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Collineau L, Rousset L, Colomb-Cotinat M, Bordier M, Bourely C. Moving towards One Health surveillance of antibiotic resistance in France: a semi-quantitative evaluation of the level of collaboration within the national surveillance system. JAC Antimicrob Resist 2024; 6:dlae008. [PMID: 38304724 PMCID: PMC10833649 DOI: 10.1093/jacamr/dlae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Objectives Collaboration between surveillance programmes is the keystone of One Health surveillance and international organizations call for integrated surveillance systems to manage antibiotic resistance (ABR). In France, the ABR surveillance system covers human, animal, food and the environment sectors, but appears to be fragmented, questioning its level of integration. This study aimed to evaluate collaboration within this system and to formulate recommendations towards more integration. Methods ECoSur, a semi-quantitative tool, was used to evaluate collaboration between surveillance programmes. A total of 31 attributes were evaluated using information from the literature and 52 interviews with surveillance actors from all four sectors. Evaluation results were visualized via three output figures displaying aspects related to governance and functionality of collaboration. Results were validated by an expert committee. Results Overall, the French collaborative strategy for ABR surveillance was well formalized and relevant to its objectives. However, a cross-sectoral coordination body was lacking to help with its practical implementation. The environmental sector was largely uncovered, but its integration appeared necessary to meet the strategy objectives. Data sharing and joint data analyses between programmes were insufficient, mainly due to limited resources and data interoperability issues. Collaboration was operational for internal and external communication of the results. Twelve recommendations were suggested to decision makers to foster collaboration within the French surveillance system and feed future strategies against ABR. Conclusions This first evaluation of collaboration within the French ABR surveillance system produced concrete recommendations to move towards One Health integrated surveillance. Both the approach and the findings could be of interest to other countries.
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Affiliation(s)
- Lucie Collineau
- University of Lyon—French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Epidemiology and Surveillance Support Unit, Lyon, France
| | - Léo Rousset
- University of Lyon—French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Epidemiology and Surveillance Support Unit, Lyon, France
- Université Claude Bernard Lyon 1, Service des Etudes Interdisciplinaires en Santé, Lyon, France
- VetAgro Sup, University of Lyon, USC 1223-RS2GP, Laboratory of Leptospira and Veterinary Analysis, Marcy L’Etoile, France
| | | | - Marion Bordier
- ASTRE, University of Montpellier, CIRAD, INRAE, Montpellier, France
- CIRAD, UMR ASTRE, Dakar, Senegal
- National Laboratory for Livestock and Veterinary Research, Senegalese Institute of Research in Agriculture, Dakar, Senegal
| | - Clémence Bourely
- French Ministry of Agriculture and Food, General Directorate for Food, Animal Health Unit, Paris, France
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Bourély C, Rousset L, Colomb-Cotinat M, Collineau L. How to move towards One Health surveillance? A qualitative study exploring the factors influencing collaborations between antimicrobial resistance surveillance programmes in France. Front Public Health 2023; 11:1123189. [PMID: 37497029 PMCID: PMC10367569 DOI: 10.3389/fpubh.2023.1123189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/05/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction Antimicrobial resistance (AMR) is a major public health issue, against which international organisations and governmental bodies call for integration between surveillance programmes involved in human, animal, and environmental sectors. Collaborations are the primary feature of integration and deserve to be supported. However, little is known about the factors that can foster collaborations between surveillance programmes. This study aimed to provide a better understanding of the factors for setting-up collaborations between AMR surveillance programmes in France. Methods We performed a qualitative study based on 36 semi-structured interviews with programmes' coordinators and 15 with key-informant experts involved in AMR surveillance. Results The implementation of collaboration between sectors was multifactorial: we identified 42 factors grouped into six categories (i.e., characteristics of the overall AMR surveillance system, features of the collaborating programme, profile of the actors involved, characteristics of the collaboration itself, broader context, and AMR research activities). Collaborations were mainly fostered by good interpersonal relationship between actors, their interest in transdisciplinary approaches and the benefits of collaboration on the programmes involved. Limited resources and the complexity of the AMR surveillance system hindered collaboration. Paradoxically, coordinators generally did not perceive collaborations as a resource-pooling tool since they generally set them up only after consolidating their own programme. Discussion Since most factors identified were not specific to AMR, these results can be useful for other collaborative surveillance system. Ultimately, they provide a better understanding of stakeholders' motivations and influences driving collaboration, and can help researchers and risk managers promoting a One Health approach against public health threats.
