The human health surveillance networks: One of the missions of the national public health agency (Santé publique France), is to coordinate surveillance, studies and expertise in antimicrobial resistance in the three healthcare sectors (including healthcare, medical, social and point of care establishments). The agency is supported by regional partners, the Centres for Prevention of Healthcare-Associated Infections (Centres de prévention des infections associées aux soins, CPias), some of which have been selected to coordinate national missions following calls for projects. These coordinator centres are grouped within the Network for the Prevention and Surveillance of Healthcare-Associated Infections (Réseau de prévention et de surveillance des infections associées aux soins, RéPias). – CPias for the Grand-Est region, in conjunction with the CPias for Nouvelle Aquitaine and the Limoges University Hospital Microbiology Department, is tasked with the nationwide surveillance and prevention of antibiotic resistance in hospitals (Surveillance et la prévention de l’antibiorésistance en établissements de santé, SPARES). The objectives of SPARES are to deploy and coordinate the surveillance of antibiotic consumption and bacterial resistance, as well as evaluate the prevention of cross-transmission of multi-drug resistant and highly-resistant bacteria in hospitals. The surveillance is based on ConsoRes,a shared tool for recording data from a healthcare application software. All healthcare institutions can take part in the initiative. – The national mission for the surveillance of antibiotic resistance and healthcare-associated infections in community medicine and medico-social institutions (Surveillance et Prévention de la Résistance aux antibiotiques et des Infections associées aux soins en soins de ville et secteur médico-social, Primo) is driven by CPias Pays-de-La-Loire and CPias Grand Est. The tool, e-Medqual ville, serves as a basis for monitoring resistance and all diagnostic laboratories wishing to do so can take part. The surveillance concerns data on resistance by Escherichia coli, Staphylococcus aureus, Enterobacter cloacae, Enterobacter aerogenes, Klebsiella pneumoniae, and Klebsiella oxytoca. – In addition to antibiotic sales analysis by the National Agency for Medicines and Health Products Safety (Agence nationale de sécurité du médicament et des produits de santé, ANSM), Santé publique France monitors nation-wide antibiotics consumption at the general practitioner level, with measurements based on national health insurance reimbursement data (National Health Data System – SNDS). The principal national and regional indicators of antibiotic resistance and consumption can be freely consulted in GEODES, the interactive portal of Santé publique France. More comprehensive annual surveillance reports can be consulted on the Santé publique France website. The clinical research networks:
- CRICS-TRIGGERSEP (Trial Group for Global Evaluation and Research in Sepsis), an F-CRIN-labelled network gathering fundamental and translational research forces in the field of sepsis.
- RENARCI (National Network for Clinical Research in Infectious Diseases), aimed at increasing the visibility and attractiveness of France in infectious disease clinical research, particularly for the development of new anti-infective agents.
- REA-REZO, a network conducting annual surveillance of antibiotic consumption for infections acquired in intensive care units and bringing together over 100 intensive care units in France.
- OUTCOMEREA, an association aimed at developing research and teaching activities to improve care for severely-ill patients.
- CLIN-Net France, a subsidiary of the European network CLIN-Net, itself a member of ECRAID, whose objective is to fight antibiotic resistance at European level and which has recently been created and supported by the European Commission. CLIN-Net federates the existing investigation networks as well as the investigators in infectious diseases, who had until that point been isolated, with the aim of facilitating the implementation of studies to develop new anti-infectives.
- The CNRs, French national reference centres linked to research units and included in the database of antibiotic resistance research teams.
- The surveillance network for antimicrobial resistance in pathogenic bacteria of animal origin (RESAPATH), stemmed from a partnership between Anses and French public and private veterinary analysis laboratories.
- The Animal Antibiotics Research Network (R2A2), coordinated by Inrae and focused on the use of antibiotics in livestock. Some observatories can also be mobilised to deal with antibiotic resistance.
- The network of the four Veterinary University Hospitals (CHUV) and the four French veterinary schools which the CHUVs rely on.
- ECOSCOPE, an observation data portal for biodiversity research.
- OZCAR (Critical Zone Observatories: Research and Application), dedicated to studying the function of land surfaces and subsoils.
- Zones Ateliers (ZA), a network focused on a functional unit (e.g. a river and its watershed, agricultural or urban landscapes).
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