National Network REA-RAISIN of Adult Intensive Care Acquired Infections Methods and Main Results

Intensive care unit (ICU) patients are among the most exposed to secondary infections, particularly due to the presence of invasive devices and to the severity of their condition. Objectives: To describe the REA-RAISIN network, a surveillance network for adult ICU acquired infections in France, and the main results. Methods: The surveillance is "patient-based", meaning that characteristics, exposure to invasive devices, and intubation- and catheter-related infections are collected at the patient level. The characteristics of this surveillance are: perennial surveillance since 2015, inclusion after a stay of at least 48 hours and surveillance limited to ICU stay. The definitions of infections have been established by consensus and are available on the website of Sante Publique France; they are compatible with the European definitions of ECDC (European Centre for Disease Control and Prevention. Results: Since 2004, 362,066 patients have been monitored, representing more than 45% of intensive care beds. The population is characterized by a slight increase in severity. There has also been a marked increase in use of the internal jugular site and a recent decrease in the rate of intubation. The most common infection is lung infection, followed by catheter-related bacteremia. Bacterial ecology has changed with a decrease in MRSA (meticillin-resistant Staphylococcus aureus) infections and an increase in Enterobacteriaceae producing ESBL (extended spectrum beta-lactamases). Conclusion: The data from the REA-RAISIN network constitute a reference both at national level with nearly 50% of the ICU beds in France and at local level, allowing each service to monitor its results.