2018年法国出现广泛耐药细菌(eXDR)

M. Colomb-Cotinat , S. Soing-Altrach , A. Leon , Y. Savitch , I. Poujol , T. Naas , V. Cattoir , A. Berger-Carbonne , L. Dortet , the CPIAS network
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引用次数: 14

摘要

本2018年医疗保健相关感染预警和反应系统(HAI-EWRS)关于产碳青霉烯酶肠杆菌科(CPE)或耐糖肽类屎肠球菌(GRE)的报告,以及国家抗微生物药物耐药性参考中心(NRC)分析的菌株,旨在描述法国新出现的广泛耐药细菌(eXDR)的流行病学和医院环境中实施的控制措施。患者和方法分析2018年1月1日至2018年1月31日期间在国家层面收到的所有HAI-EWRS eXDR报告和NRC收到的所有eXDR菌株。分析的变量为病例数、菌株数、耐药机制、样本类型、与国外的联系以及采取的控制措施。结果2018年,法国共有364家医院和155家医院报告了1704份CPE通报和315份GRE通报,自2012年以来呈上升趋势(CPE为× 6, GRE为× 3) (CPE为+66%,GRE为+57%)。eXDR菌株主要从直肠筛查拭子中分离。与入院时接受接触性预防措施的患者相比,接受标准预防措施的患者的通报更常与疫情相关。2018年NRC共收到CPE菌株2674株,GRE菌株775株,分别比2012年增加8.3株和2.8株。结论NRC每年收到的eXDR报告数量和菌株数量的增加是多因素的,但反映出eXDR在法国的传播令人担忧。感染的数量仍然很低,但本文表明,现有的建议没有得到充分实施。
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Emerging extensively drug-resistant bacteria (eXDR) in France in 2018

Objective

This 2018 report of Healthcare-Associated Infections Early Warning and Response System (HAI-EWRS) notifications of carbapenemase-producing Enterobacteriaceae (CPE) or glycopeptide-resistant Enterococcus faecium (GRE), and of strains analysed by the National Reference Center for anti-microbial resistance (NRC) aimed to describe the epidemiology of emerging extensively drug-resistant bacteria (eXDR) in France and control measures implemented in hospital settings.

Patients and methods

All HAI-EWRS notifications of eXDR received at the national level and all eXDR strains received at the NRC between January 1, 2018 and January 31, 2018 were analysed. Variables analysed were number of cases, number of strains, resistance mechanism, sample type, link with a foreign country, and control measures implemented.

Results

In 2018, 1704 CPE notifications and 315 GRE notifications were reported in France, with an increasing trend since 2012 (× 6 for CPE, × 3 for GRE), from respectively 364 and 155 hospitals (+66% for CPE, +57% for GRE since 2012). eXDR strains were mainly isolated from rectal screening swabs. Notifications with patients receiving standard precautions were more often associated with outbreaks than notifications with patients receiving contact precautions at admission. NRC received 2674 CPE strains and 775 GRE strains in 2018 (× 8.3 and × 2.8 compared with 2012).

Conclusion

The increasing annual number of eXDR notifications and eXDR strains received by the NRC is multifactorial but reflects a worrying spread of eXDR in France. The number of infections remains low, but this article shows that existing recommendations are not fully implemented.

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来源期刊
Medecine et maladies infectieuses
Medecine et maladies infectieuses 医学-传染病学
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
10.7 weeks
期刊介绍: L''organe d''expression de la Société de Pathologie Infectieuse de Langue Française (SPILF). Médecine et Maladies Infectieuses is the official publication of the Société de Pathologie Infectieuse de Langue Française (SPILF). Médecine et Maladies Infectieuses is indexed in the major databases: Medline, Web of Science/Clarivate and Scopus. The journal publishes scientific /research articles, general reviews, short communications and letters, in both English and French. The journal welcomes submissions on the various aspects of infectious pathologies and pathogenic agents. Médecine et Maladies Infectieuses focuses on clinical therapeutics, nosocomial infections, biology, prevention, as well as epidemiology and therapeutics.
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