Rates of carbapenem-resistant infections continue to increase in Europe

On the occasion of the 6th European Antibiotic Awareness Day, the European Centre for Disease Prevention and Control (ECDC) is releasing new EU-wide data on antibiotic resistance showing a marked increase of carbapenem-resistant infections. The carbapenems are a major last-line class of antibiotics used to treat healthcare-associated infections. The proportion of Klebsiella pneumoniae bloodstream infections that is resistant to carbapenems has increased between 2009 and 2012, to above 5% in 5 countries, mostly in the south of Europe. A new serious concern is the emergence and spread of carbapenem-resistant Acinetobacter species, which is above 25% in 8 of 18 countries reporting data. This indicates even more seriously limited options for treatment of patients with Acinetobacter infections. Together with EARS-Net annual report, ECDC is releasing the results of a survey based on a self-assessment by national experts from 38 countries of carbapenems-resistant infections in Europe, done for ECDC by the University Medical Centre in Groningen, in the Netherlands. The results indicate that the spread of carbapenem-resistant infections is much wider than indicated by EARS-Net, which only includes the most severe infections, i.e. bloodstream infections. If other infections, such as respiratory and urinary tract infections, are also considered, then almost all countries have reported cases, and many countries have reported regional and inter-regional spread, or even an endemic situation. As part of the same survey, experts were also asked to report on the availability of national guidance documents for the control of carbapenem-resistant infections. Slightly more than half of the participating countries have such national guidance documents in place. The majority of these are countries that reported outbreaks, a regional spread or an endemic situation. However, 17 of the 38 participating countries still lack guidance for control of carbapenem-resistant infections, and only 2 countries reported having specific guidance to deal with carbapenem-resistant Acinetobacter infections. To mark European Antibiotic Awareness Day on 18 November, more than 40 countries across Europe organise activities promoting prudent use of antibiotics under the banner “Everyone is responsible” during the week 18-24 November. ECDC is also cooperating with its partners in other regions of the world: campaigns on prudent antibiotic use are taking place in the United States, Canada and Australia during the same week.