title: [Carbapenemase-producing enterobacteriae: epidemiology, strategies to control their spread and issues].
abstract: The increasing bacterial resistance to antibiotics has become a major public health concern bringing the threat of therapeutic impasses. In this context, control of the spread of highly-resistant bacteria emerging antibiotics (BHRe), such as glycopeptide-resistant enterococci (VRE) and Enterobacteriaceae producing carbapenemases (CPE), is based on a dual strategy of reducing the prescription of antibiotics to limit the pressure selection and preventing the spread from carriers. Prevention strategy is based on three different levels such as standard precautions for all patients with a particular focus on the management of excreta, and additional precautions for BHRe carriers. What makes it difficult is that carriage is usually completely asymptomatic, enterobacteria and enterococci are normal commensal of gut microbiota. Explosive dissemination of Enterobacteriaceae producing extended spectrum beta-lactamases in hospital and community heralds the emergence of CPE whose import by patients with a history of hospitalization in abroad may be the main source of spread in France.
authors.affiliation: Unité de gestion du risque infectieux, université de Nantes, 6, rue du prof.-Yves-Boquien, 44093 Nantes cedex 01, France; EA3826, thérapeutiques cliniques et expérimentales des infections, université de Nantes, 44035 Nantes, France. Electronic address: didier.lepelletier@chu-nantes.fr.
authors.forename: D
authors.initials: D
authors.lastname: Lepelletier
authors.affiliation: EA3826, thérapeutiques cliniques et expérimentales des infections, université de Nantes, 44035 Nantes, France.
authors.forename: E
authors.initials: E
authors.lastname: Batard
authors.affiliation: Unité d'hygiène inter-hospitalière, service des maladies infectieuses et de microbiologie, CHU de Saint-Étienne, 42100 Saint-Étienne, France.
authors.forename: P
authors.initials: P
authors.lastname: Berthelot
authors.affiliation: Unité de lutte contre les infections nosocomiales, CHU d'Angers, 49100 Angers, France.
authors.forename: J-R
authors.initials: JR
authors.lastname: Zahar
authors.affiliation: Unité hospitalière de lutte contre l'infection nosocomiale, groupe hospitalier Bichat-Claude-Bernard, AP-HP, 75877 Paris, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Lucet
authors.affiliation: CLIN central de l'AP-HP, 75004 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Fournier
authors.affiliation: CLIN central de l'AP-HP, 75004 Paris, France; Laboratoire de bactériologie, hôpital La Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Jarlier
authors.affiliation: Unité de lutte contre les infections nosocomiales, service de gestion du risque infectieux, des vigilances et d'infectiologie, CHRU de Lille, 59000 Lille, France.
authors.forename: B
authors.initials: B
authors.lastname: Grandbastien
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D004755:Enterobacteriaceae / Q000187:drug effects*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D017053:Infection Control / Q000379:methods*; D001618:beta-Lactamases
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Bactéries hautement résistantes aux antibiotiques; Carbapenemase; Carbapénémases; Emergence; Highly-resistant bacteria; Prevention; Prévention; Émergence