Nesta Longitude prize

Bacteria vs. Antibiotics

Antibiotic resistance across Europe

The development of antibiotics has added an average of 20 years to our lives, according to the World Health Organization. But bacteria are becoming increasingly resistant to antibiotics, posing a significant risk as common infections become untreatable. It is estimated that more than 25,000 patients die annually in the EU due to multidrug resistance (MDR) in bacterial infections. Using the latest available data from the European Centre for Disease Prevention and Control we show the resistance levels of five bacteria to antibiotics across Europe.

Escherichia coli

Percentage of invasive isolates with resistance to third-generation cephalosporin antibiotics

Escherichia coli (E. coli) is one of the most frequent causes of bloodstream infections and community- and healthcare-associated urinary tract infections worldwide.

The percentage of samples resistant to commonly used antibiotics continues to increase throughout Europe. More than half of the samples reported in 2015 were resistant to at least one antibiotic group under surveillance. The highest resistance percentages were from southern and south-eastern Europe. Of particular concern is resistance to third-generation cephalosporins (shown) which has increased significantly at the EU/EEA level between 2012 and 2015.

Hover over the chart to see the resistance percentages.

Klebsiella pneumoniae

Percentage of invasive isolates with resistance to carbapenem antibiotics

Klebsiella pneumoniae, sometimes called Kleb, is a common cause of urinary tract, respiratory tract and bloodstream infections. It can spread rapidly between patients in healthcare settings and is a frequent cause of hospital outbreaks.

Antibiotic resistance in Kleb is a public health concern of increasing importance in Europe. Combined resistance to multiple antibiotic groups is common. Although carbapenem resistance percentages (shown) remained at low levels for most countries in 2015, resistance to carbapenems at the EU/EEA level has increased significantly over the last four years. The vast majority of the carbapenem-resistant samples had additional resistance to other antibiotic groups. Very few options are left for patients infected with multidrug-resistant Kleb with additional resistance to carbapenems.

Acinetobacter species

Percentage of invasive isolates with combined resistance to fluoroquinolone, aminoglycoside & carbapenem antibiotics

Acinetobacter mainly cause healthcare-associated infections, such as pneumonia and bloodstream infections. Its presence in healthcare settings is problematic as it can persist in the environment and is difficult to eradicate once established.

Resistance in Acinetobacter species shows large variations across Europe, with generally high resistance percentages reported from the Baltic countries and southern and south-eastern Europe. One third of countries (who gave sufficiently large samples) reported combined resistance of 50% or higher. This indicates seriously limited options for patients infected with Acinetobacter species in these countries.

Staphylococcus aureus

Percentage of invasive isolates with resistance to the antibiotic methicillin (MRSA)

Methicillin-resistant Staphylococcus aureus, more commonly known as MRSA, is one of the most frequent causes of antibiotic-resistant infections acquired in healthcare settings worldwide.

In 2015, as in previous years, large inter-country variations in resistance were observed across Europe, with percentages ranging from zero to 57%. Although resistance at the EU/EEA level decreased significantly, MRSA remains a public health priority in Europe as eight out of 30 countries reported MRSA percentages above 25%.

Enterococcus faecium

Percentage of invasive isolates with resistance to the antibiotic vancomycin

Enterococcus faecium can cause a variety of infections, including endocarditis (a heart infection), bloodstream infections, and urinary tract infections. Vancomycin-resistant enterococci (VRE) mainly cause healthcare-associated infections and often result in hospital outbreaks.

For E. faecium, high percentages of vancomycin resistance were reported from countries in eastern and south-eastern Europe. Among almost half of the reporting countries there was a significant increase in vancomycin-resistant Enterococcus faecium between 2012 and 2015. The European Centre for Disease Prevention and Control, who collect the data, have said that the "trends for individual countries may indicate a change in the epidemiology of VRE in Europe" which is particularly concerning.

A call to action

The fight against antibiotic resistance is one in which we can all play a part. By doing so we can help to safeguard these precious drugs for future generations. The World Health Organization recommends following these simple steps to help reduce antibiotic resistance:

  1. Only use antibiotics when prescribed by a certified health professional
  2. Always take the full prescription, even if you feel better
  3. Never use left-over antibiotics
  4. Never share antibiotics with others
  5. Prevent infections by regularly washing your hands, avoiding contact with sick people and keeping your vaccinations up to date

Developed by Dr. Cath Sleeman, quantitative research fellow at Nesta, and produced by Nina Cromeyer Dieke, digital content editor for the Longitude Prize at Nesta. Our thanks go to Dr. Adam P. Roberts at University College London, advisor to the Longitude Prize, for his scientific input and support.

Notes: All data come from the "Summary of the latest data on antibiotic resistance in the European Union" published by the European Centre for Disease Prevention and Control. Regions are based on the United Nations classification system, with the exception of Cyprus which is classified as Western Asia, but is included in the report. The EU/EEA figures are based on a population-weighted mean. Some significant trends in the overall data were not observed when only data from laboratories consistently reporting for all four years were included. In these cases, the changes have not been marked by red/blue lines. For more information on data collection and analysis, please consult the EARS-Net reporting protocol.