Strong #correlation between the rates of intrinsically #antibiotic #resistant species and the rates of acquired resistance in Gram-negative species causing #bacteraemia, #EU/EEA, 2016 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Strong correlation between the rates of intrinsically antibiotic-resistant species and the rates of acquired resistance in Gram-negative species causing bacteraemia, EU/EEA, 2016

Vincent Jarlier 1,2, Liselotte Diaz Högberg 3, Ole E Heuer 3, José Campos 4, Tim Eckmanns 5, Christian G Giske 6,7, Hajo Grundmann 8,Alan P Johnson 9, Gunnar Kahlmeter 10, Jos Monen 11, Annalisa Pantosti 12, Gian Maria Rossolini 13,14, Nienke van de Sande-Bruinsma 15,Alkiviadis Vatopoulos 16, Dorota Żabicka 17, Helena Žemličková 18,19, Dominique L Monnet 3, Gunnar Skov Simonsen 20,21, EARS-Net participants 22

Affiliations: 1 Sorbonne Universités (Paris 06) Inserm Centre d’Immunologie et des Maladies Infectieuses (CIMI), UMR 1135, Paris, France; 2 Assistance Publique – Hôpitaux de Paris, Pitié-Salpêtrière hospital, Laboratoire de Bactériologie-Hygiène, Paris, France; 3 European Centre for Disease Prevention and Control, Solna, Sweden; 4 Reference and Research Laboratory on Antimicrobial Resistance, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain; 5 Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany; 6 Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; 7 Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden; 8 Medical Center – University of Freiburg, Department for Infection Prevention and Hospital Epidemiology, Freiburg, Germany; 9 National Infection Service, Public Health England, London, United Kingdom; 10 Clinical Microbiology, Central Hospital, Växjö, Sweden; 11 National Institute for Public Health and the Environment, Bilthoven, the Netherlands; 12 Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; 13 Department of Experimental and Clinical Medicine, University of Florence, Italy; 14 Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy; 15 Pan American Health Organization/World Health Organization (PAHO/ WHO), Washington DC, United States; 16 Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece; 17 Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland; 18 National Institute of Public Health, National Reference Laboratory for Antibiotics, Prague, Czech Republic; 19 Department of Clinical Microbiology, Faculty of Medicine and University Hospital, Charles University, Hradec Kralove, Czech Republic; 20 Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway; 21 Research Group for Host-Microbe Interaction, Faculty of Health Sciences, UiT – The Arctic University of Norway, Tromsø, Norway; 22 The members of the group are listed at the end of the article

Correspondence:  Liselotte Diaz Högberg

Citation style for this article: Jarlier Vincent, Diaz Högberg Liselotte, Heuer Ole E, Campos José, Eckmanns Tim, Giske Christian G, Grundmann Hajo, Johnson Alan P,Kahlmeter Gunnar, Monen Jos, Pantosti Annalisa, Rossolini Gian Maria, van de Sande-Bruinsma Nienke, Vatopoulos Alkiviadis, Żabicka Dorota, Žemličková Helena,Monnet Dominique L, Simonsen Gunnar Skov, EARS-Net participants. Strong correlation between the rates of intrinsically antibiotic-resistant species and the rates of acquired resistance in Gram-negative species causing bacteraemia, EU/EEA, 2016. Euro Surveill. 2019;24(33):pii=1800538.

Received: 03 Oct 2018;   Accepted: 01 Apr 2019




Antibiotic resistance, either intrinsic or acquired, is a major obstacle for treating bacterial infections.


Our objective was to compare the country-specific species distribution of the four Gram-negative species Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter species and the proportions of selected acquired resistance traits within these species.


We used data reported for 2016 to the European Antimicrobial Resistance Surveillance Network (EARS-Net) by 30 countries in the European Union and European Economic Area.


The country-specific species distribution varied considerably. While E. coli accounted for 31.9% to 81.0% (median: 69.0%) of all reported isolates, the two most common intrinsically resistant species P. aeruginosa and Acinetobacterspp. combined (PSEACI) accounted for 5.5% to 39.2% of isolates (median: 10.1%). Similarly, large national differences were noted for the percentages of acquired non-susceptibility to third-generation cephalosporins, carbapenems and fluoroquinolones. There was a strong positive rank correlation between the country-specific percentages of PSEACI and the percentages of non-susceptibility to the above antibiotics in all four species (rho > 0.75 for 10 of the 11 pairs of variables tested).


Countries with the highest proportion of P. aeruginosa and Acinetobacter spp. were also those where the rates of acquired non-susceptibility in all four studied species were highest. The differences are probably related to national differences in antibiotic consumption and infection prevention and control routines.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Antibiotics; Drugs Resistance; Bacteremia; EU.


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Giuseppe Michieli

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum ( in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.