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European intensive care physicians’ experience of infections due to antibiotic-resistant bacteria

Authors
  • Lepape, Alain1, 2, 3
  • Jean, Astrid1, 3
  • De Waele, Jan2, 4
  • Friggeri, Arnaud1, 3
  • Savey, Anne3
  • Vanhems, Philippe3
  • Gustin, Marie Paule3
  • Monnet, Dominique L.5
  • Garnacho-Montero, José2, 6
  • Kohlenberg, Anke5
  • 1 Lyon-Sud University Hospital, Hospices Civils de Lyon, Lyon, France , Lyon (France)
  • 2 Infection Section, European Society of Intensive Care Medicine, Brussels, Belgium , Brussels (Belgium)
  • 3 Université Claude Bernard Lyon, Lyon, France , Lyon (France)
  • 4 Ghent University Hospital, Ghent, Belgium , Ghent (Belgium)
  • 5 European Centre for Disease Prevention and Control (ECDC), Solna, Sweden , Solna (Sweden)
  • 6 Virgen Macarena University Hospital, Seville, Spain , Seville (Spain)
Type
Published Article
Journal
Antimicrobial Resistance & Infection Control
Publisher
BioMed Central
Publication Date
Jan 02, 2020
Volume
9
Issue
1
Identifiers
DOI: 10.1186/s13756-019-0662-8
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundAntimicrobial resistance (AMR) compromises the treatment of patients with serious infections in intensive care units (ICUs), and intensive care physicians are increasingly facing patients with bacterial infections with limited or no adequate therapeutic options. A survey was conducted to assess the intensive care physicians’ perception of the AMR situation in the European Union/European Economic Area (EU/EEA).MethodsBetween May and July 2017, physicians working in European ICUs were invited to complete an online questionnaire hosted by the European Society of Intensive Care Medicine. The survey included 20 questions on hospital and ICU characteristics, frequency of infections with multidrug-resistant (MDR) bacteria and relevance of AMR in the respondent’s ICU, management of antimicrobial treatment as well as the use of last-line antibiotics in the six months preceding the survey. For the analysis of regional differences, EU/EEA countries were grouped into the four sub-regions of Eastern, Northern, Southern and Western Europe.ResultsOverall, 1062 responses from four European sub-regions were analysed. Infections with MDR bacteria in their ICU were rated as a major problem by 257 (24.2%), moderate problem by 360 (33.9%) and minor problem by 391 (36.8%) respondents. Third-generation cephalosporin-resistant Enterobacteriaceae were the most frequently encountered MDR bacteria followed by, in order of decreasing frequency, meticillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa and vancomycin-resistant enterococci. Perception of the relevance of the AMR problem and the frequency of specific MDR bacteria varied by European sub-region. Bacteria resistant to all or almost all available antibiotics were encountered by 132 (12.4%) respondents. Many physicians reported not having access to specific last-line antibiotics.ConclusionsThe percentage of European ICU physicians perceiving AMR as a substantial problem in their ICU is high with variation by sub-region in line with epidemiological studies. The reports of bacteria resistant to almost all available antibiotics and the limited availability of last-line antibiotics in ICUs in the EU/EEA are of concern.

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