The rapid development of transport and communication, environmental exchanges, and migration of populations creates opportunities for the spread of infectious diseases. The emergence and spread of pathogenic and epidemic pathogens is a major emerging phenomenon of the past 30 years. Some species of bacteria have become resistant to multiple antibiotics and, sometimes, to all antibiotics available: multidrug‐resistant bacteria (MDR), extensively drug‐resistant bacteria (XDR), or pan drug‐resistant bacteria (PDR). These terminologies have drawn attention to the evolution of multidrug resistance and the potential difficulties in treating bacterial infections now and in the future.

The very high levels of resistance that are currently observed result from massive exposure to antibiotics, to which humans and animals have been subjected over the past 50 years. Resistance to antibiotics concerns not only pathogens but also, and probably even more importantly, the commensally bacteria colonizing individuals (humans and animals). These are less easily detected because the carriage is asymptomatic.

More than 80 million foreign visitors travel in France each year. In the same period, 19.4 million French peoples travel to foreign countries, more often in Europe. In addition, 1.4 million French peoples live in foreign countries (i.e., 48% Europe, 20% America, 15% Africa, 8.5% in Asia‐Oceania, and 6.6% in the Near and Middle East).. The repatriation of French patients from foreign hospitals, but also health care provided to foreigners traveling in France, whatever their nationality, then expose the French population to highly resistant bacteria acquired in high resistance prevalent areas.

The risk of the emergence and spread of highly resistant bacteria from migration has been recently evaluated in France because sporadic or limited epidemic situations have occurred in the recent past with pathogens such as Clostridium difficile ribotype 027, carbapenemase‐producing Enterobacteriaceae (CPE), vancomycin‐resistant Enterococcus (VRE), or multidrug‐resistant Acinetobacter baumannii.

French guidelines to control the hospital spread of CPE and VRE from patients repatriated and travelers hospitalized in French hospitals were published in August 2010. They are so far available in French only but an official translation into English is under consideration. This article reviews the highly resistant bacteria at risk of importation from high prevalence foreign countries, having only spread to France on sporadic or limited epidemic situations, and describes the recent French guidelines to control their spread.

Haut Conseil de la Santé publique. Commission spécialisée Sécurité des patients : infections nosocomiales et autres évènements indésirables liés aux soins et aux pratiques. Recommandations pour le dépistage du portage digestif des bactéries commensales multi‐résistantes aux antibiotiques importées en France à l’occasion du rapatriement de patients en provenance de l’étranger et maîtrise de leur diffusion. 2010.

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