Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay,Paris,France.
Caisse nationale de l'assurance maladie, Direction de la stratégie des études et des statistiques,Paris,France.
Epidemiol Infect. 2019 Jan;147:e144. doi: 10.1017/S0950268819000402.
Massive use of antibiotics has led to increased bacterial resistance to these drugs, making infections more difficult to treat. Few studies have assessed the overall antimicrobial resistance (AMR) burden, and there is a paucity of comprehensive data to inform health policies. This study aims to assess the overall annual incident number of hospitalised patients with AMR infection in France, using the National Hospital Discharge database. All incident hospitalisations with acute infections in 2016 were extracted. Infections which could be linked with an infecting microorganism were first analysed. Then, an extrapolation of bacterial species and resistance status was performed, according to age class, gender and infection site to estimate the total number of AMR cases. Resistant bacteria caused 139 105 (95% CI 127 920-150 289) infections, resulting in a 12.3% (95% CI 11.3-13.2) resistance rate. ESBL-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus were the most common resistant bacteria (>50%), causing respectively 49 692 (95% CI 47 223-52 142) and 19 493 (95% CI 15 237-23 747) infections. Although assumptions are needed to provide national estimates, information from PMSI is comprehensive, covering all acute bacterial infections and a wide variety of microorganisms.
大量使用抗生素导致细菌对这些药物的耐药性增加，使感染更难治疗。很少有研究评估整体抗菌药物耐药性（AMR）负担，也缺乏全面的数据来为卫生政策提供信息。本研究旨在使用国家住院数据库评估法国住院患者 AMR 感染的年度总发病数。提取了 2016 年所有急性感染的入院病例。首先分析了可以与感染微生物相关联的感染病例。然后，根据年龄组、性别和感染部位对细菌种类和耐药状态进行推断，以估计 AMR 病例的总数。耐药菌引起了 139105 例（95%CI 127920-150289）感染，耐药率为 12.3%（95%CI 11.3-13.2）。产 ESBL 肠杆菌科和耐甲氧西林金黄色葡萄球菌是最常见的耐药菌（>50%），分别引起 49692 例（95%CI 47223-52142）和 19493 例（95%CI 15237-23747）感染。尽管提供全国估计值需要假设，但 PMSI 的信息是全面的，涵盖了所有急性细菌性感染和各种微生物。
