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Modeling Carbapenemase-producing Enterobacteriaceae episodes' evolution in France over 2010-2020

Abstract : Background Incidence of Carbapenemase-Producing Enterobacteriaceae (CPE) episodes within hospitals is rising at an alarming rate and threaten health systems and patient safety worldwide. Their number is growing in France since 2009 associated with inter-regional dissemination and importation of international cases. This study aimed at describing the dynamics of CPE episodes in France over 2010-2016 and forecasting their evolution for 2017-2020. Methods Surveillance data of CPE episodes (imported and non-imported) from August 2010 to November 2016 were issued from the French national Healthcare-Associated Infections Early Warning and Response System. Impact of seasonality on the number of CPE episodes was analyzed using seasonal-to-irregular ratios. Seven models issued from time series analysis and three ensemble stacking models (average, convex and linear stacking) were used to describe and forecast CPE episodes. The model with the best forecasting’s quality was then trained on all available data (2010-2016) and used to predict CPE episodes over 2017-2020. Results Over 2010-2016, 3,559 CPE episodes were observed in France. Compared to the average yearly trend, we observed a 30% increase in the number of CPE episodes in September and October. On the opposite, a decrease of 20% was noticed in February compared to other months. We also noticed a 1-month lagged seasonality of non-imported episodes compared to imported ones. The number of non-imported episodes appeared to grow faster than imported ones starting from 2014. Average stacking gave the best forecasts and predicted an increase over 2017-2020 with a peak up to 345 CPE episodes (95% PI [124-1,158], 80% PI [171-742]) in September 2020. Conclusions The number of CPE episodes is predicted to rise in the next years in France because of non-imported episodes. These results could help public health authorities in the definition and evaluation of new containment strategies.
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Contributor : Laurent Jonchère <>
Submitted on : Friday, February 7, 2020 - 3:11:47 PM
Last modification on : Thursday, February 4, 2021 - 6:45:29 PM

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J. Roux, Narimane Nekkab, Pascal Astagneau, Pascal Crepey. Modeling Carbapenemase-producing Enterobacteriaceae episodes' evolution in France over 2010-2020. European Journal of Public Health, Oxford University Press (OUP): Policy B - Oxford Open Option D, 2019, 29 (Supplement_4), ⟨10.1093/eurpub/ckz185.289⟩. ⟨hal-02470783⟩



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