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Strong correlation between the rates of intrinsically antibiotic-resistant species and the rates of acquired resistance in Gram-negative species causing bacteraemia, EU/EEA, 2016.

  • Jarlier, Vincent1, 2
  • Diaz Högberg, Liselotte3
  • Heuer, Ole E3
  • Campos, José4
  • Eckmanns, Tim5
  • Giske, Christian G6, 7
  • Grundmann, Hajo8
  • Johnson, Alan P9
  • Kahlmeter, Gunnar10
  • Monen, Jos11
  • Pantosti, Annalisa12
  • Rossolini, Gian Maria13, 14
  • van de Sande-Bruinsma, Nienke15
  • Vatopoulos, Alkiviadis16
  • Żabicka, Dorota17
  • Žemličková, Helena18, 19
  • Monnet, Dominique L3
  • Simonsen, Gunnar Skov20, 21
  • 1 Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière hospital, Laboratoire de Bactériologie-Hygiène, Paris, France. , (France)
  • 2 Sorbonne Universités (Paris 06) Inserm Centre d'Immunologie et des Maladies Infectieuses (CIMI), UMR 1135, Paris, France. , (France)
  • 3 European Centre for Disease Prevention and Control, Solna, Sweden. , (Sweden)
  • 4 Reference and Research Laboratory on Antimicrobial Resistance, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain. , (Spain)
  • 5 Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany. , (Germany)
  • 6 Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden. , (Sweden)
  • 7 Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden. , (Sweden)
  • 8 Medical Center - University of Freiburg, Department for Infection Prevention and Hospital Epidemiology, Freiburg, Germany. , (Germany)
  • 9 National Infection Service, Public Health England, London, United Kingdom. , (United Kingdom)
  • 10 Clinical Microbiology, Central Hospital, Växjö, Sweden. , (Sweden)
  • 11 National Institute for Public Health and the Environment, Bilthoven, the Netherlands. , (Netherlands)
  • 12 Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy. , (Italy)
  • 13 Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy. , (Italy)
  • 14 Department of Experimental and Clinical Medicine, University of Florence, Italy. , (Italy)
  • 15 Pan American Health Organization/World Health Organization (PAHO/ WHO), Washington DC, United States. , (United States)
  • 16 Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece. , (Greece)
  • 17 Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland. , (Poland)
  • 18 Department of Clinical Microbiology, Faculty of Medicine and University Hospital, Charles University, Hradec Kralove, Czech Republic. , (Czechia)
  • 19 National Institute of Public Health, National Reference Laboratory for Antibiotics, Prague, Czech Republic. , (Czechia)
  • 20 Research Group for Host-Microbe Interaction, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway. , (Norway)
  • 21 Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway. , (Norway)
Published Article
European Centre for Disease Control and Prevention (ECDC)
Publication Date
Aug 01, 2019
DOI: 10.2807/1560-7917.ES.2019.24.33.1800538
PMID: 31431208


BackgroundAntibiotic resistance, either intrinsic or acquired, is a major obstacle for treating bacterial infections.AimOur objective was to compare the country-specific species distribution of the four Gram-negative species Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter species and the proportions of selected acquired resistance traits within these species.MethodWe used data reported for 2016 to the European Antimicrobial Resistance Surveillance Network (EARS-Net) by 30 countries in the European Union and European Economic Area.ResultsThe country-specific species distribution varied considerably. While E. coli accounted for 31.9% to 81.0% (median: 69.0%) of all reported isolates, the two most common intrinsically resistant species P. aeruginosa and Acinetobacter spp. combined (PSEACI) accounted for 5.5% to 39.2% of isolates (median: 10.1%). Similarly, large national differences were noted for the percentages of acquired non-susceptibility to third-generation cephalosporins, carbapenems and fluoroquinolones. There was a strong positive rank correlation between the country-specific percentages of PSEACI and the percentages of non-susceptibility to the above antibiotics in all four species (rho > 0.75 for 10 of the 11 pairs of variables tested).ConclusionCountries with the highest proportion of P. aeruginosa and Acinetobacter spp. were also those where the rates of acquired non-susceptibility in all four studied species were highest. The differences are probably related to national differences in antibiotic consumption and infection prevention and control routines.

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