Survey on relationship between microbiological laboratories and ICUs in France

The interactions between intensive care units (ICUs) and microbiology laboratories are crucial with regard to their possible impact on antibiotic stewardship.

A national survey was conducted in 2023 among ICUs participating in the REA-REZO surveillance network, which is dedicated to ICU-associated infections in adult units in France. Each unit was invited to complete a web-based questionnaire concerning the organisation, bacteriological techniques, workflow, and antibiotic policy.

A total of 84 units (response rate: 66.7%) responded to the survey (24 university public hospitals, 52 other public hospitals, 8 private hospitals). Samples have to be transported outside the hospital in 17.9% of units. Screening of multidrug-resistant bacterial colonisation is performed for methicillin-resistant S aureus in 94.0% of units, vancomycin-resistant Enterococcus in 85.7%, ESBL in 95.4%, and carbapenem-resistant Enterobacterales in 92.9%. Systematic analysis of removed catheters is done in 57.1% of units; less frequently for bronchial secretions (16.1%). Units have access to rapid diagnostic tests for diagnosis of infections such as multiplex PCR, which are available in 88% of units for pneumonia. Mass spectrometry was not available in 19% of units. Most units (66.7%) have an intensivist referent for infections. Computerised antimicrobial prescription is available in 75% of units, protocols are available in 56%, local bacterial ecology is available in 75%, and regular meetings with ID physicians in 56% of units.

Many new technologies that reduce the time between the onset of symptoms and targeted treatment are available in ICUs. The interface between ICUs and microbiology could be improved.