# 7980
Last September, in Referral: McKenna On CDC Antibiotic Resistance Report, we looked at a new report from the CDC on the growing threat of antibiotic resistance – with with Director Thomas Frieden warning, `“If we are not careful, we will soon be in a post-antibiotic era.”
This stark forecast echoed the sentiments that World Health Director-General Margaret Chan expressed a year ago (see Chan: World Faces A `Post-Antibiotic Era’).
On November 18th, the ECDC, Hong Kong’s CHP, and the United State’s CDC will kick off their antibiotic resistance awareness campaigns for 2013. Here in the US, it signals the start of Get Smart About Antibiotics Week.
Today, the ECDC has released a massive (218 pages) surveillance report report called Antimicrobial resistance surveillance in Europe 2012, along with a smaller (10 page) summary which will be easier to digest.
Highlights on antibiotic resistance
- Antibiotic resistance is a serious threat to public health in Europe, leading to increasing healthcare costs, prolonged hospital stays, treatment failures, and sometimes death.
Over the last four years (2009 to 2012), resistance to third-generation cephalosporins in K. pneumoniae and E. coli increased significantly at EU/EEA level. Combined resistance to third-generation cephalosporins and two other important antimicrobial groups (fluoroquinolones and aminoglycosides) also increased significantly at EU/EEA level for K. pneumoniae, but not for E. coli.- The increasing trend of combined resistance in K. pneumoniae means that only a few therapeutic options (e.g., carbapenems) remain available for treatment of infected patients.
- Carbapenems form a major last-line class of antibiotics to treat infections with multidrug-resistant Gram-negative bacteria such as K. pneumoniae and E. coli, both common causes of pneumonia, urinary tract infections and bloodstream infections. However, the percentage of carbapenem-resistant K. pneumoniae is already high and increasing in some countries in the EU.
- Antimicrobial resistance data for Acinetobacter spp. are available in EARS-Net for the first time. Data for 2012 show large inter-country variations in Europe, and high levels of resistance (>25%) to carbapenems in nearly half of the reporting countries.
- In contrast, in the past few years, the percentage of meticillin-resistant Staphylococcus aureus (MRSA) has shown a significant decreasing trend at EU/EEA level, and either a continuous decrease or a stabilising trend was observed in most EU/EEA countries during the last four years. Nevertheless, MRSA remains above 25% in almost one fourth of the reporting countries, mainly in southern and eastern Europe.
- Prudent antibiotic use and comprehensive infection control strategies targeting all healthcare sectors (acute care hospitals, long-term care facilities and ambulatory care) are the cornerstones of effective interventions that aim to prevent selection and transmission of antibiotic-resistant bacteria.
Also released today is an ECDC Technical Report called Carbapenemase-producing bacteria in Europe which provides Interim results from the European survey on carbapenemase-producing Enterobacteriaceae (EuSCAPE) project 2013.
Bacteria resistant to the Carbapenem class of antibiotics (a class that includes imipenem, meropenem, doripenem, and ertapenem) – are called carbapenemases – are of particular concern since Carbapenems are often the drug of last resort for treating difficult bacterial infections.
Short of seeing an extremely high mortality influenza pandemic, I can think of no looming medical crisis more dire than the growing threat of antimicrobial resistance. The World Health Organization, the ECDC, and the CDC all consider the spread of antibiotic resistant organisms to be an extremely urgent public health concern.
So I expect I’ll be devoting a good deal of blog space to this topic over the next couple of weeks.
