Multidrug-resistant bacteria surveillance, France, 20022005
Abstract number: 1732_240
Carbonne A., Arnaud I., Coignard B., Trystram D., Marty N., Maugat S., Fosse T., Savey A., Dumartin C., Senechal H., Bertrand X., Bajolet O., Astagneau P., Jarlier V.
Background: The prevalence rate of multidrug resistant bacteria (MDRB) in French hospitals is one of the highest among European countries. Since the mid-1990s, control of MDRB patient-to-patient transmission has becoming a main priority for the national infection control programme. In 1998, hospitals were advised to strengthen MDRB surveillance and prevention based on defined national guidelines.
Methods: To assess the impact of the control programme, a national coordination of MDRB surveillance networks was set up in 2002: data were collected three months a year from volunteer hospital laboratories. All diagnosis specimens (a strain with the same antibiotype per patient) of methicillin-resistant Staphylococcus aureus (MRSA), and Enterobacteriaceae producing extended-spectrum b-lactamase (ESBLE) were prospectively included. The incidence rate per 1000 patientdays (pd) was estimated for MRSA and ESBLE. Incidence between 2002 and 2005 was compared using the Poisson confidence interval.
Results: The number of participating laboratories has increased from 478 in 2002 to 589 in 2005. The incidence per 1000 pd was the highest in intensive care unit (2.24), compared to 0.76 in acute care and 0.39 in long-term care facilities. When all care units were considered, the incidence of MRSA decreased significantly from 0.63 in 2002 to 0.58 per 1000 pd in 2005. The decrease was observed mostly in acute care and intensive care units. The incidence of ESBLE increased significantly from 0.13 to 0.16 per 1000 pd. This increase was observed in all type of care facilities. Enterobacter aerogenes was the most frequent ESBLE (36%), in 2002 and Escherichia coli (39%) in 2005.
Conclusion: These results demonstrates the positive impact of the national prevention programme on hospital-acquired MRSA rates. However, the incidence remains high and efforts have to be sustained. In contrast, incidence of ESBLE is increasing, especially ESBL Escherichia coli, which could be a threat for the community.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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