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. 2017 Apr;23(4):582-589.
doi: 10.3201/eid2304.161399.

Implementation and Initial Analysis of a Laboratory-Based Weekly Biosurveillance System, Provence-Alpes-Côte d'Azur, France

Michael Huart, Gabriel Bedubourg, Cédric Abat, Philippe Colson, Jean Marc Rolain, Hervé Chaudet, Pierre Edouard Fournier, Didier Raoult, Xavier Deparis

Implementation and Initial Analysis of a Laboratory-Based Weekly Biosurveillance System, Provence-Alpes-Côte d'Azur, France

Michael Huart et al. Emerg Infect Dis. 2017 Apr.

Abstract

We describe the implementation of an automated infectious disease surveillance system that uses data collected from 210 microbiologic laboratories throughout the Provence-Alpes-Côte d'Azur region in France. Each week, these facilities report bacterial species that have been isolated from patients in their area. An alarm is triggered whenever the case count for a bacterial species infection exceeds 2 SDs of the historical mean for that species at the participating laboratory. At its inception in July 2013, the system monitored 611 bacterial species. During July 1, 2013-March 20, 2016, weekly analyses of incoming surveillance data generated 34 alarms signaling possible infectious disease outbreaks; after investigation, 14 (41%) of these alarms resulted in health alerts declared by the regional health authority. We are currently improving the system by developing an Internet-based surveillance platform and extending our surveillance to include more laboratories in the region.

Keywords: France; PACA; PACASurvE; Provence-Alpes-Côte d’Azur; bacteria; biosurveillance; epidemiologic surveillance system; epidemiology; infectious diseases; microbiology laboratories.

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Figures

Figure 1
Figure 1
Laboratories participating in the Provence Alpes Côte d’Azur Surveillance Epidemiologic System, France, July 1, 2013–March 20, 2016. Black dots indicate participating laboratories; black boxes indicate public laboratories; text labels indicate private laboratories and areas of activity. Asterisks (*) denote laboratories using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for identification of species; all other laboratories shown use biochemical bacterial identification. CH, Centre Hospitalier (Central Hospital); CHU, Centre Hospitalier Universitaire (Central University Hospital); IHU, Institut Hospitalo-Universitaire (Hospital–University Institute); LABM, Laboratoire de Biologie Médicale (Medical Laboratory).
Figure 2
Figure 2
Flow diagram of all epidemiologic surveillance systems implemented by the Institut Hospitalo-Universitaire Méditérannée Infection, Assistance Publique-Hôpitaux de Marseille, France. ARS, Agence Régionale de Santé (Regional Health Agency); BALYSES, Bacterial Real-Time Laboratory-Based Surveillance System; CDS, Centre de Santé (Health Center); CHG, Centre Hospitalier Général (General Hospital Center); CHU, Centre Hospitalier Universitaire (Central University Hospital); CLIN, Comité de Lutte contre les Infections Nosocomiales (Committee for the Fight Against Nosocomial Infections); DGS, Direction Générale de la Santé (Directorate General for Health); EPIMIC, Epidemiologic Surveillance and Alert Based on Microbiological Data; IHU/AP-HM, Institut Hospitalo-Universitaire/Assistance Publique-Hôpitaux de Marseille; INVS, Institut Nationale de Veille Sanitaire (National Institute for Public Health Surveillance); LABM, Laboratoire de Biologie Médicale (Medical Laboratory); MARSS, Marseille Antibiotic Resistance Surveillance System; PACASurvE, Provence Alpes Côte d’Azur Surveillance Epidemiologic System. Diagram is based on the workflow described by Abat et Al. 2013 (10).
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