Glycopeptide-resistant enterococci in healthcare facilities in France: epidemiological data from the nosocomial infection reporting system, July 2001–June 2015
Glycopeptide-resistant enterococci (GRE) are enterococci that have developed an unnatural resistance to at least one antibiotic in the glycopeptide class. Furthermore, Enterococcus faecium is classified as an emerging highly resistant bacterium (EHRB). According to data from the European Antimicrobial Resistance Surveillance Network (EARS-Net), the proportion of ERG has increased significantly in Europe since 2002, but it has remained stable and below 2% in France since 2007 (0.5% in 2014). The objective of this study was to describe trends in reports of ERG infection/colonization received through the external reporting system for nosocomial infections (SIN) from July 2001 to June 2015. The characteristics of these SIN reports (reporting departments, infections/colonizations, control measures) were analyzed. During the study period, 17,743 SINs were submitted, of which 1,440 (8.1%) involved ERG, corresponding to nearly 3,000 patients in 486 facilities. The majority of SINs involving ERG (84%) reported colonization, 8% reported infection, and 3% reported both. Three regions accounted for more than half of the ERG SINs, particularly between 2007 and 2010: Île-de-France (30%), Lorraine (18%), and Nord-Pas-de-Calais (10%). For 29% of the reported episodes, these were clustered cases, with a median of 3 cases per episode. Enterococcus faecium was implicated in 95% of the SINs, and the VanA-type resistance mechanism was the most frequently identified (72%). More than 70% of facilities were conducting local investigations and had implemented control measures by the date of reporting. The description of an outbreak in the Southwest subregion illustrates these investigation and prevention protocols. The number of ERG SINs increased significantly between 2003 (5 SINs, or 0.7% of total SINs) and 2008 (245 SINs, or 18.6%), a period marked by major outbreaks in northern and eastern France. This figure decreased in 2009 and stabilized between 110 and 155 reported cases (approximately 8%) through 2014. Since then, the proportion of ERG reports appears to be increasing, with 114 reports (9.9%) received for the first six months of 2015.
Author(s): Subiros M, Bervas C, Venier AG, Colomb Cotinat M, Soing Altrach S, Pontiès V, Blanchard H, Simon L, Bernet C, Senechal H, Vaux S, Coignard B
Publishing year: 2016
Pages: 419-27
Weekly Epidemiological Bulletin, 2016, n° 24-25, p. 419-27
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