Objective: Controlling outbreaks of nosocomial infections is a priority for public healthcare in France. This study concerned the incidence of multidrug-resistant bacteria (MDRB) in Lorraine and the impact of the national guidelines for the prevention of MDRB.
Methods: A multicenter incidence study was conducted for 5 months, in volunteer hospitals. Samples collected for the clinical diagnostic were included. The bacteria studied were: methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella sp., Enterobacter sp., and other Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBL), and vancomycin resistant Enterococci sp.
Results: A total of 30 hospitals were included in the surveillance of MDRB. During the study period (2001-2003), 17874 strains were identified. MRSA reached 29.3% of the 4038 strains of S. aureus, 20.9%, 1.23% and 1.21% of ESBL, respectively, for Enterobacter sp., Klebsiella sp., and other Enterobacteriaceae (for 895, 1061 and 9419 strains). Overall, the incidence of MRSA reached 0.55 per 1000 hospital-days and 0.087 for Enterobacter sp. The incidence increased during the 3 years, from 3.36 to 4.84 per 1000 new patients for MRSA, and from 0.43 to 0.90 for Enterobacter sp.
Conclusion: Despite guidelines on isolation, MRSA remains poorly controlled and requires more efficient measures. Surveillance of ESBL should be improved.