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Affiliation(s)
- Clémence Bourély
- French Ministry of Agriculture and Food, General Directorate for Food, Animal Health Unit, Paris, France
| | - Léo Rousset
- Epidemiology and Support to Surveillance Unit, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), University of Lyon, Lyon, France
- Claude Bernard University Lyon 1, Lyon, France
- VetAgro Sup, Marcy-L'Étoile, France
| | | | - Lucie Collineau
- Epidemiology and Support to Surveillance Unit, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), University of Lyon, Lyon, France
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Moura P, Collineau L, Sandberg M, Tomassone L, De Meneghi D, Norström M, Bennani H, Häsler B, Colomb-Cotinat M, Bourély C, Filippitzi ME, Mediouni S, Boriani E, Asaduzzaman M, Caniça M, Aenishaenslin C, Alban L. Users' perception of the OH-EpiCap evaluation tool based on its application to nine national antimicrobial resistance surveillance systems. Front Public Health 2023; 11:1138645. [PMID: 37404278 PMCID: PMC10315896 DOI: 10.3389/fpubh.2023.1138645] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction Antimicrobial resistance (AMR) is a One Health (OH) challenge. To achieve or maintain an effective and efficient AMR surveillance system, it is crucial to evaluate its performance in meeting the proposed objectives, while complying with resource restrictions. The OH-EpiCap tool was created to evaluate the degree of compliance of hazard surveillance activities with essential OH concepts across the following dimensions: organization, operational activities, and impact of the surveillance system. We present feedback on the application of the OH-EpiCap tool from a user's perspective, based on the use of the tool to evaluate nine national AMR surveillance systems, each with different contexts and objectives. Methods The OH-EpiCap was assessed using the updated CoEvalAMR methodology. This methodology allows the evaluation of the content themes and functional aspects of the tool and captures the user's subjective experiences via a strengths, weaknesses, opportunities, and threats (SWOT) approach. Results and Discussion The results of the evaluation of the OH-EpiCap are presented and discussed. The OH-EpiCap is an easy-to-use tool, which can facilitate a fast macro-overview of the application of the OH concept to AMR surveillance. When used by specialists in the matter, an evaluation using OH-EpiCap can serve as a basis for the discussion of possible adaptations of AMR surveillance activities or targeting areas that may be further investigated using other evaluation tools.
