The European Dimension

Antimicrobial resistance causes 25.000 deaths in the European Union per year.
The extra costs associated to the treatment of these infections are estimated
at 1500 million euros annually, only in Europe.

(https://amr-review.org/)

The increase in the number of infections caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) and the emergence of carbapenemases-producing Enterobacteriaceae (CPE) has become a worrisome clinical issue. Carbapenems belong to the group of antibiotics used as last resort for life-threatening infections caused by ESBL-producing Enterobacteriaceae, such as Klebsiella pneumoniae and Escherichia coli.

Recently, the WHO has considered carbapenem and 3rd generation cephalosporin-resistant Enterobacteriaceae in third position among the global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. As shown in the following figures, it is an increasing problem:

Source: ECDC, 2009

Incidence of carbapenemases-producing Enterobacteriaceae (CPE)

Occurrence of carbapenemase-producing Enterobacteriaceae in 38 European countries based on self-assessment by the national experts, March 2013

Occurrence of carbapenemase-producing Enterobacteriaceae (K. pneumoniae and E. coli) as assessed by national experts, 38 European countries, May 2015

Percentage of invasive E. coli isolates with resistance to carbapenems, 2014

2016

Klebsiella pneumoniae. Percentage (%) of invasive isolates with resistance to carbapenems, by country, EU/EEA countries, 2014

Klebsiella pneumoniae. Percentage (%) of invasive isolates with resistance to carbapenems, by country, EU/EEA countries, 2016

Both extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E)
and Carbapenem-resistant Enterobacteriaceae represent
an immediate public health threat that requires urgent actions.