The healthcare-associated infection surveillance system led by Santé publique France makes it possible to track trends in specific HAI indicators.

The incidence of healthcare-associated infections is no longer declining

Since 1996, national prevalence surveys (NPS) of healthcare-associated infections (HAIs) and antimicrobial treatments (AMT) have been conducted approximately every 5 years.

In 2017, the NPS on HIs and AIs aimed to measure their prevalence on a specific day between May 15 and June 30 and to describe their characteristics in healthcare facilities (HCFs) in France. The protocol was based on that of the European survey led by the ECDC. This 6th national survey was implemented and coordinated by Santé publique France in partnership with 5 Cpias.

The results of the 2017 ENP confirm the findings of previous surveys: on a given day in France, one in 20 hospitalized patients has at least one nosocomial infection, and nearly one in seven patients receives antibiotic treatment.

Since 2012, the overall prevalence of infected patients has remained stable, whereas it had declined steadily between 2001 and 2012. Compared to other European countries, France’s ranking regarding the prevalence of infected patients in short-stay healthcare facilities declined in 2017 compared to 2012.

These results underscore the need to continue efforts to prevent healthcare-associated infections by targeting the most common and/or most serious infections (urinary tract infections, surgical site infections, pneumonia, bacteremia). Finally, regional variations in the prevalence of infected or treated patients, while they may be explained by differences in patient or facility characteristics, must be identified and taken into account as part of a regional rollout of the initiatives now promoted by the national missions for the prevention and surveillance of healthcare-associated infections (HAIs).

ENP 2017 – Results

Previous results

Healthcare-associated infections in nursing homes are less common and less severe than in healthcare facilities

This national survey on the prevalence of healthcare-associated infections (HAIs) and antibiotic treatments (ATBs) in long-term care facilities measured, on a specific day between May 16 and June 30, 2016, the prevalence of HAIs and ATBs prescribed to residents.

Nearly 3 out of every 100 residents were infected on the day of the survey. Among residents with an indwelling invasive device on the day of the survey (urinary catheter), nearly 1 in 10 residents was infected.
The most common infections were urinary tract infections, lower respiratory tract infections, and skin and soft tissue infections.

The prevalence of infected residents is low compared to other existing French or international data in the medical-social sector.

Repeating this national survey every 5 years will allow for long-term monitoring of these indicators.

The next survey in nursing homes is scheduled for 2024.

Prev’Ehpad 2016 – Results

HALT 2010 – Results

Thiolet JM, Lejeune B, Coignard B. National Prevalence Survey in Nursing Homes for Dependent Elderly (HALT), France, June–September 2010. Results. Oral presentations. 22nd Congress of the French Society of Hospital Hygiene, Lyon, June 9, 2011

An upward trend over the past 5 years in surgical site infections (SSIs) for hip revisions

In 2018, 95,388 procedures were reported across 357 healthcare facilities participating in the surveillance program. The crude incidence of SSI is estimated at 1.64% [1.55–1.72] and at 0.72% [0.56–0.91] for patients without risk factors.

Notable trends over the past 5 years show an increase in incidence during hip replacement revisions, confirming the rise observed in 2016/2017, and a decrease for abdominal hysterectomies. A national initiative on the surveillance and prevention of infection risks associated with surgical procedures and interventional medicine (SPICMI) will take over from the ISO-Raisin surveillance program starting in 2020. This program will develop a semi-automated collection of ISO events based on routine computerized data collected by the hospital information system.

Previous results

• 2017 Results

• 2016 Results

• 2015 Results

• 2014 Results

• 2013 Results

• 2012 Results

• 2011 Results

• 2009–2010 Results

• 2008 Results

• 2007 Results

• Results 1999–2006

• Results 1999-2005

• Results 1999–2004

• Results 2001–2002 and 2003

• Results 1999–2000

An increase in the incidence rate of central line-associated bacteremia, without an increase in the incidence of pneumonia in 2020

Surveillance of catheter-related bacteremias: monitoring incidence in intensive care

In 2020, the incidence of central venous catheter (CVC)-related bacteremias in intensive care was 1.67 per 1,000 catheterization days, whereas the Propias target for this indicator is less than 1 per 1,000 catheterization days

The main microorganisms responsible for catheter-related bacteremia are coagulase-negative staphylococci (38%), S. aureus (20%), and Enterobacteriaceae (22.4%).

