Antibiotic resistance soars in Europe

August 12, 2004

News

Nature Medicine 10, 6 (2004) doi:10.1038/nm0104-6b

Antibiotic resistance soars in EuropeTony Sheldon Utrecht

Responding to "worrying trends" in antimicrobial resistance in Europe, the European Union has announced two new projects, totaling $16 million, to study how resistance arises.There is increasing incidence of Escherichia coli strains resistant to third-generation cephalosporins, a consistent rise in fluoroquinolone resistance, and resistance rates of more than 50% to ampicillin, according to a new report from the European Antimicrobial Resistance Surveillance System (EARSS), an infectious disease network of 28 countries.Resistance to third-generation cephalosporins has remained lower than 6% in most countries. But higher rates in some eastern European countries are associated with the spread of strains producing -lactamases, enzymes that can destroy aminopenicillins such as ampicillin. The EARSS also reports a "consistent and marked" rise in fluoroquinolone-resistant E. coli in many European countries. Rates of resistance are currently about 10%, but eight countries experienced a 1.5-fold increase in just two years.Resistance in E. coli to traditional antibiotics such as aminopenicillins is now common in Europe, with only Finland and Sweden reporting rates of less than 30%. Among the 25 countries surveyed, resistance rates varied from 25% to 64%. More than half of all strains isolated from bloodstream infections harbor plasmids that encode -lactamases. The report is based on routinely generated antimicrobial susceptibility data from 700 laboratories and an estimated sample population of 100 million.EARSS monitors resistance in several other major pathogens, including Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis and E. faecium, but it singles out E. coli resistance as showing the most worrying trends. Multiresistant bacteria pose a "potentially serious impediment" to transplant surgery, cancer therapy and treatment of infections, warns Hajo Grundmann, project leader for the EARSS.

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