[Status of public health in hospitals in France]

The situation of hygiene in hospitals in France has been greatly improved in the late 1980's with the commitment for public hospitals to set up a local committee against nosocomial infections (N.I.). This has been completed by the creation of Coordination Committees at the regional level in France and one central National Committee in charge of defining politics and priorities in hygiene. From early 1990, several epidemiological surveys have been set up, both at the national and regional level, displaying nosocomial infection prevalence rates of approximately 6 to 16%. High risk groups population for nosocomial infections had been targeted as a priority in the different survey programs: wounds, bacteremias, surgery wards and intensive care units. The epidemiologic situation of France, as in south Europe, is characterized by a high rate of multiple antibiotic-resistant strains. The methicillin resistance rate of S. aureus was over 40%. A specific program to prevent Staphylococcus aureus transmission had led to a significant decrease of this prevalence rate (32%). Prevention of nosocomial infections is now considered by French Health Authorities and health care providers as a public health priority giving their frequency, morbidity and mortality rates, and costs. Optimizing prevention of nosocomial infections should be considered as a significant marker for quality of care and safety of hospitalized patients. They might play a significant role in budgeting hospitals.