Bourigault C, Corvec S, Bemer P, Juvin M-E, Guillouzouic A, Crémet L, Reynaud A, Leprince C, Lepelletier D
Unité de gestion du risque infectieux, service de bactériologie-hygiène, Le Tourville, 5, rue du Pr-Yves-Boquien, 44093 Nantes cedex 01, France.
Pathol Biol (Paris). 2013 Oct;61(5):217-22. doi: 10.1016/j.patbio.2012.06.001. Epub 2012 Jul 26.
The French national surveillance program of multidrug-resistant bacteria (MDR) shows an increase of enterobacteriaceae-producing extended-spectrum beta-lactamases (ESBLE) incidence. The objectives of this study were to assess: the incidence of EBLSE in a large French university hospital between 2005 and 2010, and the difference of barrier precautions implementation between ESBL and other MDR.
The ESBLE incidence measure used data from the laboratory of bacteriology. The application of isolation and barrier precautions was analyzed from the MRB national surveillance data over a 3-year period from 2006 to 2008. Data were entered and analyzed using Epi Info software. The Chi(2) test was used for the comparison of proportions.
The overall incidence of ESBLE was significantly higher in 2010 than in 2005 (0.20/1000 patients-days vs 0.03/1000 patients-days, respectively) (P<0.001). The same was observed for Escherichia coli incidence with rates ranging from 0.02/1000 patients-days in 2005 to 0.15/1000 patients-days in 2010. Isolation precautions for patients with EBLSE were applied in relation for most patients with MRB (ESBLE vs others), without significant difference.
The surveillance programme of MRB showed a significant increase of ESBLE, especially for E. coli. Isolation and barrier precautions were used for most patients with MRB, including ESBLE.
法国国家多重耐药菌监测项目显示,产超广谱β-内酰胺酶(ESBLE)的肠杆菌科细菌发病率有所上升。本研究的目的是评估:2005年至2010年期间,一家大型法国大学医院中EBLSE的发病率,以及ESBL与其他多重耐药菌在实施隔离预防措施方面的差异。
EBLSE发病率的测量采用了细菌学实验室的数据。从2006年至2008年的3年期间,通过MRB国家监测数据对隔离和屏障预防措施的应用情况进行了分析。数据使用Epi Info软件录入和分析。采用卡方检验进行比例比较。
2010年ESBLE的总体发病率显著高于2005年(分别为0.20/1000患者日和0.03/1000患者日)(P<0.001)。大肠杆菌发病率也呈现同样的情况,发病率从2005年的0.02/1000患者日上升至2010年的0.15/1000患者日。对于大多数多重耐药菌患者(ESBLE与其他细菌),针对EBLSE患者的隔离预防措施的应用情况并无显著差异。
多重耐药菌监测项目显示ESBLE显著增加,尤其是大肠杆菌。大多数多重耐药菌患者,包括ESBLE患者,都采取了隔离和屏障预防措施。