The issue of nosocomial infections
A nosocomial infection (from the latin word nosocomium, meaning "hospital") is a hospital-acquired infection. These pathologies are a very important issue of public health. Indeed, about 5 millions nosocomial infections are counted in the USA1 and in the EU2 each year, which represent 1 hospitalization out of 10. Hospital stay is then longer of about 10 to 20 days3,4, which induces an important overcost of about €10 0005. Overall, they put the health of the patients at risk, with a death rate of 5%1.
The situation have turned more and more worrisome because the nosocomial pathogens have developed resistance to the main antibiotics used in clinics. Doctors face increasing difficulties to treat them. Indeed, Staphylococcus aureus is the cause of 20% of nosocomial infections in France, and it is resistant to methicillin up to 50%6. Actually, it is very often multiresistant to aminoglycosides, fluoroquinolones, and macrolides7. Still, Pseudomonas aeruginosa, the 3rd cause of nosocomial infections in France, with a prevalence of 11%6, is more and more frequently multiresistant to its reference treatments: aminoglycosides, carbapenems, and ciprofloxacin8.
References on the issue of nosocomial infections:
1 Klevens RM et al. Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002. Pub. Health Rep. 122 : 160-166 (2007)
2 Annual epidemiological report on communicable diseases in Europe. Ed.: Andrew Amato-Gauci et Andrea Ammon. European Centre for Disease Prevention and Control (2007)
3 Graves N et al. Effect of Healthcare-Acquired Infectionon Length Hospital Stay and Cost. Infect. Control Hosp. Epidemiol. 28 : 280-292 (2007)
4 Sheng WH et al. Comparative impact of hospital-acquired infections on medical costs, length of hospital stay and outcome between community hospitals and medical centres. J. Hosp. Infect. 59 : 205-214 (2005)
5 Stone PW et al. Systematic review of economic analyses of health care-associated infections. Am. J. Infect. Control 33 : 501-509 (2005)
6 Boucher HW et al. Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of America. Clin. Infect. Dis. 48 : 1-12 (2009)
7 Réseau d’Alerte, d’Investigation et de Surveillance des Infections Nosocomiales. Enquête nationale de prévalence des infections nosocomiales, juin 2006 - Résultats préliminaires 12 janvier 2007. Institut National de Veille Sanitaire (2007)
8 Diekema DJ et al. Survey of Infections Due to Staphylococcus Species: Frequency of Occurrence and Antimicrobial Susceptibility of Isolates Collected in the United States, Canada, Latin America, Europe, and the Western Pacific Region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clin. Infect. Dis. 32 (Suppl. 2) : S114-S132 (2001)
9 European Antimicrobial Resistance Surveillance System. EARSS Annual Report 2005. European Antimicrobial Resistance Surveillance System (2006)