As part of the European network (ECDC), national prevalence surveys (NPS) on healthcare-associated infections (HAIs) and antimicrobial treatments have been conducted in France since 2010 in long-term care facilities for the elderly (Ehpad).

The most recent ENP, conducted in 2024, was coordinated at the national level by Santé publique France in collaboration with the Network for the Prevention of Infections and Antibiotic Resistance (RéPIA) and, at the regional level, by the Support Centers for the Prevention of Healthcare-Associated Infections (CPias) and the Regional Centers for Antibiotic Therapy (CRAtb).

The objective of this survey is to produce prevalence indicators for residents infected and treated with antibiotics (ATB) in nursing homes and to compare them with those from the previous ENP conducted in 2016 (Prev’Ehpad). It also aims to engage all healthcare professionals in nursing homes and prescribers in a surveillance initiative. Its ultimate goal is to contribute to improving the safety of care for residents and to identify priorities for action regarding the prevention of infection risk and the appropriate use of antibiotics.

• Learn more on the survey page

What are the main findings of the 2024 survey?

A decline in the prevalence of healthcare-associated infections compared to 2016

The prevalence of residents infected with at least one healthcare-associated infection (HAI) in 2024 is estimated at 2.35%. This means that nearly one in 40 residents has at least one healthcare-associated infection (HAI) on any given day in a nursing home. This prevalence is lower than that measured in 2016 (2.93%).

Residents aged 85 and older, hospitalized within the 3 months prior to the survey, wheelchair-bound or bedridden, incontinent, with pressure ulcers, who underwent surgery within the 30 days prior to the survey, and who were exposed to at least one invasive device have significantly more HAIs than residents without these risk factors.

In 2024, 2,652 healthcare-associated infections were documented, representing a prevalence of 2.41%. The most common infections were respiratory (36.2%), urinary tract (31.7%), and skin (25.8%).

The most frequently observed pathogens for urinary tract infections confirmed by urine culture and sensitivity testing (UCST) are, as in 2016, Escherichia coli (53.9%), Proteus mirabilis (7.5%), and Klebsiella pneumoniae (11.6%).

Stable prevalence of antibiotic treatment

In 2024, 2.87% of residents were treated with at least one antibiotic on a given day, a rate that remained stable compared to 2016 (2.76%). Antibiotic prescribing is more common in nursing homes without a procedure for reevaluating antibiotic therapy, without access to an antibiotic therapy specialist, and without access to hygiene expertise.

The majority of treatments are administered orally (86%). Prescriptions for preventive purposes (prophylaxis) are on the rise: 22% in 2024 compared to 13.6% in 2016.

For 34% of curative treatments, the expected duration exceeds 7 days, and reevaluation within 3 days is performed in 31.8% of cases (31.4% in 2016).