Dossier n. 201/2010 [Abstract] Surveillance of antimicrobial resistance and consumption of systemic antibiotics in Emilia-Romagna. Report 2008

This report is based on data obtained from the regional antibiotic resistance surveillance system of Emilia-Romagna in 2008. For some pathogens, particularly when isolated from blood cultures, the period 2003-2008 was also analyzed. Furthermore, we report data regarding antibiotic consumption both in the hospital and in the community, with a more detailed analysis on the last one. In this report a special attention was given to two emerging problems: a) Acinetobacter spp and extended spectrum betalactamase (ESBL) producing Enterobacteriaceae and b) difficult to treat Escherichia coli and Klebsiella pneumoniae resistances.


Antimicrobial resistance surveillance

Data from 2008 show a constant increase of resistance to III generation cefalosporins, quinolones and aminoglicosides, excluding amikacin - in Escherichia coli (isolates from blood cultures: 21.7%, 38.8% and 18.4% of resistance, respectively) and in Klebsiella pneumoniae (31.3%, 29.9% e 25.6% of resistance respectively). An increase in the number of patients with an isolation of Acinetobacter baumannii, was also observed, despite the total number of patients remained quite low: 419 in 2007 and 503 in 2008 (+20%). The number of patients with isolation of ESBL producing Enterobacteriaceae, significantly increased both for E. coli, going from 13.1% in 2007 to 20.1%, and for K. pneumoniae, going from 22.5% to 26.2%. No significant increase was observed in antibiotic resistance for Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus spp.


Systemic antimicrobial consumption

The consumption of systemic antimicrobials continues to increase. In the community, antimicrobial consumption is high in every age class, with a global consumption equal to 19.4 DDD for 1,000 person-days, being highest in the extreme classes of age (0-6 years and over 80 years). The most frequently prescribed antibiotics, both in hospital and the community, are inhibitor-associated penicillins, followed by quinolones and cephalosporins, (2.7 and 1.6 DDD/1,000 person-days, respectively).