Surveillance of multidrug-resistant bacteria in healthcare facilities in France. BMR-Raisin Network. 2013 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 2013, 1,347 HCFs participated in the surveillance program, representing an 182% increase since 2002 and covering 78.3% of hospital beds in France. For MRSA, the overall incidence density (ID) was 0.30 per 1,000 hospital days (HD) and ranged from 0.26 to 0.37 depending on the subregion. It was higher in short-stay care (0.40) and intensive care (1.06) than in follow-up care and rehabilitation and long-term care (SSR-SLD) (0.20). Since 2002, the MRSA ID has decreased by 53% overall and by 58% in intensive care. For EBLSE, the overall incidence rate was 0.55 per 1,000 patient-days, ranging from 0.33 to 0.69 depending on the subregion. It was twice as high in short-stay care (0.76) as in SSR-SLD (0.33). Since 2002, the incidence rate of EBLSE has quadrupled (+325%), and the proportion of Escherichia coli (E. coli) among EBLSE has increased from 19% to 59%. 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 to be between 31,000 and 45,000, including approximately 4,000 to 5,000 bacteremias, and that of EBLSE between 40,000 and 83,000, including between 4,000 and 9,000 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: 2015
Pages: 104 p.
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