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The impact of antibiotic resistant infections in Europe Antibiotic-resistant bacteria cause a heavy burden of infections, deaths, and disability-adjusted life years within 30 countries in Europe

Over time, bacteria have evolved to become resistant to some types of antibiotics, the medicines designed to destroy them. Due to this resistance, certain types of bacteria can no longer be destroyed by normal means. This is a big problem, as the infections from these bacteria are more difficult to treat, and they require a more intensive solution. However, in order to develop solutions to this problem, we need to know the extent of the problem. We know a great deal about how antibiotic resistance occurs, but we don’t have much hard data on how widespread it really it – where it is occurring and in what populations. Currently, there is not a lot of data that has been collected in a standard way to show the extent of antibiotic resistance.

Therefore, researchers from many different universities and organizations in Europe came together to estimate the burden of infections caused by antibiotic-resistant bacteria in the European Union and the European Economic Area in 2015. These researchers defined “burden” of infections as the number of cases of all types of infections caused by antibiotic-resistant bacteria, the number of deaths that were attributed to those specific antibiotic-resistant bacteria, and the years lost due to poor health, disability, or early death caused by these infections (also known as disability-adjusted life-years, or DALYs).

This study focused on eight different types of antibiotic-resistant bacteria that are frequently found in  blood or cerebrospinal fluid of infected patients. These eight types included Acinetobacter, Enterococcus faecalisEnterococcus faecium; Escherichia coliKlebsiella pneumoniae; Pseudomonas aeruginosa; Staphylococcus aureus (MRSA); and Streptococcus pneumoniae. They studied five types of infections involving these bacteria: bloodstream infections, urinary tract infections, respiratory tract infections, surgical site infections, and “other” infections. The researchers took data from all countries in the EU and EEA regarding the number of cases, the number of deaths, the locations, severity, and years of life lost due to disability for all the five types of bacteria studied. They used that data to build a statistical model (like a computer simulation) of the problem to be able to understand the estimate the total burden of these antibiotic-resistant infections for these 30 countries in 2015, because they were not able to study or have data for all the people in this area with antibiotic-resistant infections for that year.

The models estimated that in 2015, there were 671,689 cases of infection due to antibiotic-resistant bacteria in the 30 countries contained within the European Union and the European Economic Area. These infections were estimated to cause 33,110 deaths and 874,541 disability-adjusted life-years. This means that there were 131 antibiotic-resistant infections per 100,000 people and 6.44 deaths per 100,000 people in these countries during 2015. Most of these infections occurred in infants less than 1 year of age, or in adults aged 65 years or older. The researchers also found that 63.5% of these antibiotic-resistant infections were associated with health care, showing that the majority of these infections occur in hospitals or other places that perform health care. Furthermore, the burden of antibiotic-resistant infections (measured by disability-adjusted life-years) in this region is comparable to all of the combined burdens of three other infectious diseases (the flu, tuberculosis, and HIV) in the same region. These results show how big of an issue antibiotic-resistant bacteria is right now, and we need to find a way to stop these infections from occurring and affecting so many people around the world.

Article Information

Edited By: Gina Riggio
Source: Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis.
Publication Date: November 5, 2018

Paper Author(s): Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, Colomb-Cotinat M, Kretzschmar ME, Devleesschauwer B, Cecchini M, Ouakrim DA, Oliveira TC, Struelens MJ, Suetens C, Monnet DL; Burden of AMR Collaborative Group.

Paper Institution(s): European Centre for Disease Prevention and Control, University Medical Center Utrecht, European Centre for Disease Prevention and Control, University Hospital of North Norway, The Arctic University of Norway, Santé publique France, National Institute for Public Health and the Environment, Sciensano, Ghent University, Organisation for Economic Co-operation and Development.

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