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Health burden of infections with antibiotic-resistant bacteria in the EU/EEA


In November 2022 the European Centre for Disease Prevention and Control (ECDC) released its technical report ‘Assessing the health burden of infections with antibiotic-resistant bacteria in the EU/EEA, 2016-2020’. The report aimed to provide updated estimates of the burden of infections with selected bacterium–antibiotic resistance combinations in the European Union/European Economic Area (EU/EEA) in 2016-2020 and assess how this burden has changed from previous estimates.

Conclusions and potential implications [extract from the report]

The results of this study confirm that further public health efforts are urgently needed to reduce the burden of antibiotic resistance in the EU/EEA. Reducing the spread of antibiotic-resistant bacteria will have a significant positive impact on population health and future healthcare expenditure in the EU/EEA. As a major part of the burden of infections with antibiotic-resistant bacteria is associated with healthcare, further surveillance, as well as further improvements in infection prevention and control, both in hospitals and in long-term care, remain essential. In addition, areas of inappropriate antibiotic use need to be addressed within comprehensive antimicrobial stewardship, and programmes targeting both the community and healthcare settings play an important role. Relatively little investment per capita in prevention and control of antibiotic resistance and antimicrobial stewardship could pay itself back within a year, allowing thousands of deaths to be avoided, and producing savings in healthcare costs in the long run. Putting into practice national and European-level action plans remains important in several areas, and further updates and renewal of the plans should be undertaken when necessary.

Estimations of the burden of infections with antibiotic-resistant bacteria presented as
disability-adjusted life years (DALYs) per 100 000 population by country, EU/EEA, 2016-2020

Updated studies on the burden of antibiotic resistance in the EU/EEA performed at regular intervals, including relevant updates on the evidence and methodology, both on the side of the initial surveillance and incidence estimation, as well as the disease progression in the affected population/individuals, can provide important evidence for policy formulation and evaluation. Further updates can include attempts to estimate the attributability of the health burden to antibiotic resistance rather than to infections, or including more bacterium–antibiotic resistance combinations. Further studies are also needed to estimate the effects of the COVID-19 pandemic on the burden of antibiotic resistance, including further pandemic years into the analysis.

The ECDC methodology is openly available for further work via the latest releases of the BCoDE (Burden of Communicable Disease in Europe) toolkit, which already allows for estimations and updates for different antibiotic-resistance bacteria and infections.