Antibiotic Resistance on the Rise in Europe

A new report indicates that additional efforts may be needed to control antibiotic resistance in Europe.

The European Centre for Disease Prevention and Control (ECDC) recently released a report containing data concerning antibiotic use and resistance on the 9th European Antibiotic Awareness Day.

As much as 50% of antibiotics are not used properly, which has led to an increasing amount of antibiotic resistant bacterium that can cause life-threatening infections. This phenomenon has proven to be an issue in Europe, as well as the United States and other countries.

“Antibiotic resistance is one of the most pressing public health issues of our time," said Vytenis Andriukaitis, European Commissioner for Health and Food Safety. "If we don’t tackle it, we can go back to a time when even the simplest medical operations were not possible, and organ transplants, cancer chemotherapy or intensive care even less so. The European Commission will launch a new Action Plan next year so that we can, together with our partners in the EU [European Union] Member States and internationally, continue to ensure that the prevention and control of antibiotic resistance is strengthened within a one-health approach.”

In 2015, the ECDC reported that both bacteria and antibiotics under surveillance continued to become more resistant. Specifically, resistance to carbapenem by Klebsiella pneumonia increased from 6.2% in 2012 to 8.1% in 2015.

Investigators also found that resistance to carbapenems and poylmyxins, such as colistin, were reported by a majority of the countries. These groups of antibiotics are considered the last treatment option for patients who demonstrated resistance to other antibiotics, according to the report.

The ECDC discovered that although resistance seems to be increasing, so does the use of antibiotics in hospitals. However, they reported the utilization of the drugs in the community decreased during this time.

“Antibiotic resistance in Klebsiella pneumoniae is of increasing concern in Europe. More than one-third of the isolates reported to ECDC for 2015 were resistant to at least 1 of the antibiotic groups under surveillance, and combined resistance to multiple antibiotic groups was common. Moreover, the emergence of K. pneumoniae infections with combined resistance to carbapenems and colistin is worrisome and an important warning that options for treatment are now even more limited than in the past,” said Andrea Ammon, MD, MPH, acting director ECDC. “However, the decrease of antibiotic consumption in the community in 6 countries is a positive sign and shows that we are starting to use antibiotics more prudently. Prudent use of antibiotics is pivotal, both in the community and in hospitals, to ensure that these drugs remain effective.”

The report also found that antibiotic resistance is also increasing in Escherichia coli, which is a common cause of blood infections and urinary tract infections. According to the ECDC, this bacterium requires surveillance since the percentage of isolates resistant to antibiotics continues to increase across the continent.

Investigators found that the percentage of methicillin-resistant Staphylococcus aureus (MRSA) decreased significantly between 2012 and 2015, which is positive news for the countries. However, MRSA is still a threat to public health since 8 of 30 countries included reported percentages over 25%.

Activities promoting the cautious and appropriate use of antibiotics will be organized across 40 countries in the European region during the week of November 18, 2016, to mark European Antibiotic Awareness day. The ECDC works along with the World Health Organization (WHO) and partners World Antibiotic Awareness Week.

The ECDC will also launch an event called the “European Antibiotic Awareness Day: the future is now,” which will demonstrate the current situation and future steps that must be taken, according to the report. The event will show how antibiotic resistance can affect our everyday lives, and what can be done to preserve the effectiveness of the drugs.

“Surveillance of antibiotic resistance is the backbone of our work in defense of antibiotics’ effectiveness. Until we know where resistance is, we cannot prioritize action. This is why we focus on expanding the map of antibiotic resistance beyond the European Union countries through the Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR) network,” said Zsuzsanna Jakab, PhD, WHO regional director for Europe. “What the report indicates is of concern: our patients are exposed to resistant bacteria in hospitals due to overuse and misuse of antibiotics and poor infection prevention and control. We urge our leaders to use this evidence and accelerate their response to a major global health threat of our time.”