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These results demonstrate the positive impact of the national ICP on MRSA rates. In contrast, ESBLE incidence, especially ESBL-producing E. coli, is increasing dramatically and represents a serious threat for hospitals and for the community that deserves specific control actions.

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We describe an outbreak of severe subcutaneous infections due to nontuberculous mycobacteria following mesotherapy. Epidemiological studies and molecular comparisons of Mycobacterium chelonae strains from different patients and the environment suggested that contamination may be associated with inappropriate cleaning of the multiple-injection device with tap water. CASE REPORTIn January 2007, a general practitioner notified the health authorities and the regional center for nosocomial infection control of a cluster of subcutaneous infections due to nontuberculosis mycobacteria (NTM) following mesotherapy.A complete screening for all potentially exposed patients who underwent mesotherapy with the practitioner from 1 October 2006 (the date of the first mesotherapy in the medical room suspected of contamination) to 15 January 2007 (the date of disruption of the mesotherapy practice) was designed. Each patient was contacted both by phone and by mail and urged to be examined by a specialist in the department of infectious diseases at a tertiary-care reference hospital in Paris. A retrospective cohort study of all exposed patients was performed to describe the temporal and spatial distribution of cases and identify risk factors. A case was defined as certain if the exposed patient had clinical subcutaneous lesions at the site of mesotherapy injections in association with cultures positive for NTM. A case was defined as probable if the exposed patient had clinical subcutaneous lesions but smear and culture results negative for NTM. An assessment study of hygiene practices was performed by an infection control practitioner at the outpatient clinic to determine potential risk factors to be tested in a comparative epidemiological study. Risk factors included the day of an outpatient visit, a patient's place in a series of patients receiving therapy on the same day, and the site of and reason for injections. For each case, the incubation period was estimated as the time between the last mesotherapy session before the onset of symptoms and the date of the first symptoms of NTM infection. Comparisons of means and proportions were calculated with standard statistics. As the clinic was closed on Wednesdays, Saturdays, and Sundays, visits on the days after closure, i.e., Mondays and Thursdays, were considered as a potential risk factor, expressed as the number of such visits per 100 patient visits. Multivariate analysis was performed using stepwise logistic regression with P-to-enter and P-to-remove values at 0.20. The Hosmer-Lemeshow statistic was used to test the goodness of fit of the model. All calculations were performed using SAS software release 8.02 (SAS Institute, Cary, NC) and considered significant at P of Ͻ0.05.Samples from tap water in the medical examination room, as well as from the injection device and topical creams, were examined to search for mycobacteria. Products used for mesotherapy injections were recovered from the office and analyzed by the laboratory of the French Agency for Sanitary Safety in Health P...

Phages are envisioned for a variety of uses including (1) the biocontrol of pathogenic bacteria in agriculture and food industries, (2) the modulation of dysbiotic flora, (3) the eradication of pathogenic bacteria infecting humans or animals. The scope of the present review is limited to the medical setting in human, when a therapeutic effect is needed against a clearly defined bacterial target (or a few defined targets simultaneously).

Our data suggest that the use and exposure levels of glycol ethers have qualitatively and quantitatively changed dramatically over recent years. Particular attention should be paid in the future to alkoxypropionic acids derived from minor isomers of propylene glycol ether derivatives.

Citation style for this article:Arnaud I, Maugat S, Jarlier V, Astagneau P. Ongoing increasing temporal and geographical trends of the incidence of extended-spectrum beta-lactamase-producing Enterobacteriaceae infections in France, 2009. Euro Surveill. 201520(36) E xtended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are a major focus of multidrug-resistant organisms (MRO) surveillance programmes in France. To describe the temporal and geographical trends of these pathogens, we conducted an epidemiological study based on data extracted from the nationwide MRO surveillance network from 2009 to 2013. During this time, the incidence of ESBL-E infections in French hospitals increased by 73%, from 0.35 to 0.60 per 1,000 patient days (PD) (p < 0.001) and ESBL-E bacteraemia by 77%, from 0.03 to 0.05 per 1,000 PD (p < 0.001). The incidence of ESBL-E infections was higher in intensive-care units (1.62 to 2.44 per 1,000 PD (p < 0.001)) than in recovery and long-term care facilities (0.20 to 0.31 per 1,000 PD (p < 0.001)). Escherichia coli was the most frequent extended-spectrum betalactamase-producing (ESBL) pathogen, representing 59% (26,238/44,425) of all ESBL isolates, followed by Klebsiella pneumoniae (20%; 8,856/44,425) in 2013. The most frequent infection was urinary tract infection, for all species. The incidence of ESBL-E varied by region but showed an upward trend overall. Reinforcement of control measures for halting the spread of such MRO is crucial.

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