Seize années de surveillance des infections invasives bactériennes en France (1991-2006) Ã travers le réseau EPIBAC

In order to monitor the main community-acquired invasive bacterial infections in France, the hospital-based laboratories of the Epibac network report bacteraemia and meningitis cases of Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae and Streptococcus pyogenes. With more than fifteen years of validated data, and with in 2006, a coverage of nearly 80% of acute care hospital admissions and an exhaustiveness of reporting of about 80%, the Epibac database allowed trend analyses, national incidence estimates and assessment of the impact of prevention measures, mainly vaccinations, on the diseases under study. The analyses show the dramatic decrease in H. influenzae invasive diseases incidence in the early 90's, following the introduction of the H. influenzae type b infant vaccination, the decrease in invasive diseases incidence caused by L. monocytogenes after the control measures adopted in 1992 and the recent inversion of this trend, the impact of recently introduced pneumococcal vaccination through the decrease in S. pneumoniae invasive diseases in children and the reduction of the number of early invasive diseases due to S. agalactiae since the adoption of preventive measures during pregnancy. Comparability of these data with those of other surveillance system, when they exist, reinforces the validity of the Epibac surveillance system and analyses made from its data. This voluntary network remains the unique way to estimate the national incidence of invasive bacterial infections not covered by a statutory notification system.