Since 2011, it has been part of a program of similar surveys conducted in all European Union countries under the auspices of the ECDC. In 2022, Santé publique France coordinated a new edition of this survey through the Network for the Prevention of Healthcare-Associated Infections (Repias) and in collaboration with the Support Centers for the Prevention of Healthcare-Associated Infections (CPias), and is publishing the initial results today.

Healthcare-associated infections: one in 18 hospitalized patients affected

The 2022 ENP was conducted on a single day between May 15 and June 30, 2022. It focused on nosocomial infections—that is, infections contracted in healthcare facilities that occur during or following a patient’s care and that were neither present nor in the incubation period at the start of that care.

A total of 1,155 healthcare facilities participated, involving 151,676 patients. Nearly one in two facilities participated in this survey, a very satisfactory proportion given the significant constraints related to the COVID-19 pandemic that were weighing on these facilities at the time.

The results show a prevalence of infected patients of 5.71%, meaning that one in 18 hospitalized patients had at least one nosocomial infection. This prevalence of infected patients increased between 2017 and 2022 (+14.7%). Nosocomial SARS-CoV-2 (COVID-19) infections accounted for half of this increase. Excluding these, the prevalence of infected patients was 5.35%, relatively stable compared to the 2017 estimate (4.98%).

The prevalence of infected patients varied by facility type and the department treating the patient. It was higher in cancer centers (15.81%) and regional/university hospitals (8.58%), intensive care units (23.17%), and medical wards (6.84%)—types of facilities and departments where patients face an increased risk of infectious complications due to factors such as age over 65, health status (life-threatening condition, immune status, and malignant disease), surgical procedures, or exposure to invasive devices.

Furthermore, there was considerable stability in the distribution of the main sites of nosocomial infections and the main microorganisms isolated from infections between 2017 and 2022. Thus, the four main sites of nosocomial infections (urinary tract infections, pneumonia, surgical site infections, and bacteremia) accounted for 70.7% of documented infection sites, a proportion that remained stable compared to 2017 (71.5%). Similarly, the four main microorganisms (Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa) accounted for 48.3% of microorganisms isolated from infections, a proportion that remained relatively stable compared to 2017 (50.2%).

Increasing prevalence of patients treated with antibiotics

The survey results show that one in six patients hospitalized in a healthcare facility received at least one systemic antibiotic treatment in 2022, representing a prevalence of 16.24%. The prevalence of patients treated with antibiotics increased by 7.5% between 2017 and 2022.

One in two patients was treated with antibiotics in intensive care units (49.19%), and one in four in medical (25.72%) or surgical (26.97%) wards.

The five most commonly prescribed antibiotics or antibiotic combinations in 2022 were different from those observed in 2017 and were: amoxicillin-clavulanic acid, ceftriaxone, piperacillin-tazobactam, amoxicillin, and cotrimoxazole. They accounted for half of the drugs prescribed in healthcare facilities (49.9%).

These results encourage the continuation of efforts to prevent healthcare-associated infections by targeting the most common infections and strengthening initiatives to promote the appropriate use of antibiotics.

Data from the French survey will be submitted to the ECDC; the first results produced at the European level by the ECDC are expected to be available in early 2024 and will allow for a comparison of the situation in France with that of other countries.

For more information:

• On healthcare-associated infections

• On antibiotic resistance and antibiotic use

• Surveillance of antibiotic consumption and bacterial resistance in healthcare facilities. Spares Mission – 2021 Results