MDRO INFECTIONS AND ANTIBIOTIC-RESISTANCE

[Date of last update: January 2021]

Antimicrobial resistance is considered one of the greatest threats to public health globally (WHO, 2020). [7]
The resistance that bacteria - but also viruses, fungi and parasites - have developed is a process that has accelerated in recent decades due to the abuse and misuse of antimicrobials , not only in the medical clinic, but also in animal husbandry and agriculture (WHO, 2020) (PCAST US Government, 2020) [6] (Peter J. Collignon, 2019). [5]

There are eight microorganisms that in all Europe and Italy are under surveillance. Among the Gram negative we have Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter species. Among the Gram-positive Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Enterococcus faecium (ECDC, 2020) [2] (Istituto Superiore di Sanità, 2021). [4]
In European countries and in the European economic area, including Italy, the resistance levels of negative Grams is still high, despite 2015 and 2019, the changes were moderate. Resistance to carbapenems, especially for Klebsiella, Acinetobacter and Pseudomonas species, is a worrying phenomenon. Among the Gram positive, resistance levels show a slight decrease, apart from Enterococcus faecium which has a continuous increase in the percentage of resistance to vancomycin (from 10.5% in 2015 to 18.3% in 2019). The countries of Northern Europe have a lower percentage of resistance than those of South-Eastern Europe. (ECDC, 2020) [2] 

The main measures to be taken to curb the pressure that antibiotic resistance is placing on global health and health systems are: the prudent use of antimicrobials through the implementation of effective antimicrobial stewardship, effective infection control measures in healthcare contexts and the development of new drugs and vaccines. (Evelina Tacconelli, 2018) [3] (ECDC, Surveillance of antimicrobial resistance in Europe 2018, 2019) [1]