1. Prevention and control of highly antibiotic-resistant bacteria in a Pacific territory: Feedback from New Caledonia between 2004 and 2020
- Author
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Camille Cheval, Antoine Biron, Alexandre Bourles, Cécile Cazorla, Frédérique Ducrocq, Caroline Fijalkowski, Claire Fouquet, Cyrille Goarant, Ann-Claire Gourinat, Julien Colot, Sylvie Chevalier, Christine Le Provost, Philippe Saliou, Benoit Marot, Centre hospitalier territorial Gaston-Bourret [Dumbea] (CHT), Centre hospitalier territorial Gaston-Bourret [Nouméa], Institut Pasteur de Nouvelle-Calédonie, Réseau International des Instituts Pasteur (RIIP), Direction des Affaires sanitaires et sociales de la Nouvelle-Calédonie [Nouméa] (DASS [Nouméa]), Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) (GGB), EFS-Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), and Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)
- Subjects
medicine.medical_specialty ,Multi drug resistant bacteria ,Enterococcus faecium ,Carbapenem-resistant enterobacteriaceae ,medicine.disease_cause ,Feedback ,Multi-drug-resistant bacteria ,03 medical and health sciences ,0302 clinical medicine ,Antibiotic resistance ,New Caledonia ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,medicine ,Humans ,Infection control ,Vancomycin-resistant Enterococcus ,Prospective Studies ,030212 general & internal medicine ,0303 health sciences ,biology ,030306 microbiology ,business.industry ,Prevention ,Outbreak ,biology.organism_classification ,Anti-Bacterial Agents ,3. Good health ,Carbapenem-resistant Enterobacteriaceae ,Infectious Diseases ,Vancomycin ,business ,medicine.drug - Abstract
International audience; ObjectiveCarbapenemase-producing Enterobacteriaceae (CRE) and Enterococcus faecium resistant to vancomycin (VRE) constitute major threats to public health worldwide. The Pacific area is concerned and has implemented strategies to control antimicrobial resistance (AMR). However, accurate epidemiological data are rarely reported. Our study aimed to present the strategies applied to prevent and control the spread of highly resistant bacteria in the Pacific territory of New Caledonia.Patients and methodsCohort prospective study of all cases of highly resistant bacteria (HRB) isolated in New Caledonia from September 2004 to December 2020. Evaluation of the impact of the infection control measures implemented in healthcare settings: screening strategy, cohorting unit, IT tools and control of antibiotic prescriptions.ResultsA total of 346 patients with HRB were identified. Most of them (63.0%) were infected or colonized by VRE (n = 218) and 128 by CRE. While the number of CREs significantly increased from 2013 to 2020 (P < 0.0001), control procedures have limited their dissemination. Most patients were colonized by IMP-4-CRE (n = 124/128). The incidence density of VRE significantly decreased from 38.52 for 100,000 hospitalisation-days in 2015 to 4.19 for 100,000 hospitalisation-days in 2019 due to systematic screening of patients before sanitary repatriation from Australia and cohorting implementation. The risk of VRE diffusion is now well under control.ConclusionsOur study confirms that it is possible to control the spread of AMR in a circumscribed territory by means of a global control strategy involving screening, cohorting unit, IT tools and antibiotic prescription controls.
- Published
- 2021
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