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French National Program for Prevention of Healthcare-Associated Infections and Antimicrobial Resistance, 1992–2008: Positive Trends, But Perseverance Needed

Published online by Cambridge University Press:  02 January 2015

Jean Carlet*
Affiliation:
French National Authority for Health, (Haute Autorité Santé), Saint-Denis, France
Pascal Astagneau
Affiliation:
Regional Center for Nosocomial Infection Control (C-CLIN Paris Nord), Université Pierre et Marie Curie, France
Christian Brun-Buisson
Affiliation:
Paris, CHU Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Val-de-Marne, Créteil, France
Bruno Coignard
Affiliation:
Institut de Veille Sanitaire (InVS), Saint-Maurice, France
Valérie Salomon
Affiliation:
Directorate for Hospitalization and Care Organization, Ministry of Health and Sport, France
Béatrice Tran
Affiliation:
Directorate for Hospitalization and Care Organization, Ministry of Health and Sport, France
Jean-Claude Desenclos
Affiliation:
Institut de Veille Sanitaire (InVS), Saint-Maurice, France
Vincent Jarlier
Affiliation:
Bacteriology-Hygiene, Hospital Pitié-Salpêtrière, France
Benoît Schlemmer
Affiliation:
Saint-Louis Hospital, AP-HP, University Paris Diderot, France
Pierre Parneix
Affiliation:
Southwestern France Hospital-Associated Infection Control Center, (C-CLIN Sud-ouest-CHU Pellegrin), Bordeaux, France
Bernard Regnier
Affiliation:
Medical Intensive Care Unit, Bichat Hospital, France
Jacques Fabry
Affiliation:
Université Lyon 1, Lyon, France
*
Head of the Prospective Research and Safety Program, French National Authority for Health, Saint-Denis, France( j.carlet@has-sante.fr)

Abstract

Objective.

To describe the French program for the prevention of healthcare-associated infections and antibiotic resistance and provide results for some of the indicators available to evaluate the program. In addition to structures and process indicators, the 2 outcome indicators selected were the rate of surgical site infection and the proportion of methicillin-resistant Staphylococcus aureus (MRSA) isolates among the S. aureus isolates recovered.

Design.

Descriptive study of the evolution of the national structures for control of healthcare-associated infections since 1992. Through national surveillance networks, process indicators were available from 1993 to 2006, surgical site infection rates were available from 1999 to 2005, and prevalence rates for MRSA infection were available from 2001 to 2007.

Results.

A comprehensive national program has gradually been set up in France during the period from 1993 to 2004, which included strengthening of organized infection control activities at the local, regional, and national levels and developing large networks for surveillance of specific infections and antibiotic resistance. These achievements were complemented by instituting mandatory notification for unusual nosocomial events, especially outbreaks. The second phase of the program involved the implementation of 5 national quality indicators with public reporting. Surgical site infection rates decreased by 25% over a 6-year period. In France, the median proportion of MRSA among S. aureus isolates recovered from patients with bacteremia decreased from 33.4% to 25.7% during the period from 2001 to 2007, whereas this proportion increased in many other European countries.

Conclusions.

Very few national programs have been evaluated since the Study on the Efficacy of Nosocomial Infection Control. Although continuing efforts are required, the French program appears to have been effective at reducing infection rates.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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