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Affiliation(s)
- Pedro Moura
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Lucie Collineau
- University of Lyon - French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Epidemiology and Surveillance Support Unit, Lyon, France
| | - Marianne Sandberg
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Laura Tomassone
- Department of Veterinary Sciences, University of Turin, AgroVet campus, Grugliasco-Turin, Italy
| | - Daniele De Meneghi
- Department of Veterinary Sciences, University of Turin, AgroVet campus, Grugliasco-Turin, Italy
| | | | - Houda Bennani
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Barbara Häsler
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | | | - Clémence Bourély
- French Ministry of Agriculture and Food, General Directorate for Food, Animal Health Unit, Paris, France
| | - Maria-Eleni Filippitzi
- Laboratory of Animal Health Economics, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Veterinary Epidemiology Unit, Sciensano, Brussels, Belgium
| | - Sarah Mediouni
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | | | - Muhammad Asaduzzaman
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Manuela Caniça
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cécile Aenishaenslin
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Lis Alban
- Department of Food Safety, Veterinary Issues and Risk Analysis, Danish Agriculture and Food Council, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
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Collineau L, Bourély C, Rousset L, Berger-Carbonne A, Ploy MC, Pulcini C, Colomb-Cotinat M. Towards One Health surveillance of antibiotic resistance: characterisation and mapping of existing programmes in humans, animals, food and the environment in France, 2021. Euro Surveill 2023; 28:2200804. [PMID: 37261729 PMCID: PMC10236929 DOI: 10.2807/1560-7917.es.2023.28.22.2200804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/30/2023] [Indexed: 06/02/2023] Open
Abstract
BackgroundInternational organisations are calling for One Health approaches to tackle antimicrobial resistance. In France, getting an overview of the current surveillance system and its level of integration is difficult due to the diversity of surveillance programmes.AimThis study aimed to map and describe all French surveillance programmes for antibiotic resistance (ABR), antibiotic use (ABU) and antibiotic residues, in humans, animals, food and the environment, in 2021. Another objective was to identify integration points, gaps and overlaps in the system.MethodsWe reviewed the literature for surveillance programmes and their descriptions. To further characterise programmes found, semi-directed interviews were conducted with their coordinators.ResultsIn total 48 programmes in the human (n = 35), animal (n = 12), food (n = 3) and/or the environment (n = 1) sectors were identified; 35 programmes focused on ABR, 14 on ABU and two on antibiotic residues. Two programmes were cross-sectoral. Among the 35 ABR programmes, 23 collected bacterial isolates. Bacteria most targeted were Escherichia coli (n = 17 programmes), Klebsiella pneumoniae (n = 13), and Staphylococcus aureus (n = 12). Extended-spectrum beta-lactamase-producing E. coli was monitored by most ABR programmes (15 of 35) in humans, animals and food, and is a good candidate for integrated analyses. ABU indicators were highly variable. Areas poorly covered were the environmental sector, overseas territories, antibiotic-resistant-bacterial colonisation in humans and ABU in companion animals.ConclusionThe French surveillance system appears extensive but has gaps and is highly fragmented. We believe our mapping will interest policymakers and surveillance stakeholders. Our methodology may inspire other countries considering One Health surveillance of ABR.
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Affiliation(s)
- Lucie Collineau
- University of Lyon, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Epidemiology and Surveillance Support Unit, Lyon, France
| | - Clémence Bourély
- French Ministry of Agriculture and Food Sovereignty, General Directorate for Food, Animal Health Unit, Paris, France
| | - Léo Rousset
- University of Lyon, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Epidemiology and Surveillance Support Unit, Lyon, France
- Claude Bernard University Lyon 1, Lyon, France
- VetAgro Sup, Marcy L'Etoile, France
| | - Anne Berger-Carbonne
- Direction des maladies infectieuses, Santé Publique France, Saint-Maurice, France
| | - Marie-Cécile Ploy
- Université de Limoges, INSERM, CHU Limoges, UMR 1092, Limoges, France
| | - Céline Pulcini
- French Ministry for Health and prevention, Paris, France
- CHRU-Nancy, Université de Lorraine, Nancy, France
- Université de Lorraine, APEMAC, Nancy, France
