European Network for the Surveillance of Antimicrobial Resistance (EARS-Net): Results for France from 2001 to 2010 and its Position in Europe
Since 2001, France has participated in the European surveillance of antibiotic resistance in Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae in cases of bacteremia (European Antimicrobial Resistance Surveillance System [EARSS]) through several laboratory networks affiliated with the National Observatory for the Epidemiology of Bacterial Antibiotic Resistance (Onerba). The proportion of methicillin-resistant S. aureus (MRSA) strains decreased from 2001 to 2010 (33.2% to 21.5%). This decrease occurred both for bacteremias diagnosed during the first two days after admission (25% to 17%) and for late-onset bacteremias during the second week (34% to 25%), third week (45% to 27%), or later (53% to 36%). The proportion of strains resistant to third-generation cephalosporins (3GC) among E. coli remained stable from 2002 to 2005 (approximately 2%), but has increased since then (8.6% in 2010), with two-thirds of these strains found to produce extended-spectrum β-lactamases (ESBL). The increase was more pronounced in late-onset bacteremias: 2–7% during the first two days after admission, but 2–13% during the third week and 4–15% thereafter. In 2010, the proportion of resistant strains was highest in intensive care (13.2%) and lowest in obstetrics and gynecology (1.5%). The proportion of C3G-resistant strains of K. pneumoniae increased from 2005 to 2010 (4.9% to 19.3%), with three-quarters of these strains detected as producing ESBL. The increase was more pronounced in late-onset bacteremia: 3% to 13% during the first two days, but 4% to 28% during the third week and 13% to 33% thereafter. The proportions of resistance to C3G were particularly high in intensive care units (38%) in 2010. The EARSS results show that France: is among the small number of countries where the proportion of MRSA in S. aureus has decreased significantly in recent years; occupied, in 2010, a median position regarding E. coli resistance to C3Gs, although this was less favorable than in 2008, due to a sharper increase than in the Scandinavian countries; and was in an unfavorable position regarding K. pneumoniae resistance to C3G, having fallen from fifth to 15th place in Europe between 2005 and 2010. This suggests insufficient control of the spread of this type of resistance (primarily linked to ESBL) in these two species.
Author(s): Trystram D, Chardon H, Pean Y, Delarbre JM, Costa Y, Maugat S, Coignard B, Jarlier V
Publishing year: 2013
Pages: 73-8
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