peer-reviewed international journals. Step 2 evaluated the scope and relevance
of content in NosoBase® by searching for all documents from 2015 indexed in
NosoBase® under hand hygiene related keywords, and analyzing them according to
publication language, document type (e.g., legislation, research, or
guidelines), and target audience. Step 3 evaluated the strengths, weaknesses,
and opportunities of the documentation centre services, with input from the
librarians.
Step 1: Availability and Coverage of Citations in
NosoBase®
The theme of hand hygiene was selected as it
represents an important aspect of IPC. Three systematic reviews on hand hygiene
practices were selected from a simple straightforward search on PubMed
(keywords: “hand hygiene systematic review” and “Cochrane AND hand hygiene
systematic review”) for the most recent publication on January 26, 2017,
representing three different peer-reviewed international medical journals.
Initially, the authors discussed the importance of including a Cochrane
systematic review, but at the time of searching none were found that fit the
criteria of date and theme. We have chosen to leave the keyword search
“Cochrane” here for transparency to reflect the search process. The three
selected reviews are listed below.
Review 1:
Musuuza, J. S., Barker, A., Ngam, C., Vellardita, L.,
& Safdar, N. (2016). Assessment of fidelity in interventions to improve
hand hygiene of healthcare workers: A systematic review. Infection Control & Hospital Epidemiology, 37(5), 567-575.
·
Search: PubMed, CINAHL, Cochrane, Web of Science, up
to 19 June 2015.
·
The review described limited electronic grey
literature searching (p. 568).
·
Keywords used: implementation fidelity, intervention
fidelity, intervention compliance, hand washing, hand hygiene, hand
disinfection.
·
120 citations; author affiliations: United States.
Review 2:
Kingston, L., O’Connell, N. H., & Dunne, C. P.
(2016). Hand hygiene-related clinical trials reported since 2010: A systematic
review. Journal of Hospital Infection, 92(4),
309-320.
·
Search: PubMed, CINAHL. Studies from the US and
Europe, from Dec 2009 (after the publication of the WHO hand hygiene
guidelines), up to Feb 2014.
·
The contact author confirmed that grey literature and
hand searching were not conducted for this study.
·
Keywords used: hand hygiene, hand washing,
observation, and clinical trial.
·
88 citations; author affiliations: Ireland.
Review 3:
Luangasanatip, N., Hongsuwan, M., Limmathurotsakul,
D., Lubell, Y., Lee, A. S., Harbarth, S., Day, N. P. J., Graves, N., & Cooper, B. S. (2015). Comparative efficacy of interventions to
promote hand hygiene in hospital: Systematic review and network meta-analysis. BMJ, 351, h3728.
·
Search: MEDLINE, Embase, CINAHL, NHS Economic
Evaluation Database, NHS Centre for Reviews & Dissemination, Cochrane, EPOC
register, studies from Dec 2009 to Feb 2014.
·
The review appendix listed only electronic searching.
·
Same keywords as former systematic reviews from 1980
to 2009.
·
89 citations; author affiliations: Thailand,
Australia, United Kingdom, Switzerland.
For each systematic review, all bibliographic
citations were listed on a spreadsheet indicating availability, whether
directly related to hand hygiene practices, and whether indexed under hand
hygiene keywords, with a note for comments. Their availability in the database
of NosoBase® was verified during February 2017.
Step 2: Scope and Relevance of Content in NosoBase®
A search was performed on February 9, 2017, for all
indexed documents under hand hygiene related keywords from the database of
NosoBase®. The year 2015 was chosen since publications from the end of 2016
were not yet completely indexed by February 2017. The documents were analyzed
according to the publication language and document type (e.g., legislation,
research article, or guidelines), as well as target audience.