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Paumier A, Ben Hmidene G, Vaux S, Olivier C, Floret N, Golliot F, Pellissier G, Rouveix E, Abiteboul D, Colomb-Cotinat M. Professionnels en établissements de santé infectés par le SARS-CoV-2 : le bilan après deux ans de pandémie. MÉDECINE ET MALADIES INFECTIEUSES FORMATION 2022. [PMCID: PMC9152522 DOI: 10.1016/j.mmifmc.2022.03.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Les professionnels travaillant en établissements de santé (PES) sont exposés au risque d'infection par le SARS-CoV-2. Une enquête a été mise en place afin d'objectiver l'impact de la pandémie dans cette population spécifique. Matériels et méthodes Un web questionnaire a été proposé mi-avril 2020 à tous les établissements de santé (ES) publics ou privés. Les ES volontaires saisissent de manière hebdomadaire le nombre de nouveaux cas de PES infectés et les décès attribuables. La région, la catégorie professionnelle, le service sont également recueillis. Les proportions de PES infectés ont été estimées en rapportant le nombre de cas aux données de la Statistique annuelle des établissements de santé 2019. Résultats 1 450 des 3 636 ES ont participé au moins une fois à l'enquête, à savoir 74,7% des PES salariés en France. Au cours de la 5ème vague, 337 ES ont participé à l'enquête soit 20,7 % des PES salariés en France. Du 1er Mars 2020 au 15 Février 2022, 118 340 PES, correspondant à 12,1 % des PES exerçant dans les ES participants ont été infectés par le SARS-CoV2, avec 19 décès attribuables. La répartition hebdomadaire du nombre de cas montre 5 pics de contamination enregistrés durant les 5 vagues épidémiques successives, le 5e pic étant le plus important. Parmi ces PES, 62,8 % des cas étaient des soignants dont 22 % d'infirmiers et 18 % d'aides-soignants. Rapportés aux effectifs globaux par catégorie professionnelle dans ces ES, les aides-soignants et les kinésithérapeutes étaient les professions les plus infectées (respectivement 12,8 et 12,2 pour 100 professionnels travaillant dans les ES participants). Les PES contaminés travaillaient principalement dans des services de MCO (42,3 %) ou médicotechniques (25,4 %). Des disparités régionales dans la proportion de PES infectés étaient observées au cours des différentes vagues. Lors de la 5ème vague, la Guadeloupe et l'Occitanie sont les régions où les PES sont les plus touchés par la COVID-19. Conclusion Cette enquête montre les mêmes tendances temporelles et géographiques qu'en population générale. L'augmentation du nombre de cas chez les PES lors de la 5ème vague est en lien avec la diffusion rapide du variant Omicron. La participation des ES a varié au cours du temps. Malgré un protocole d'enquête reposant sur la déclaration volontaire, plus de 130 ES (20 % des PES salariés) participent régulièrement à l'enquête et permettent de considérer que ces résultats donnent une bonne estimation de la dynamique de contamination des PES. Bien que l'objectif de cette étude n'était pas de déterminer les circonstances de contamination, il semble que les professions ayant des contacts fréquents et prolongés avec les patients (aides-soignants, kinésithérapeutes) sont proportionnellement les plus touchées. Aucun lien d'intérêt
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Affiliation(s)
- A. Paumier
- Santé publique France, Saint-Maurice, France
| | | | - S. Vaux
- Santé publique France, Saint-Maurice, France
| | | | - N. Floret
- CPias Bourgogne-Franche-Comté, Besançon, France
| | - F. Golliot
- Santé publique France, Saint-Maurice, France
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Colomb-Cotinat M, Poujol I, Monluc S, Vaux S, Olivier C, Le Vu S, Floret N, Golliot F, Berger-Carbonne A. Burden of COVID-19 on workers in hospital settings: The French situation during the first wave of the pandemic. Infect Dis Now 2021; 51:560-563. [PMID: 34245939 PMCID: PMC8262402 DOI: 10.1016/j.idnow.2021.06.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/11/2021] [Accepted: 06/29/2021] [Indexed: 11/28/2022]
Abstract
We launched a survey in April 2020 to assess the number and proportion of hospital workers infected during the first wave of the COVID-19 pandemic in France, and to assess the attributable mortality. All French hospital settings (HS) were invited to declare new cases and attributable deaths by occupation category each week. Between March 1 and June 28, 2020, participating HS accounted for 69.5% of the total number of HS workers in France, and declared 31,088 infected workers; 16 died from the infection. We estimated that 3.43% (95% CI: 3.42–3.45) of French workers in HS, and 3.97% (95% CI: 3.95–3.99) of healthcare workers were infected during the first wave. Workers in regions with a cumulative rate of hospitalized COVID-19 patients equal or above the national rate, HS other than tertiary hospitals, or occupations with frequent patient contacts were particularly impacted. Targeted prevention campaigns should be elaborated.
