Surveillance of multidrug-resistant bacteria in healthcare facilities: BMR-Raisin Network, France, 2017 Results
Controlling the spread of multidrug-resistant bacteria (MDRB) in healthcare facilities is a priority of the National Program for the Prevention of Healthcare-Associated Infections (PROPIAS). 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 healthcare facilities. In 2017, 1,311 HCFs participated in the surveillance program, covering 73% of hospital beds in France. For MRSA, the overall incidence rate (IR) was 0.23 per 1,000 patient-days. It was higher in short-stay units (0.33), particularly in intensive care (0.75), than in post-acute care (0.11) and long-term care (0.08). Since 2002, the MRSA ID has decreased by 64% overall and by 70% in intensive care. For EBLSE, the overall ID was 0.67 per 1,000 patient-days, showing for the first time since 2002 a slight downward trend compared to the previous year. It was twice as high in short-stay care (0.93) as in post-surgical care (0.43) and three times higher than in long-term care (0.25). Since 2002, the incidence rate of EBLSE has increased 5.2-fold (+416%), and the proportion of Escherichia coli among EBLSE cases has risen from 19% to 54%. The continued decline in the incidence of MRSA suggests a positive impact of the prevention measures implemented in the units participating in the network. The annual number of MRSA-related healthcare-associated infections (HAIs) is, however, estimated at between 19,000 and 32,000, including approximately 3,900 to 5,500 bacteremias, and that of carbapenem-resistant E. coli (CRE) at between 47,000 and 95,000, including between 6,200 and 11,300 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 Isabelle, Jarlier Vincent
Publishing year: 2019
Pages: 94 p.
Collection: Studies and Surveys
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