Step 3: Quality Review of the Documentation Centre
Services
Using the National Conservatory of Arts and Crafts and
National Institute for Documentation Techniques (CNAM INTD, http://intd.cnam.fr/)
methodologies as models (Toneatti, 2008; Palisse, 2011), a qualitative
descriptive approach was chosen for this study, examining six categories:
communication, accessibility, production, management, marketing, and
opportunities, through a modified SWOT analysis (strengths, weaknesses, and
opportunities, with threats analyzed under weaknesses).
Semi-structured face-to-face discussions using the
modified SWOT analysis and categories were conducted with the on-site
librarians (co-authors) separately. Semi-structured discussions using the same
analysis and categories were conducted by the librarian co-authors with three
other librarians from the other NosoBase® documentation centres, during
regularly scheduled telephone conference meetings between February and July
2017, as part of the meeting agenda, and by electronic mail due to time and
geographical constraints. Report drafts resulting from input obtained during
the above discussions were created. The librarian meetings were not recorded
nor transcribed, but minutes were kept and circulated for verification, as per
normal practice. Ethics approval was not obtained as it was an internal quality
assurance exercise.
Results
Step 1: Availability and Coverage of Citations in
NosoBase®
There were a variety of citations included in the
bibliographies of the three systematic reviews, including articles on
methodology and economic impact (review 1); surveillance, good practice, and
psychology (review 2); and systematic review methodologies, meta-analysis,
statistics, and models (review 3). These and other non-hand hygiene related
references were included in the category “other.” Hand hygiene references were
defined as articles directly related to research in hand hygiene practices. See
Table 1 and Figure 1 for the comparison between the three systematic reviews
and the database NosoBase®.
From Table 1, NosoBase® is shown to have indexed
70.8%, 80.7% and 80.9% of hand hygiene citations from each systematic review.
Articles that were not available in NosoBase® were mainly from specialized
nursing journals (e.g., Plastic Surgical
Nursing, Nursing Times, Critical Care Nursing Quarterly, Clinical Nursing Research, and The American Journal of Nursing) or
regional and national journals not in its repertoire or with a lower Scimago
ranking (e.g., Journal of the Medical
Association of Thailand, Annals of
the Royal College of Surgeons of England, Medical Journal of Australia, Scandinavian
Journal of Infectious Diseases, and Life
Science Journal - Acta Zhenzhou University Overseas Edition). See Scimago, https://www.scimagojr.com/.
Table 1
Number of Citations (All or Hand Hygiene/HH), from the
Three Systematic Reviews, versus Number of Citations Available in NosoBase®
|
|
Systematic review |
Availability in NosoBase® |
|||||
|
|
All citations |
HH citations |
All citations |
HH citations |
|||
|
|
Number (n) |
n |
% |
n |
% |
n |
% |
|
Review 1 |
120 |
106 |
88.3 |
79 |
65.8 |
75 |
70.8 |
|
Review 2 |
88 |
57 |
64.8 |
55 |
62.5 |
46 |
80.7 |
|
Review 3 |
89 |
47 |
52.8 |
48 |
53.9 |
38 |
80.9 |
Figure 1
Number of citations (All or Hand Hygiene/HH
citations), from the three systematic reviews, versus number of citations
available in NosoBase®.
The contact author for each systematic review
confirmed that the literature search was carried out either by information professionals/librarians,
or by researchers previously trained by them. The contact authors for Reviews 1
and 3 did not confirm whether grey literature searching was done. The contact
author for Review 2 confirmed that a grey literature search was undertaken. Of
the three systematic reviews, all three searched PubMed/MEDLINE but none
searched Google Scholar. It was interesting to note that across the three
systematic reviews, 10 references were cited by two reviews. Only two references
were cited by all three systematic reviews.
Step 2: Scope and Relevance of Content in NosoBase®
Of the 200 documents indexed in NosoBase® in 2015 with
hand hygiene keywords, the majority were research articles. Out of 200 items,
45 (22.5%) were published in French. The following French journals were
represented: Aide-soignante, Hygiènes,
Inter-bloc, Noso-info, Pratiques psychologiques, Risques et qualité en milieu
de soins, Soins aides-soignantes, Soins, and national infection control
bulletins. A majority of these journals are not indexed in commercial or other
well-known databases.
