Bertrand X, Mouchot L, Jebabli M, Bajolet O, Aho S, Blech M-F, Eloy C, Floret N, Gayet S, Talon D, Tronel H
Service d'hygiène hospitalière, Centre Hospitalier Universitaire Besançon, Besançon, France.
Eur J Clin Microbiol Infect Dis. 2008 Nov;27(11):1113-7. doi: 10.1007/s10096-008-0536-0. Epub 2008 May 17.
The objective of this study was to describe trends for the years 2004 to 2006 in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae-producing extended-spectrum beta-lactamase (ESBLE) in a large hospital network (70 hospitals in eastern France). The incidence of MRSA per 1,000 patient-days decreased significantly from 0.55 in 2004 to 0.45 in 2006. This trend was observed in medicine and surgery units, whereas MRSA incidence was stable in intensive care, paediatric and obstetric units. The incidence of blood cultures positive for MRSA remained stable at 0.04 per 1,000 patient-days. Conversely, the incidence of ESBLE increased significantly from 0.04 in 2004 to 0.08 in 2006. This increase was caused by the spread of ESBLE-producing Escherichia coli. The mean consumption of alcohol-based gel and solution (ABS), expressed in litres per 1,000 patient-days, was 3.3 in 2002, 4.5 in 2003, 5.4 in 2004 and 6.4 in 2005. There was no association between the consumption of ABS and MRSA incidence. These findings suggest that the French recommendations for the control of multi-drug-resistant bacteria (MDRB) have been effective in reducing, or at least stabilising, the incidence of MRSA in an international context of general increase. However, the diffusion of ESBLE-producing E. coli is a matter of concern and should be carefully monitored.
本研究的目的是描述2004年至2006年期间，法国东部一个大型医院网络（70家医院）中耐甲氧西林金黄色葡萄球菌（MRSA）和产超广谱β-内酰胺酶（ESBLE）肠杆菌科细菌的发病率趋势。每1000个患者日的MRSA发病率从2004年的0.55显著下降至2006年的0.45。在内科和外科病房观察到了这种趋势，而重症监护、儿科和产科病房的MRSA发病率保持稳定。MRSA血培养阳性率每1000个患者日保持在0.04稳定水平。相反，ESBLE的发病率从2004年的0.04显著增加至2006年的0.08。这种增加是由产ESBLE的大肠杆菌传播所致。以每1000个患者日升数表示的酒精基凝胶和溶液（ABS）的平均消耗量在2002年为3.3，2003年为4.5，2004年为5.4，2005年为6.4。ABS的消耗量与MRSA发病率之间没有关联。这些发现表明，法国控制多重耐药菌（MDRB）的建议在全球普遍增加的背景下，有效地降低了或至少稳定了MRSA的发病率。然而，产ESBLE大肠杆菌的传播令人担忧，应予以密切监测。