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Affiliation(s)
- M Colomb-Cotinat
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France.
| | - I Poujol
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - S Monluc
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - S Vaux
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - C Olivier
- Groupe d'étude sur le risque d'exposition des soignants aux agents infectieux (GERES), Paris, France
| | - S Le Vu
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - N Floret
- CPias Bourgogne-Franche-Comté, Besançon, France
| | - F Golliot
- Santé publique France, Direction des régions, Saint-Maurice, France
| | - A Berger-Carbonne
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
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Roux J, Nekkab N, Colomb-Cotinat M, Astagneau P, Crépey P. Time-series modelling for the quantification of seasonality and forecasting antibiotic-resistant episodes: application to carbapenemase-producing Enterobacteriaceae episodes in France over 2010-20. J Antimicrob Chemother 2021; 76:226-232. [PMID: 32929455 DOI: 10.1093/jac/dkaa388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/17/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Carbapenemase-producing Enterobacteriaceae (CPE) cause resistant healthcare-associated infections that jeopardize healthcare systems and patient safety worldwide. The number of CPE episodes has been increasing in France since 2009, but the dynamics are still poorly understood. OBJECTIVES To use time-series modelling to describe the dynamics of CPE episodes from August 2010 to December 2016 and to forecast the evolution of CPE episodes for the 2017-20 period. METHODS We used time series to analyse CPE episodes from August 2010 to November 2016 reported to the French national surveillance system. The impact of seasonality was quantified using seasonal-to-irregular ratios. Seven time-series models and three ensemble stacking models (average, convex and linear stacking) were assessed and compared with forecast CPE episodes during 2017-20. RESULTS During 2010-16, 3559 CPE episodes were observed in France. Compared with the average yearly trend, we observed a 30% increase in the number of CPE episodes in the autumn. We noticed a 1 month lagged seasonality of non-imported episodes compared with imported episodes. Average stacking gave the best forecasts and predicted an increase during 2017-20 with a peak up to 345 CPE episodes (95% prediction interval = 124-1158, 80% prediction interval = 171-742) in September 2020. CONCLUSIONS The observed seasonality of CPE episodes sheds light on potential factors associated with the increased frequency of episodes, which need further investigation. Our model predicts that the number of CPE episodes will continue to rise in the coming years in France, mainly due to local dissemination, associated with bacterial carriage by patients in the community, which is becoming an immediate challenge with regard to outbreak control.
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Affiliation(s)
- Jonathan Roux
- Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and health services research) - EA 7449, Rennes, France
| | - Narimane Nekkab
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris, France.,Institut Pasteur, Cnam, Unité PACRI, Paris, France
| | | | - Pascal Astagneau
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Centre de prévention des infections associées aux soins, Paris, France
| | - Pascal Crépey
- Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and health services research) - EA 7449, Rennes, France
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Colomb-Cotinat M, Assouvie L, Durand J, Daniau C, Leon L, Maugat S, Soing-Altrach S, Gateau C, Couturier J, Arnaud I, Astagneau P, Berger-Carbonne A, Barbut F. Epidemiology of Clostridioides difficile infections, France, 2010 to 2017. Euro Surveill 2019; 24:1800638. [PMID: 31481147 PMCID: PMC6724465 DOI: 10.2807/1560-7917.es.2019.24.35.1800638] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BackgroundClostridioides difficile is a leading cause of healthcare-associated diarrhoea in middle and high-income countries. Up to 2018, there has been no systematic, annual surveillance for C. difficile infections (CDI) in France.AimsTo provide an updated overview of the epidemiology of CDI in France between 2010 and 2017 based on five different data sources.MethodsThis is a descriptive study of retrospective surveillance and alerts data. Incidence of CDI cases was estimated through the CDI incidence survey (2016) and data from the French National Uniform Hospital Discharge Database (PMSI; 2010-16). Testing frequency for CDI was estimated through the CDI incidence survey and point prevalence studies on healthcare-associated infections (HAI; 2012 and 2017). The national early warning response system for HAI (HAI-EWRS, 2012-17) and National Reference Laboratory data (2012-17) were used to follow the number of severe CDI cases and/or outbreaks.ResultsIn 2016, CDI incidence in acute care was 3.6 cases per 10,000 patient days (PD). There was a statistically significant increase in CDI incidence between 2010 and 2016 (+ 14% annually) and testing frequency was 47.4 per 10,000 PD. The number of CDI HAI-EWRS notifications decreased between 2015 and 2017 with only a few large outbreaks reported.ConclusionThe CDI incidence estimate increased from 2010, but remained below the European average of 7 per 10,000 PD in 2014; there were fewer severe cases or clusters reported in France. The consistency between PMSI and laboratory-based estimated CDI incidence could allow for more routine monitoring of CDI incidence.
