New WHO report shows comparable antibiotic resistance in EU and non-EU countries in the European Region

WHO/Saskia Nahrgang

Antibiotics are still available over the counter in several countries in the WHO European Region

On the occasion of the first World Antibiotic Awareness Week on 16–22 November 2015, WHO/Europe releases its first report on antibiotic resistance in five non-European Union (EU) countries of the WHO European Region. The new report shows that antibiotic resistance in non-EU countries in the Region is comparable with that in their EU neighbours.

"The European picture on antibiotic resistance has been incomplete, and this has represented a major gap in terms of knowledge and action. With this report, we are now able to gather information from a number of non-EU countries to complement the EU overview", says Dr Zsuzsanna Jakab, WHO Regional Director for Europe. "This is a first step to a better insight into antibiotic resistance in the whole Region in order to provide guidance to countries that are building or strengthening their national surveillance. We call on all European countries to join WHO/Europe's network and complete the picture."  

"This first report on antibiotic resistance in five non-EU countries of the WHO European Region provides a vital insight into antibiotic resistance patterns east of the EU and shows that neighbouring countries are facing similar challenges, in particular the emergence of resistance to last-line antibiotics. Antibiotic resistance is a global threat; that is why the ECDC is a partner with the World Health Organization for the first World Antibiotic Awareness Week", comments Dr Andrea Ammon, Acting Director, European Centre for Disease Preventions and Control (ECDC). 

Different but comparable levels of antibiotic resistance

The latest report of the Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR) network shows that, despite different levels of resistance, antibiotic resistance is a serious health threat in five countries: Belarus, Serbia, Switzerland, the Former Yugoslav Republic of Macedonia and Turkey. 

"It is becoming more and more difficult for patients to recover from infections, as the resistance of pathogens to the power of antibiotics and, worse, to last-resort antibiotics, is increasing steadily. This, coupled with the extremely slow development of new antibiotics, makes infections of the respiratory and urinary tract, bloodstream and skin likely to become untreatable and thus deadly," says Dr Nedret Emiroglu, Director of Communicable Diseases, Health Security, and Environment at WHO/Europe.

  • The resistance pattern in Switzerland is similar to that in northern European countries, most of which have low levels of resistance and high levels of awareness. However, relatively high resistance (11%) to the last-resort antibiotic carbapenem is found in the Acinetobacter bacteria that cause pneumonia and wound infections. Resistance to last-resort antibiotics means that there are no or very few alternatives left to save patients.  
  • Turkey reported resistance levels similar to those of south-eastern European countries. The relatively high level of carbapenem resistance found in Escherichia coli (4%) was the result of a large hospital outbreak and subsequent spread throughout the country.
  • Belarus, Serbia and the Former Yugoslav Republic of Macedonia reported high levels of resistance similar to those in their neighbouring EU countries, in, for example, Acinetobacter spp. and Pseudomonas aeruginosa.

A new report stemming from new CAESAR data

The data collected by CAESAR network complement those gathered by the ECDC through the antimicrobial resistance surveillance system of the EU and the antimicrobial resistance interactive database (EARS-Net) and contribute to a pan-European overview of trends in and sources of antibiotic resistance. 

"Besides giving an overview of resistance levels, the CAESAR report also encourages countries to provide accurate resistance data through improved surveillance", adds Danilo Lo Fo Wong, Programme Manager for Antimicrobial Resistance in WHO/Europe. "This factual knowledge allows countries to identify sources and follow resistance patterns, provide treatment guidance to physicians, as well as increase awareness among policy-makers and the public."

WHO/Europe and CAESAR partners, the European Society of Infectious Disease and the National Institute of Public Health and the Environment of the Netherlands are committed to extending CAESAR to the whole of the European Region and to supporting countries in building their capacity to set up or strengthen their national AMR surveillance networks.