Nosocomial infections: cases up by almost 15%, Covid singled out

1 in 18 hospitalized patients in France is affected by at least one nosocomial infection: a rebound caused in part by Covid-19, according to a national survey on these infections contracted in a health establishment, carried out by Public Health France (SPF).

The 2022 edition of the Public Health France survey – which is carried out every five years – was carried out between May 15 and June 30, on a given day, among 1,155 health establishments, which represented more of 150,000 patients.

After have stagnated from 2012 to 2017 and fell steadily between 2001 and 2012, the proportion of infected patients increased between 2017 and 2022 (+ 14.7%), notes SPF, in a press release published on Friday. Health authorities estimate the number of deaths linked to around 4,200 to nosocomial infections each year in France.

Compared to its European neighbours, France is in the middle range (17th out of 31 countries in 2017 for nosocomial prevalence). It will be necessary to wait until 2024 for the finalization of the surveys carried out in Europe in 2022.

Covid-19 responsible for part of the increase

The Covid-19 epidemic has weighed, directly or indirectly: “The proportion of infected patients is higher than that of five years ago, but the nosocomial Covid-19 infections represent half of the increase notes Anne Berger-Carbonne, head of the healthcare-ociated infections and antibiotic resistance unit at SPF.

In his eyes, “it is a very broad photograph which is not so bad in the wake of the terrible Covid crisis. We expected worse”. If we exclude nosocomial Covid-19 cases, the proportion of patients infected in 2022 remains on the rise (+ 7.5%) but “not significantly” compared to that estimated in 2017, according to the health agency. .

SPF thus observes that “ compared to 2017patients hospitalized in 2022 presented an increased risk of infectious complications”, due to more vulnerable profiles or the use of invasive care devices.

In 2022, hospital activity remained affected by the Covid pandemic but also by the “outpatient turn” of the health system, “so that people hospitalized were in a more serious situation”, in the eyes of Anne Berger-Carbonne . A phenomenon which is accompanied by a shortening of the duration of hospitalization, when long stays are reserved for the most serious cases.

Four bacteria account for nearly half of cases

Nosocomial infections continue to be observed more often in intensive care units which treat more vulnerable patients and exposed to invasive devices (catheter, respiratory istance, urinary catheter): one in four patients who contract an infection went through an intensive care unit.

Urinary infections, linked to surgery, pneumonia, bacteraemia (presence of bacteria in the blood) remain the main manifestations of the scourge. Four bacteria, including E.coli and the Staphylococcus aureusare involved in almost one in two cases of nosocomial infection in hospital, a stable figure compared to 2017.

Another lesson from the survey: around one in six hospitalized patients receives antibiotic treatment, a proportion up 7.5% compared to 2017. “It’s not a very good sign”, notes the specialist from Public Health France , Anne Berger-Carbonne.

I’antibiotic resistancethe fact that some bacteria eventually become antibiotic resistant, is indeed considered a major threat by global health authorities. One in four patients is treated with antibiotics in intensive care, one in two in medicine or surgery, according to the SPF survey.

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