Surveillance of multidrug-resistant bacteria in healthcare facilities in France. BMR-Raisin Network. 2014 Results
Controlling the spread of multidrug-resistant bacteria (MDRB) in healthcare facilities is a priority of the national program to combat healthcare-associated infections (HAIs). Since 2002, Raisin has coordinated surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-producing Enterobacteriaceae) isolated from diagnostic specimens in French HCFs. In 2014, 1,442 HCFs participated in the surveillance program, representing a 202% increase since 2002 and covering 76% of hospital beds in France. For MRSA, the overall incidence density (ID) was 0.27 per 1,000 patient-days and ranged from 0.20 to 0.34 depending on the region. It was higher in short-stay units (0.38) and intensive care units (0.95) than in long-term care facilities (0.16). Since 2002, the MRSA ID has decreased by 57% overall and by 62% in intensive care. For EBLSE, the overall incidence rate was 0.62 per 1,000 patient-days, ranging from 0.38 to 0.80 depending on the region. It was twice as high in short-stay care (0.86) as in long-term care (0.37). Since 2002, the incidence rate of EBLSE has increased 4.8-fold (+375%), and the proportion of Escherichia coli among EBLSE has risen from 19% to 58%. The decrease in MRSA incidence suggests a positive impact of the prevention measures implemented in the departments participating in the network. The annual number of MRSA-related healthcare-associated infections (HAIs) is, however, estimated at between 25,000 and 42,000, including approximately 3,000 to 5,000 bacteremias, and that of EBLSE at between 46,000 and 97,000, including between 4,000 and 10,000 bacteremias. Finally, the increase in the incidence of EBLSE, particularly E. coli, is a cause for concern and may serve as a potential reservoir for the emergence of new carbapenem-resistant strains.
Author(s): Arnaud I, Jarlier V
Publishing year: 2016
Pages: 107 p.
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