[Bacteria, multiresistant to antibiotics, in intensive care units: epidemiological context and strategies of control]

In France, many hospitals have reported high prevalence of multiply resistant strains, mostly in intensive care units. However, resistance has spred to other medical or surgical wards, and to rehabilitation or long term care facilities as well. Both antibiotic misure and cross-colonization via tronsient carriage on bouds of caregivers account for these epidemics. In turn, high prevalence of resistance leads to increased antibiotic prescriting which results in extra costs and further emergence of new resistance mechanisms. In addition, such high prevalence might well contribute to increased morbidity and extra-incidence of nosocomial infections. Control of resistant strains requires proper use of antibiotics and prevention of cross-colonization, which relies on identification of reservoirs and effective implementation of isolation precautions.