The changing epidemiology of bacteraemias in Europe : trends from the European Antimicrobial Resistance Surveillance System

摘要: We investigated bacteraemia trends for five major bacterial pathogens, Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Enterococcus faecalis and faecium, determined how expanding antimicrobial resistance influenced the total burden of bacteraemias in Europe. Aetiological fractions species antibiotic phenotypes were extracted from European Antimicrobial Resistance Surveillance System (EARSS) database laboratories, which consistently reported between 2002 2008. Trend analyses used generalized linear models. Robustness results was assessed by iterative analysis different geographic regions. From to 2008, overall number reports increased annually 6.4% (95% confidence interval (CI) 6.2-6.5%), 46 095 67 876. In subset laboratories providing denominator information, incidence 0.58/1000 patient-days 0.90/1000 (7.2% per year; 95% CI 6.9-7.5%). The frequency isolates S. aureus pneumoniae moderately, while increase E. coli faecium more pronounced. Bacteraemias caused methicillin-resistant until 2005 (7.6% 6.1-9.1%), then decreased (-4.8% -6.1 -3.5%), whereas attributable methicillin-sensitive continuously (3.4% 3.0-3.7). Increasing rates mainly antibiotic-resistant phenotypes. Our data suggest that bloodstream infection has been increasing all during EARSS surveillance. Trends driven resistant strains clearly dissociated susceptible isolates. It appears infections with clones add rather than replace bacteria. As a consequence, expansion creates an additional strain on healthcare systems.