TY - RPRT T1 - Programme de surveillance des septicémies à l'hôpital en Belgique - Rapport annuel 2013, Données 2000 - 2013 Y1 - 2014 A1 - Hammami, Naïma A1 - Marie-Laurence Lambert KW - Belgique KW - Bloodstream infection KW - Bloodstream infections KW - data KW - hospital KW - hospitals KW - INFECTION KW - infections KW - report KW - septicemie KW - Surveillance AB -

In 2013, 109 hospital sites participated for at least 3 months (minimum required per year) to the surveillance program for bloodstream infections (BSI) in hospitals. This indicates a clear increase compared with previous years and could be attributed to a revision of the protocol in 2013, but also to a political decision which will make the reporting of certain indicators mandatory for the quality indicator project. This emphasizes the priority that is given to the prevention of infections acquired in hospitals and the feasibility of this surveillance. In 2013, a total of 5.316 episodes of BSI acquired in hospitals were reported. The mean incidence was 5.9 BSI/1,000 admissions and 8.2/10,000 patient days (pd). The incidence of SEP acquired in intensive care (ICU) was 17.2/1,000 ICU admissions and 39.1/10,000 ICU pd. Although the incidence was higher in ICU, 79% of episodes were acquired in another service. These incidences seemed stable from 2000 to 2013, but the variability in the number of hospitals that participated per year complicated the interpretation of the annual trends at the national level. A pathogen was isolated in 85% of the BSI episodes, and the proportion of skin contaminants decreased from 2000 to 2013. The specific incidence of BSI with E. coli acquired in hospitals increased from 1.2 in 2000 to 2.0/10,000 pd in 2013. For Klebsiella pneumoniae it rose from 0.3 to 0.6/10,000 pd, respectively. The annual mean incidence density of BSI associated with a central line (CLABSI) was 2.2/10,000 pd in 2013. The suspected origin of BSI acquired in the hospital was a central line in 27% of the episodes and 54% was considered to be secondary to another infection site (21% was attributed to a urinary and 11% to pulmonary infection). An association with an invasive device was reported for 51% of these urinary and 39% of these pulmonary infections. In total there was an association with an invasive device reported in 44% of the BSI acquired in hospitals. Microbiological documentation was available for 55% of these BSI associated with an invasive device (same microorganism in blood culture/suspected origin). The most frequent micro-organisms in BSI acquired in the hospital were E. coli (22%), coagulasenegative staphylococci (13%) and Staphylococcus aureus (11%). Antibiotic resistance of these S. aureus strains to methicillin was 21%, this of Enterococcus faecalis and faecium against glycopeptides (vancomycin, teicoplanin; VRE) 1.6%, the antibiotic resistance of E. coli against 3rd generation cephalosporins (C3G) and carbapenems (CAR; imipenems, meropenems, doripenems) respectively 12% and 0.3%. Finally, the resistance of P. aeruginosa and Acinetobacter sp. against carbapenems was respectively 17% and 5%. Little data was available for international comparisons. The incidences of BSI acquired in hospitals and ICU for Belgium were higher than those reported by Quebec (Canada). The proportion of antibiotic resistance of the SEP surveillance were in line with those reported by Canada, France and the EARS-Net network for Europe. Our results linked to the antibiotic resistance were slightly higher than those reported by the EARS-Net for Belgium in 2012 (nosocomial and other infections, invasive isolates only). The results highlight the importance of strengthening prevention measures against BSI acquired in hospitals, particularly against BSI associated with invasive devices. In addition, it is a well performing tool for the monitoring of antibiotic resistance.

PB - WIV-ISP CY - Brussels ER -