Skip to main content

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

  • Jean Carlet (a1), Pascal Astagneau (a2), Christian Brun-Buisson (a3), Bruno Coignard (a4), Valérie Salomon (a5), Béatrice Tran (a5), Jean-Claude Desenclos (a4), Vincent Jarlier (a6), Benoît Schlemmer (a7), Pierre Parneix (a8), Bernard Regnier (a9), Jacques Fabry (a10) and French National Program for Prevention of Healthcare-Associated Infections and Antimicrobial Resistance...

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.


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.


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.


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.

Corresponding author
Head of the Prospective Research and Safety Program, French National Authority for Health, Saint-Denis, France(
Hide All
1.Conseil de l'Europe. Résolution (72) 31 du 19 septembre 1972 concernant l'hygiène hospitalière. Journal Officiel du Conseil de l'Europe 1973;5468.
2.Institut de veille sanitaire. Surveillance des infections du site opératoire en France de 1999 à 2004. Résultats. Novembre 2006. Available at: Accessed June 4, 2009.
3.The National Observatory of Bacterial Resistance Epidemiology (ONERBA). Available at: Accessed June 4, 2009.
4.Dutch National Institute for Public Health and the Environment. European Antimicrobial Resistance Surveillance System, 2005 annual report Available at ( Accessed June 4, 2009.
5.Improving Patient Safety in Europe. Rates of SSI and MRSA in France with those of several other European countries using the data produced by the European HELICS. Available at: Accessed June 4, 2009.
6.Institut de veille sanitaire. Bulletin epidemiologique hebdomadaire, 51-52/2006 du 26/12/06. Available at: 51_52/beh_51_52_2006.pdf). Accessed June 4, 2009.
7.The French Prevalence Survey Study Group. Prevalence of nosocomial infection in France: results of the nation-wide survey in 1996. J Hosp Infect 2000;46:186193.
8.Lepoutre, A, Branger, B, Garreau, N, et al pour le Réseau d’alerte, d’investigation et de surveillance des infections nosocomiales (Raisin). Deuxième enquête nationale de prévalence des infections nosocomiales, France. Surveillance nationale des maladies infectieuses (SNMI) 2001-2003. Institut de veille sanitaire, 2005. Available at: http://wwwìons/2TO5/srmii/infections_noso_enquete.htm. Accessed June 4, 2009.
9.Pokier Bègue, E, Chaib, A, Georges, S, Coignard, B, pour le Réseau d'Alerte, d'Investigation et de Surveillance des Infections Nosocomiales (Raisin). Caractéristiques des établissements de santé participant aux réseaux de surveillance des infections nosocomiales du Raisin en 2003. In: Program and abstracts of the Journées de veille sanitaire, November 29-30, 2005; Paris, France. Available at: Accessed June 4, 2009.
10.Institut de veille sanitaire. Surveillance dés infections du site opératoire en France de 1999 à 2004. Résultats. Novembre 2006. Available at: Accessed June 4, 2009.
11.Wilson, J, Ramboer, I, Suetens, C, HELICS-SSI Working Group. Hospitals in Europe Link for Infection Control through Surveillance (HELICS). Inter-country comparison of rates of surgical infection-opportunities and limitations. J Hosp Infect 2007;65(suppl 2):165167.
12.Suetens, C, Morales, I, Savey, A, et al.European surveillance of ICU-acquired infections (HELICS-ICU): methods and main results. J Hosp Infect 2007;65(suppl 2):171173.
13.Haute Autorité de Santé. Recommandation professionnelle: stratégie d’antibiothérapie et prévention des résistances bactériennes en établissement de santé. Available at: Accessed June 4, 2009.
14.French Ministry of Health. Les infections nosocomiales: tableau de bord des infections nosocomiales dans les établissements de santé. Available at: Accessed June 4, 2009.
15.Institut de veille sanitaire. Surveillance des infections du site opératoire en France de 1999 à 2004. Résultats. Novembre 2006. Available at: Accessed June 4, 2009.
16.Centers for Disease Control and Prevention. National Nosocomial Infections Surveillance System, reports and publications. Available at: http: // Accessed June 4, 2009.
17.Hospitals in Europe Link for Infection Error! Hyperlink reference not valid.urveillance. SSI Stat report 2004 final version. Available at: Error! Hyperlink reference not Accessed June 4, 2009.
18.Anonymous. Recent trends in antimicrobial resistance among Streptococcus pneumoniae and Staphylococcus aureus isolates: the French experience. Euro Surveill 2008;13:16. Available at: 19035. Accessed June 4, 2009.
19.Haley, RW, Quade Freeman, HE, et al.The SENIC Project. Study on the efficacy of nosocomial infections (SENIC Project): summary of study design. Am J Epidemiol 1980;111:472485.
20.Rioux, C, Grandbastien, B, Astagneau, P. Impact of a six-year control program on surgical site infections in France: results of the INCISO surveillance. J Hosp Infect 2007;66:217223.
21.Gastmeier, P, Coignard, B, Horan, T. Surveillance for healthcare-associated infections. In: M'ikanatha, NM, Lynfield, R, Van Beneden, CA, de Valk, H, eds. Infectious disease surveillance. 1st ed. Maiden, MA: Blackwell Publishing, 2007:159170.
22.Gastmeier, P, Geifers, C, Brandt, C, et al.Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect 2006;64:1622.
23.Mannten, J, van den Hof, S, Brandt, C, et al.Comparison of the National Surgical Site Infection surveillance data between The Netherlands and Germany: PREZIES versus KISS. J Hosp Infect 2007;66:224231.
24.Burack, JH, Impellizzeri, P, Hömel, P, Cunningham, JN Jr.Public reporting of surgical mortality: a survey of New York State cardiothoracic surgeons. Ann Thorac Surg 1999;68:11951200.
25.Rioux, C, Grandbastien, B, Astagneau, P. The standardized incidence ratio as a reliable tool for surgical site infection surveillance. Infect Control Hosp Epidemiol 2006;27:817824.
26.Jodra, VM, Rodela, AR, Martinez, EM, et al.Standardized infection ratios for 3 general surgery procedures: a comparison between Spanish hospitals and US centers participating in the National Nosocomial Infections Surveillance System. Infect Control Hosp Epidemiol 2003;24:744748.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed