Drug-resistant superbugs are rising uncontrollably in Europe. Experts are calling for prudent use of antibiotics and for control of healthcare-associated infections.
In a survey conducted through the European Society of Intensive Care Medicine (ESICM), as many as 55 different bacteria were reported by the doctors as being totally resistant to antibiotics, including bugs that cause pneumonia, urinary tract infections, respiratory problems, wound infections and in serious cases blood stream infection and meningitis.
Methicillin-resistant staphylococcus aureus
(MRSA) and third-generation cephalosporin-resistant Enterobacteriaceae
were the most frequently reported antibiotic-resistant bacteria.
Antibiotic-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacteriaceae
, were more frequently reported, with the exception of MRSA, according to the survey. The first results have been published in the Eurosurveillance journal to mark the European Antibiotics Awareness Day on Nov.18.
''Antibiotic resistance is a threat to public health and compromises appropriate therapy of infected patients, in particular for infections in the most severely ill in hospitals. Increasingly, intensive care physicians in Europe and elsewhere are confronted with patients infected by bacteria for which limited or no adequate therapeutic options are available,'' it was observed.
It has also been stressed the figures were likely to be an underestimate as the survey only covered a snapshot in time and a small number of doctors across Europe.
In hospitals, intensive care units are considered as areas where antibiotic resistance problems are the largest due to the combination of multiple factors. These factors include the concentration of severely ill patients requiring specialised care, the high frequency of use of medical devices and the high frequency of antibiotic treatment . Not surprisingly, most intensive care physicians that participated in the survey felt that antibiotic resistance was a major or significant problem in their practice.
A recent joint technical report of European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMEA) had also shown that, with the exception of MRSA, the burden of antibiotic resistance in Europe was now mostly due to antibiotic-resistant Gram-negative bacteria, totally or almost totally resistant to available antibiotics.
What is of greater concern is that the joint technical report also showed that there were very few new antibiotics with a novel mechanism of action in development to meet the challenge of multidrug-resistant bacteria. Patients with infections due to carbapenem-resistant Gram-negative bacteria often require the use of old and toxic antibiotics such as colistin, it had been pointed out.
Prudent use of antibiotics is not the only strategy for fighting antibiotic resistance. Good infection control practices, including hand hygiene as well as the screening and isolation of infected patients are necessary to prevent the spread of resistant bacteria. Several European countries have or have had national or regional campaigns on hand hygiene, but improving hand hygiene practices remains a challenge in many countries. A European Union (EU) Council Recommendation on patient safety, including the prevention and control of healthcare-associated infections has been adopted by EU Health Ministers on 9 June 2009 and lists a series of actions in this area. ECDC will provide support by developing guidance documents for prevention of control of these infections.
Developing and marketing of new antibiotics with novel mechanisms of action represents a further essential strategy against antibiotic resistance as resistance inevitably builds over time. A recent report from ECDC and the European Medicines Agency (EMEA) identified a gap between increasing prevalence of multidrug-resistant bacteria in the EU and the current state of the development pipeline for new antibiotics . This topic is one of the priorities of the current Swedish Presidency of the EU and was discussed at the conference "Innovative Incentives for Effective Antibacterials.''
The ECDC is also writing to all GPs in Europe warning them against widespread use of antibiotics for minor diseases as the problem is growing.
Zsuzsanna Jakab, Director of the ECDC, said: "Rising levels of resistance being reported across Europe to a number of essential antibiotics, and the emergence of bacteria that are resistant to all known antibiotics, is directly linked to the use of antibiotics.
''Without effective antibiotics, modern medical treatments such as operations, transplants and intensive care will become impossible. European Antibiotic Awareness Day aims to raise awareness about the threat to public health of antibiotic resistance and to communicate about the importance of prudent antibiotic use in order to turn the tide on antibiotic resistance."