The documents listed included four legislative texts
from the Public Health Council (HCSP), the French National Organization for
Standardization (AFNOR), and the French Republic Official Journal (Journal officiel de la République française).
Also included were guidelines from the World Health Organization (WHO), the
Cochrane Library, the National IPC Learned Society (SF2H), and the National
Institute of Public Health of Quebec.
The documents reflected a wide target audience,
including health professionals such as doctors, nurses, nursing assistants,
surgeons, anesthetists, radiologists, pharmacists, IPC specialists, laboratory
technicians, and general practitioners; as well as hospital managers, patients,
hospital visitors, medical or nursing students, medical researchers,
epidemiologists, the general public, and hospital engineers. Corresponding
healthcare structures included hospitals, nursing homes, community healthcare
centres, and training institutes.
Step 3: Quality Review of the Documentation Centre
Services
From the semi-structured discussions with the
librarians, the documentation centre services were described and summarized in
six categories according to strengths, weaknesses, and opportunities.
Communication
Regarding strengths in this area, there is a monthly
newsletter NosoVeille highlighting
new arrivals and publications (e.g., legislation) and a trimester thematic
publication NosoTheme in a French
professional IPC journal. Also, the brand NosoBase® and its documentation
services have become well known to IPC professionals for over the past 20
years. However, its current weaknesses include irregular social media presence
(e.g., in Twitter, Facebook, or YouTube), despite already having some presence
there. Its brand is also less well known outside of France. There is therefore
an opportunity for growth through increasing social media communication with
better frequency in more channels (e.g., LinkedIn), and exploring communication
channels outside of France.
Accessibility
In terms of accessibility, there is free online access
to the NosoBase® database and web resources, with phone and email access to
librarians for bibliographic aid and advice. However, the new database system
(transitioned in March 2017) required current users to adapt to the new
interface. There is also an urgent need for a search engine to access the
website resources due to data growth. The opportunities for improvement involve
facilitating access through user guides and facilitating website navigation and
searching through an efficient search engine.
Production
The strengths of NosoBase® lie in its rich collection
of French and multilingual documents (e.g., English, Spanish, and German);
diverse IPC related documentation (legislation, guidelines, and toolkits);
articles in multiple formats (paper and electronic); and a new generation
Functional Requirements for Bibliographic Records (FRBR) database system. It
also has a librarian curated specialized IPC thesaurus. However, there is a
lack of standardized internal procedures, and it was significantly
time-consuming to adapt and format the new database system. The thesaurus is
not updated regularly, and it needs to evolve along MeSH terms. There is
therefore opportunity for growth through streamlining and standardizing work
procedures, through exploiting the functions in the new database system, and
through revising the IPC thesaurus to evolve with MeSH terms. The development
of a bilingual thesaurus would be helpful to bridge the content.
Management
There are annual reviews of the documentation centre
activities and great strength in a centralized purchasing department and
budget, with centralized IT services and staff training programs consolidating
resources and expertise. However, this also resulted in reduced flexibility and
an increase in the time needed for change. The quality assurance activities are
sporadic and irregular. There is a need to encourage quality assurance
processes to create value.
Marketing
NosoBase® presents multiple channels established over
a significant period with professional learned societies and the French Public
Health Agency. It has been involved regularly in professional conferences and
in the establishment of national guidelines, and has a strong presence on these
websites and professional forums. However, there have been few user
satisfaction surveys, and there is an insufficient use of modern user feedback
channels, such as through social media. Opportunities for growth involve
analyzing modern user needs to better adapt services, and growing its online
presence through European and international IPC channels (e.g., WHO and CDC).
NosoBase® could be marketed towards medical students and non-IPC healthcare
professionals, as well as other francophone countries.
