Surveillance of antimicrobial resistance in Europe : annual report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) 2016

The results presented in this report are based on antimicrobial resistance data from invasive isolates reported to EARS-Net by 30 European Union (EU) and European Economic Area (EEA) countries in 2017 (data referring to 2016), and on trend analyses of data reported by the participating countries for the period 2013 to 2016. As in previous years, the antimicrobial resistance situation in Europe displays wide variations depending on the bacterial species, antimicrobial group and geographical region. For several bacterial species-antimicrobial group combinations, a north-to-south and a west-to-east gradient is evident in Europe. In general, lower resistance percentages were reported by countries in the north while higher percentages were reported in the south and east of Europe. These differences are most likely related to variations in antimicrobial use, infection prevention and control practices, and dissimilarities in diagnostic and healthcare utilisation patterns in the countries. For E. coli, significant increases in the EU/EEA population- weighted mean percentages for third-generation cephalosporin resistance and aminoglycoside resistance, as well as for combined resistance to three key antimicrobial groups (fluoroquinolones, third-generation cephalosporins and aminoglycosides) were observed for the period 2013 to 2016. This is a continuation of the increasing trends reported by EARS-Net in previous years. By contrast, there was some indication that the overall resistance situation for K. pneumoniae was stabilising at the EU/EEA level during the same period. There were small though significant decreases in the EU/EEA population- weighted mean percentages for K. pneumoniae between 2013 and 2016 for most antimicrobial groups under regular surveillance, with the notable exception of carbapenem resistance. However, at the individual country level, the same encouraging development was not always seen, and increasing resistance percentages in K. pneumoniae were reported from several countries, mainly those with comparatively high resistance.