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. 2019 Aug;24(33):1800538.
doi: 10.2807/1560-7917.ES.2019.24.33.1800538.

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

Vincent Jarlier  1   2 , Liselotte Diaz Högberg  3 , Ole E Heuer  3 , José Campos  4 , Tim Eckmanns  5 , Christian G Giske  6   7 , Hajo Grundmann  8 , Alan P Johnson  9 , Gunnar Kahlmeter  10 , Jos Monen  11 , Annalisa Pantosti  12 , Gian Maria Rossolini  13   14 , Nienke van de Sande-Bruinsma  15 , Alkiviadis Vatopoulos  16 , Dorota Żabicka  17 , Helena Žemličková  18   19 , Dominique L Monnet  3 , Gunnar Skov Simonsen  20   21 ; EARS-Net participants  22
Affiliations

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

Vincent Jarlier et al. Euro Surveill. 2019 Aug.

Abstract

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.

Keywords: Gram-negative bacilli; antibiotic resistance; antimicrobial resistance; bacterial infections; bloodstream infection.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Distribution of fully susceptible (S) and non-susceptible (I or R) isolates in four Gram-negative species isolated from blood or cerebrospinal fluid, 30 EU/EEA countries, 2016 (n = 173,540)
Figure 2
Figure 2
Scattergrams showing the sum of proportions of Pseudomonas aeruginosa and Acinetobacter spp. combined (PSEACI) (n = 20,995) among four Gram-negative speciesa and proportions of various acquired non-susceptibility and species, 30 EU/EEA countries, 2016
See this image and copyright information in PMC

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