National multidrug-resistant bacteria (MDRB) surveillance in France through the RAISIN network: a 9 year experience. - Archive ouverte HAL Access content directly
Journal Articles Journal of Antimicrobial Chemotherapy Year : 2013

National multidrug-resistant bacteria (MDRB) surveillance in France through the RAISIN network: a 9 year experience.

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Anne Carbonne
  • Function : Author
Isabelle Arnaud
  • Function : Author
Sylvie Maugat
  • Function : Author
Nicole Marty
  • Function : Author
Catherine Dumartin
  • Function : Author
Thierry Fosse
  • Function : Author
Mathieu Eveillard
Hélène Sénéchal
  • Function : Author
Pascal Astagneau
  • Function : Author
Vincent Jarlier
  • Function : Author
Non Renseigné
  • Function : Author

Abstract

BACKGROUND: In the mid-1990s, the prevalence rate of multidrug-resistant bacteria (MDRB) in French hospitals was high and control of MDRB spread then became a major priority in the national infection control programme (ICP). METHODS: To evaluate the impact of the ICP, a national coordination of MDRB surveillance was set up in 2002. Data were collected 3months a year in healthcare facilities (HCFs) on a voluntary basis. All clinical specimens of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE) were prospectively included. Incidences per 1000 patient days (PDs) were calculated and trends in incidence from 2003 to 2010 were assessed. RESULTS: Participation in the surveillance increased from 478 HCFs in 2002 to 933 in 2010. In 2010, MRSA incidence was 0.40/1000 PDs: 1.14 in intensive care units (ICUs), 0.48 in acute care facilities (ACFs) and 0.27 in rehabilitation and long-term care facilities (RLTCFs). ESBLE incidence was 0.39/1000 PDs: 1.63 in ICUs, 0.46 in ACFs and 0.23 in RLTCFs. MRSA incidence significantly decreased from 0.72/1000 PDs in 2003 to 0.41/1000 PDs in 2010 (P < 10); in contrast, ESBLE incidence significantly increased from 0.17/1000 PDs to 0.48/1000 PDs (P < 10). The most prevalent ESBLE were Enterobacter aerogenes (34%) and Escherichia coli (25%) in 2003 and E. coli (60%) and Klebsiella pneumoniae (18%) in 2010. CONCLUSION: These results demonstrate the positive impact of the national ICP on MRSA rates. In contrast, ESBLE incidence, especially ESBL-producing E. coli, is increasing dramatically and represents a serious threat for hospitals and for the community that deserves specific control actions.

Dates and versions

hal-00802748 , version 1 (20-03-2013)

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Anne Carbonne, Isabelle Arnaud, Sylvie Maugat, Nicole Marty, Catherine Dumartin, et al.. National multidrug-resistant bacteria (MDRB) surveillance in France through the RAISIN network: a 9 year experience.. Journal of Antimicrobial Chemotherapy, 2013, 68 (4), pp.954-9. ⟨10.1093/jac/dks464⟩. ⟨hal-00802748⟩
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