title: Ongoing increasing temporal and geographical trends of the incidence of extended-spectrum beta-lactamase-producing Enterobacteriaceae infections in France, 2009 to 2013.
abstract: Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are a major focus of multidrug-resistant organisms (MRO) surveillance programmes in France. To describe the temporal and geographical trends of these pathogens, we conducted an epidemiological study based on data extracted from the nationwide MRO surveillance network from 2009 to 2013. During this time, the incidence of ESBL-E infections in French hospitals increased by 73%, from 0.35 to 0.60 per 1,000 patient days (PD) (p<0.001) and ESBL-E bacteraemia by 77%, from 0.03 to 0.05 per 1,000 PD (p<0.001). The incidence of ESBL-E infections was higher in intensive-care units (1.62 to 2.44 per 1,000 PD (p<0.001)) than in recovery and long-term care facilities (0.20 to 0.31 per 1,000 PD (p<0.001)). Escherichia coli was the most frequent extended-spectrum beta-lactamase-producing (ESBL) pathogen, representing 59% (26,238/44,425) of all ESBL isolates, followed by Klebsiella pneumoniae (20%; 8,856/44,425) in 2013. The most frequent infection was urinary tract infection, for all species. The incidence of ESBL-E varied by region but showed an upward trend overall. Reinforcement of control measures for halting the spread of such MRO is crucial.
authors.affiliation: Regional Coordinating Centre for Healthcare-Associated Infections Control (CClin Paris - Nord), Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnaud
authors.forename: Sylvie
authors.initials: S
authors.lastname: Maugat
authors.forename: Vincent
authors.initials: V
authors.lastname: Jarlier
authors.forename: Pascal
authors.initials: P
authors.lastname: Astagneau
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D004755:Enterobacteriaceae / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: ESBLE; antibiotic resistance; cross-transmission; emerging infection