Combined resistance to multiple antibiotics: A growing problem in the EU

November 15, 2017

On the occasion of the 10th European Antibiotic Awareness Day, the European Centre for Disease Prevention and Control (ECDC) is releasing its latest EU-wide data on antibiotic resistance, as well as its guidance on prevention and control of carbapenem-resistant Enterobacteriaceae (CRE). In 2016, combined resistance to several antibiotic groups continued to increase for Escherichia coli and Acinetobacter species. This situation is of great concern as patients infected with these multidrug-resistant bacteria have very limited treatment options.

Vytenis Andriukaitis, European Commissioner for Health and Food Safety, said: "with increasing resistance even to last-line antibiotics we face a frightening future where routine surgery, childbirth, pneumonia and even skin infections could once again become life threatening. To preserve our ability to effectively treat infections in humans and animals, we need to bridge differences between EU Member States and raise the level of all of them to that of the highest performer". He added: "that is the key objective of the new EU One Health action plan against AMR adopted this June. It focuses on areas that support and add value to Member States' actions to deliver innovative, effective and sustainable responses to AMR. It is only by working together at European and international level, collaborating and cooperating across all relevant sectors, that we can control and reverse AMR".

For Escherichia coli, combined resistance, measured as resistance to fluoroquinolones, third-generation cephalosporins and aminoglycosides, increased significantly between 2013 and 2016. Furthermore, in 2016, high percentages of Acinetobacter species isolates, with combined resistance to carbapenems, aminoglycosides and fluoroquinolones, were reported in southern and south-eastern Europe, as well as the Baltic countries.

Nevertheless, it is encouraging to see that long-term efforts are slowly leading to positive results and that it is still possible to reverse the trends: the latest ECDC data indicate that the overall resistance situation for Klebsiella pneumoniae seems to be stabilising in Europe, although this was not always observed at national level, with some countries still showing an increase in combined resistance. Furthermore, the percentage of meticillin-resistant Staphylococcus aureus (MRSA) further decreased between 2013 and 2016. However, MRSA remains an issue as 10 out of 30 countries still report high percentages.

Andrea Ammon, ECDC Director, stated: "even though we are starting to see some slight progress, we need to remain vigilant and work even harder to reduce the levels of antibiotic resistance. There are still significant increases in combined resistance for Escherichia coli and Acinetobacter species throughout Europe, and this situation is of great concern as patients infected with these multidrug-resistant bacteria have very limited treatment options". She added: "prudent antibiotic use and comprehensive infection prevention and control strategies targeting all healthcare sectors are fundamental. This is why today, ECDC is also launching its guidance on carbapenem-resistant Enterobacteriaceae".

Zsuzsanna Jakab, WHO Regional Director for Europe said: "antimicrobial resistance is increasingly widespread in the WHO European Region as resistant microbes know no borders. Effective infection prevention and control is one of our most powerful weapons to address this global health threat". She noted: "On this year World Antibiotic Awareness Week, WHO calls on health workers in the European Region to prevent the spread of antimicrobial resistance in health care settings through proper hand hygiene".

Resistance to carbapenems, an important last-line antibiotic group, continues to be reported mostly by countries with already high levels of multidrug-resistant bacteria. In these countries, the options to treat patients with carbapenem-resistant Enterobacteriaceae (CRE) infections are often limited to combination therapy and older antibiotics, such as colistin. The further emergence of resistance to colistin is a serious warning that options are becoming even more limited. Resistance percentages varied widely across Europe, being generally higher in southern and south-eastern Europe than in northern Europe.
-end-
Notes to the editor:

European Antibiotic Awareness Day


European Antibiotic Awareness Day (EAAD) is a European health initiative coordinated by ECDC which provides a platform and support for national campaigns on the prudent use of antibiotics. Each year, EAAD is marked by national campaigns during the week of 18 November. Prudent use means only using antibiotics when they are needed, with the correct dose, dosage intervals and duration of the course http://antibiotic.ecdc.europa.eu.

This year, the date of 18 November marks the 10th European Antibiotics Awareness Day. ECDC, in cooperation with the European Commission, will host an EU-level event entitled 'Keeping antibiotics working'. The event will take place in Brussels on 15 November 2017, from 9:00 to 13:00 CET. ECDC and partner organisations will be tweeting live using the hashtag #EAAD. Web stream: https://youtu.be/Biw-5Jx64jE.

Furthermore, ECDC is launching a social media initiative called #KeepAntibioticsWorking, which aims to highlight the fact that everyone has a role to play in ensuring that these medicines remain effective. ECDC is asking policymakers, governmental institutions, professional and patient organisations, as well as health professionals and the general public to show what action they are taking to address the problem of antibiotic resistance. Anyone can take part by sharing messages, pictures or videos during the week of 13-19 November 2017 on different social media channels, using the hashtag #KeepAntibioticsWorking.

World Antibiotic Awareness Week


The World Health Organization is leading World Antibiotic Awareness Week (WAAW) with the slogan 'Antibiotics: Handle with Care'. The campaign calls on individuals, governments and health and agriculture professionals to take action to address this urgent health problem. The third WAAW will take place on 13-19 November 2017. EAAD partners with WAAW. Follow #AntibioticResistance. http://www.who.int/campaigns/world-antibiotic-awareness-week/en/.

European Centre for Disease Prevention and Control (ECDC)

Related Antibiotic Resistance Articles from Brightsurf:

Discovery promising for millions at risk from antibiotic resistance
There is new hope for approximately 700,000 people who die each year from antibiotic resistant infections, with University of Queensland researchers discovering how bacteria share antibiotic-resistance genes.

Pollution linked to antibiotic resistance
Antibiotic resistance is an increasing health problem, but new research suggests it is not only caused by the overuse of antibiotics.

Antibiotic resistance and the need for personalized treatments
Scientists have discovered that the microbiota of each individual determines the maintenance of antibiotic resistant bacteria in the gut: whereas in some individuals resistant bacteria are quickly eliminated, in others they are not.

One of the mechanisms of Staphylococcus antibiotic resistance deciphered
The Russian side is represented by Structural Biology Lab (Kazan Federal University) and Institute of Proteins (Russian Academy of Sciences).

Antibiotic-resistance in Tanzania is an environmental problem
WSU study finds that environmental transmission rather than antibiotic use explains the presence of antibiotic-resistant bacteria in people, domestic animals and wildlife.

Stressed-out dust is sharing antibiotic resistance genes
A new Northwestern University study is the first to find that bacteria living in household dust can spread antibiotic resistance genes.

Cause of antibiotic resistance identified
Bacteria can change form in human body, hiding the cell wall inside themselves to avoid detection.

The solution to antibiotic resistance could be in your kitchen sponge
Researchers from the New York Institute of Technology (NYIT) have discovered bacteriophages, viruses that infect bacteria, living in their kitchen sponges.

Antibiotic resistance in spore-forming probiotic bacteria
New research has found that six probiotic Bacillus strains are resistant to several antibiotics.

How bacteria acquire antibiotic resistance in the presence of antibiotics
A new study's disconcerting findings reveal how antibiotic resistance is able to spread between bacteria cells despite the presence of antibiotics that should prevent them from growing.

Read More: Antibiotic Resistance News and Antibiotic Resistance Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.