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 facility, conducted by Public Health France (SPF).
The 2022 edition of Public Health's France survey – which is conducted every five years – was conducted between May 15 and June 30, on a given day, among 1,155 health facilities, representing more than 150,000 patients.
After stagnating from 2012 to 2017 and falling steadily between 2001 and 2012, the proportion of infected patients increased between 2017 and 2022 (+ 14.7%), notes SPF, in a statement published Friday. Health authorities estimate that about 4,200 deaths are linked to nosocomial infections each year in France.
Compared to its European neighbours, the France is average (17th out of 31 countries in 2017 for nosocomial prevalence). It will be necessary to wait until 2024 for the finalization of the surveys conducted in Europe in 2022.
Covid-19 responsible for part of the rise
The Covid-19 epidemic has weighed heavily, directly or indirectly: "The proportion of infected patients is higher than five years ago, but nosocomial Covid-19 infections represent half of the increase," says Anne Berger-Carbonne, head of the Healthcare-associated infections and antibiotic resistance unit at SPF.
In his eyes, "it is a very broad photograph that is not so bad in the wake of the terrible Covid crisis. We expected worse." If we exclude nosocomial cases of Covid-19, the proportion of infected patients in 2022 remains up (+ 7.5%) but "not significantly" compared to that estimated in 2017, according to the health agency.
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SPF observes that "compared to 2017, patients hospitalized in 2022 presented increased risks 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 "ambulatory shift" of the health system, "so that hospitalized people were in a more serious situation", in the eyes of Anne Berger-Carbonne. A phenomenon that 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 all cases
Nosocomial infections are still more common in intensive care units that treat more vulnerable patients exposed to invasive devices (catheter, respiratory support, urinary catheter): one in four patients who contract an infection has gone through an intensive care unit.
Urinary tract infections, related to surgery, pneumonia, bacteremia (presence of bacteria in the blood) remain the main manifestations of the scourge. Four bacteria, including E. coli and Staphylococcus aureus, are implicated in nearly one in two cases of hospital-acquired infection, a stable figure compared to 2017.
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Another takeaway from the survey: about one in six hospitalized patients receive antibiotic treatment, a proportion up 7.5% from 2017. "This is not a very good sign," says France Public Health specialist Anne Berger-Carbonne.
Antibiotic resistance, the fact that some bacteria eventually become resistant to antibiotics, 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 medical or surgical departments, according to the SPF survey.