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Affiliation(s)
- Mélanie Colomb-Cotinat
- Santé publique France, Saint-Maurice, France
- These authors contributed equally and share first authorship
| | - Laetitia Assouvie
- Santé publique France, Saint-Maurice, France
- These authors contributed equally and share first authorship
| | | | - Côme Daniau
- Santé publique France, Saint-Maurice, France
| | - Lucie Leon
- Santé publique France, Saint-Maurice, France
| | | | | | - Cécile Gateau
- National reference laboratory for anaerobic bacteria and C. difficile, St Antoine Hospital, Paris, France
| | - Jeanne Couturier
- National reference laboratory for anaerobic bacteria and C. difficile, St Antoine Hospital, Paris, France
| | - Isabelle Arnaud
- Regional center for prevention of healthcare associated infections, Paris, France
| | - Pascal Astagneau
- Regional center for prevention of healthcare associated infections, Paris, France
| | | | - Frédéric Barbut
- National reference laboratory for anaerobic bacteria and C. difficile, St Antoine Hospital, Paris, France
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Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, Colomb-Cotinat M, Kretzschmar ME, Devleesschauwer B, Cecchini M, Ouakrim DA, Oliveira TC, Struelens MJ, Suetens C, Monnet DL. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis 2019; 19:56-66. [PMID: 30409683 PMCID: PMC6300481 DOI: 10.1016/s1473-3099(18)30605-4] [Citation(s) in RCA: 1625] [Impact Index Per Article: 325.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/28/2018] [Accepted: 09/25/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs). METHODS We estimated the incidence of infections with 16 antibiotic resistance-bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011-12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature. FINDINGS From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148-763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480-38 430) attributable deaths and 874 541 (768 837-989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece. INTERPRETATION Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases. FUNDING European Centre for Disease Prevention and Control.
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Affiliation(s)
- Alessandro Cassini
- European Centre for Disease Prevention and Control, Solna, Sweden; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
| | | | | | | | - Ana Hoxha
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Gunnar Skov Simonsen
- University Hospital of North Norway, Tromsø, Norway; Research Group for Host-Microbe Interaction, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Mirjam E Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Michele Cecchini
- Organisation for Economic Co-operation and Development, Paris, France
| | - Driss Ait Ouakrim
- Organisation for Economic Co-operation and Development, Paris, France
| | | | - Marc J Struelens
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Carl Suetens
- European Centre for Disease Prevention and Control, Solna, Sweden
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Bon E, Gadouri K, Avril C, Camuset G, Balleydier E, Mathieu I, Picot S, Jaubert J, Ballas R, Colomb-Cotinat M, Tristan A, Bouchiat C, Filleul L, Pagès F. Possible outbreak of skin infections due to Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus on a commercial ship in 2012–2014. Int Marit Health 2017; 68:70-71. [DOI: 10.5603/imh.2017.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/03/2017] [Accepted: 03/06/2017] [Indexed: 11/25/2022] Open
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Deschamps C, Vicente P, Segouin C, Colomb-Cotinat M. Évaluation financière de la professionnalisation du codage dans un CHU parisien. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.01.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Colomb-Cotinat M, Kunzli B, Deschamps C, Segouin C, Vicente P. Facteurs associés au recodage de séjours ciblés par des données bactériologiques. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.01.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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