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Resistant pathogens burden Europe

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More than 8,000 excess deaths in Europe during 2007 were associated with bloodstream infections caused by methicillin-resistant Staphylococcus aureus and third-generation cephalosporin-resistant Escherichia coli.

“Importantly, a possible shift in the burden of antibiotic resistance from gram-positive to gram-negative infections is concerning,” Marlieke E.A. de Kraker, MSc, of the National Institute for Public Health and the Environment in Bilthoven, Netherlands, told Orthopedics Today’s sister publication Infectious Disease News. “Such forecasts suggest that despite anticipated gains in the control of [methicillin-resistant Staphylococcus aureus] MRSA, the increasing number of infections caused by third-generation cephalosporin-resistant gram-negative pathogens, such as [Escherichia coli] E. coli, is likely to outweigh this achievement soon. This increasing burden will have a big impact on already stretched health systems.”

Marlieke E.A.de Kraker

Data were pooled from the European Antimicrobial Resistance Surveillance System (including more than 1,200 European hospitals) and national health care statistics to determine the number of bloodstream infections caused by MRSA and third-generation cephalosporin-resistant E. coli across 31 European countries. Excess deaths, hospital stay and hospital expenditures associated with infections caused by these two pathogens were based on data prospectively collected in 13 different hospitals in as many European countries.

Of 27,711 MRSA-associated bloodstream infections, there were 5,503 excess deaths and an extension of 255,683 hospital days. Of 15,183 third-generation cephalosporin-resistant E. coli bloodstream infections, there were 2,712 excess deaths and 120,065 extended hospital days.

Compared with $63.1 million in total costs attributed to extended hospital stays for MRSA bloodstream infections, total costs for third-generation cephalosporin-resistant E. coli were $29.7 million.

“The burden of antimicrobial resistance is large and increasing,” de Kraker said. “In most hospitals, action plans to combat are already in place, but resistant infections caused by gram-negative pathogens should not be neglected because they could potentially lead to much higher number of patients. Prudent use of antibiotics in the community, as well as in the hospital, is very important. In addition, proper infection control policies and hygiene measures in hospitals are of paramount importance.” – by Ashley DeNyse

Reference:

• de Kraker MEA, Davey PG, Grundmann H. Mortality and hospital stay associated with resistant Staphylococcus aureus and Escherichia coli bacteremia: Estimating the burden of antibiotic resistance in Europe. PLoS Med. 2011;doi:10.1371/journal.pmed.1001104.
• Disclosure: This work was funded by DG-Sanco, University Medical Center Groningen, and the Netherlands National Institute for Public Health and the Environment. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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