Surveillance of ventilator-associated pneumonia (VAP): no decrease in incidence in 2020

In 2020, 896 ventilator-associated pneumonia (VAP) cases were reported.

The incidence of VAP was estimated at 22.67 per 1,000 ventilator days.

The main microorganisms associated with VAP are Enterobacteriaceae (42.8%), P. aeruginosa (20.6%), S. aureus (14.4%), and Candida (3.4%).

Previous results

• 2017 Results

• 2016 Results

• 2015 Results

• 2014 Results

• 2013 Results

• 2012 Results

• 2011 Results

• 2010 Results

• 2009 Results

• 2008 Results

• 2007 Results

• 2006 Results

• 2005 Results

• 2004 Results

Results of the national surveillance of nosocomial bacteremia in healthcare facilities: the BN-Raisin network from 2001 to 2006 

A Decline in Blood-Exposure Incidents Among Healthcare Workers in 2015

In 2015, 14,624 blood exposure incidents were documented in 825 healthcare facilities. The overall incidence of blood exposure incidents was 5.7 per 100 beds. This decreased by 23.0% overall and by 23.8% in the stable 2008–2015 cohort (n=231 healthcare facilities). Percutaneous blood exposure incidents (n=11,476) were the most common cause of reported blood exposure incidents, primarily associated with needle sticks (n=9,703), half of which were related to needle handling (48.4%). Within the stable cohort, the proper use of gloves increased from 68.5% in 2008 to 76.9% in 2015.

In contrast, the availability of sharps containers remained stable: 70.4% in 2008 to 72.0% in 2015. In 2015, 31.9% of blood-exposure incidents were preventable through adherence to standard precautions. Within the stable 2008–2015 cohort, a significant decrease in the proportion of preventable blood-exposure incidents was observed (from 39.9% in 2008 to 31.9% in 2015).

The results show a steady decline in blood exposure incidents and suggest that workplace safety for healthcare professionals has improved significantly in recent years. Beyond these very positive results, this surveillance has provided a better understanding of blood exposure incidents, an essential step in guiding prevention strategies.

A data entry tool remains available; for more information, contact the CPias or the Study Group on the Risk of Healthcare Workers’ Exposure to Infectious Agents (GERES).

Previous results

• 2013–2014 results

• 2011–2012 results

• 2010 results

• 2009 results

• 2008 results

• 2007 results

• 2006 results

• 2005 results

• 2004 results

• 2003 results

• 2002 results

Reports and alerts regarding healthcare-associated infections [excluding emerging highly antibiotic-resistant bacteria (HARB)]

• The reporting newsletter, a publication by Santé publique France launched in conjunction with the rollout of the e-SIN online reporting tool for healthcare-associated infections in late 2011, can be downloaded via this link. It is scheduled for multi-year publication. Its purpose is to promote and highlight the healthcare-associated infection (HAI) reporting system. It provides updates on key developments related to reporting (notable incidents, the emergence of an epidemic) and highlights the latest regulatory and operational changes to the system. The Support Centers for the Prevention of Healthcare-Associated Infections (CPias), which contribute significantly to its production, also make it available on their respective websites.

• Use of e-SIN is restricted to professionals in healthcare facilities (hygiene practitioners and reporting officers), Regional Health Agencies (ARS), CPias, and Santé publique France, including regional units. Access to the e-SIN application requires prior registration in the e-SIN application directory via a form specific to each user type: healthcare facility, regional health agency, CPias, or Santé publique France regional units. Once the registration is validated by the administrator, the user will receive their e-SIN login credentials within a maximum of 7 days.

• The goal of this HAI reporting tool is to streamline information sharing among the various stakeholders, thereby improving responsiveness to critical situations and simplifying procedures. Studies based on data from external HAI reporting are available on the website and in the section dedicated to the BEH journal.

Results

• Annual Report on Non-BHRe Reports via e-SIN, France 2023

• Annual report on BHRe reports via e-SIN, France 2023

• Non-BHRe and non-COVID-19 IAS reports in 2022

• Report on Streptococcus pyogenes IAS reports in France, 2017–2022

• Annual report on BHRe reports via e-SIN, France 2022

• Summary of e-SIN reports in Neonatology in France, 2012–2022

• Epidemiology of BHRe among patients (military and civilian) from Ukraine hospitalized in France, 2022