The European Centre for Disease Prevention and Control (ECDC) released the latest annual data on antimicrobial resistance trends in 30 European Union (EU) and European Economic Area (EEA) countries today, in anticipation of the European Antibiotic Awareness Day, which takes place on Nov 18.
The surveillance data showed increasing trends among several bacteria, most notably in rates of combined resistance for Escherichia coli. Combined resistance is measured as resistance to fluoroquinolones, third-generation cephalosporins, and aminoglycosides. Overall, resistance rates among E coli isolates jumped from 2013 through 2016, with more than half of all isolates sampled across Europe resistant to at least one antibiotic.
In addition to increasing E coli resistance rates, the ECDC reported for the second year in a row that a high percentage of Acinetobacter species isolates taken in southern and southeastern Europe, as well as the Baltic countries, showed combined resistance to carbapenems, aminoglycosides, and fluoroquinolones. Acinetobacter bacteria are common in healthcare settings, often resulting in treatment-resistant pneumonia.
"Ten out of 26 countries reporting resistance results for 10 or more isolates had percentages of 50% or higher for this type of combined resistance," the ECDC said. "This is an indication of seriously limited options for the treatment of patients infected with Acinetobacter species in these countries."
In general, resistance rates were higher in southern and Eastern Europe, with Italy and Spain reporting increasing trends in all bacteria strains surveilled.
MRSA declines, Klebsiella stabilizes
The report did offer some good news, however. The percentage of methicillin-resistant Staphylococcus aureus (MRSA) decreased significantly from 2013 through 2016. But, MRSA remains a public health priority in Europe as 10 out of 30 countries reported MRSA percentages above 25% in 2016.
In addition, resistance among isolates of Klebsiella pneumoniae, which commonly causes urinary tract, respiratory tract, and bloodstream infections, seemed to be stabilizing across EU/EEA countries. Still, more than 30% of isolates from this bacterial group were resistant to at least one antibiotic.
"The high percentages of isolates with resistance to key antimicrobial groups reported from many countries are therefore of great concern and represent a serious threat to patient safety in Europe," the ECDC concludes. "Prudent antimicrobial use and comprehensive infection prevention and control strategies targeting all healthcare sectors are the cornerstones of effective intervention to prevent the selection and transmission of bacteria resistant to antimicrobial agents."
This week, the ECDC also launched a social media initiative called #KeepAntibioticsWorking, which aims to raise awareness about antibiotic resistance and guidance on preventing carbapenem-resistant Enterobacteriaceae infections (see related CIDRAP News scan).
Nov 15 ECDC surveillance data
Nov 15 ECDC press release