Discussion
Step 1 and Step 2 of this study highlighted the
potential of a specialized or subject-specific bibliographic database providing
literature curated by trained librarians. NosoBase® presented good coverage and
availability of research articles on the theme of hand hygiene. It is practical
and relevant for French users as it contains and regularly updates new French
legislation and guidelines linked to IPC in healthcare, as well as
international IPC guidelines. It carries good representation and scope of
French language health journals in this field, a majority of which are not
indexed internationally or are not on PubMed.
However, Step 3 of this study underlines the need for
more modern approaches in communication and marketing to encourage access by
modern users. NosoBase® needs to adapt its website and database access
accordingly, with better brand presence on social media, and a more
user-friendly approach. NosoBase® has taken positive steps towards this by
transitioning in 2017 to a new FRBR database system, enabling documentation to
be stored according to modern multiple formats such as electronic or
multimedia. Earlier studies have highlighted the need to evolve traditional
librarian services toward point of care (Lamb, Jefferson, & White, 1975;
reviewed by Van Kessell, 2012). NosoBase® needs to examine such approaches in
the future.
This study has limitations. The systematic reviews
were selected based on a date cutoff with very simplified keywords. The search
was limited to a sample size of three systematic reviews and a single theme of
hand hygiene. Qualitative discussions were limited to a select number of
librarians who were closely involved with NosoBase® documentation centres;
information obtained from users of the database and services may have provided
different perspectives.
This is the first quality assurance review of the content of the bibliographic
database NosoBase®. A previous quality assurance review was based on a user
satisfaction survey about the web resources in general (Sanlaville, Angibaud,
Girot, Lebascle, & Yvars, 2011). This study can thus be used as a
foundation for future bibliographic content review. Hand hygiene may be a theme
that naturally interests a wider audience than expected. However, infection
control and prevention is in general a multidisciplinary field and has a wide
target audience. The next steps proposed by this study are to encourage
NosoBase® to include more nursing care journals, and to expand this assessment
by searching and comparing with other systematic reviews on different IPC
themes.
In 2015, a French language based portal, LiSSa, which
stands for Scientific Literature on Health, was created and financed by the national
research agency (ANR), acknowledging “the shared opinion of the National
Academy of Medicine, that [it was necessary in France] to have a bibliographic
database to improve the visibility, access and dynamism of medical and
paramedical literature in French” (Griffon, Scheurs, & Darmoni, 2016, p.
956). It is an encouraging development toward which NosoBase® hopes to
contribute.
Conclusion
Specialized or subject-specific bibliographic
databases came into being due to the growth and proliferation of publications.
However, they currently face increasing costs of maintenance, competition from
free online access to multidisciplinary databases such as PubMed, and the
development of online search engines such as Google Scholar. Evidence based
practices in librarianship also led to the development of methodologies to
evaluate the relevance of documentation centres.
This study explored the relevance of the national IPC
bibliographic database NosoBase® and its documentation centre services. The
results indicate its relevance, reflected by a good coverage and availability
of citations from three systematic reviews based on the theme of hand hygiene,
a wide scope of content based on hand hygiene related keywords, and an
important listing of French language based publications and grey literature.
The qualitative approach through semi-structured discussions with all the
librarians in the various documentation centres provided a framework analysis
of strengths, weaknesses, and opportunities of the documentation centre
services. Due to the ever-changing landscape of information services and
access, documentation centres need to continuously measure the quality of their
contribution, and base their practice on evidence. NosoBase® has a rich
heritage in France in the specialized multidisciplinary field of infection
prevention and control. By adapting to modern user needs and improving
communication and access, NosoBase® will be able to contribute towards evidence
based health practice and evidence based librarianship.
Epilogue: Due to restructuring of national infection
control centres and related budgets, the funding of NosoBase® has been
dramatically reduced in 2019, and its activities will be taken up by a single
different infection control centre, limiting updates mainly to French
legislation and recommendations. Its bibliographic database has been suspended.
The database BDSP faces a similar fate.
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