Trends in antimicrobial resistance among Escherichia coli in Europe reported via the European Antimicrobial Resistance Surveillance System (EARSS)

Abstract number: 1134_04_119

Tiemersma E., Bruinsma N., Monen J.C.M., Degener J.E., Grundmann H.


The prevalence of fluoroquinolone resistant Escherichia coli has been increasing in Europe in recent years. This trend might have led to the use of newer antimicrobial drugs and thus, increasing resistance to e.g. third generation cephalosporins and possibly, multiple drug resistance. We explored trends of antimicrobial resistance among invasive E. coli isolates reported through the European Antimicrobial Resistance Surveillance System (EARSS), focusing on resistance to third generation cephalosporins and on multiple drug resistance.


Participating laboratories carry out routine antimicrobial susceptibility testing for invasive E. coli isolates. Data are collected at national level and forwarded to the EARSS database. Between 2001 and 2003, 502 laboratories from 25 countries reported susceptibility results for 58,061 E. coli isolates. Test results were available for aminopenicillins (92% of the isolates), 3rd generation cephalosporins (95%), fluoroquinolones (91%) and aminoglycosides (97%). Multiple drug resistance was defined as resistance to at least 3 drugs. Trends in resistance were calculated using the Cochran Armitage test (two-sided p < 0.05).


From 2001 to 2003, 7 countries (Austria, Bulgaria, Spain, Finland, Croatia, the Netherlands and Portugal) witnessed a significant increase in resistance to third generation cephalosporins, whereas resistance decreased in Czech Republic and Slovakia. Eighty-one per cent of the isolates was tested for all 4 antibiotics included in the EARSS protocol, of which 50% were susceptible to all antibiotics. Multiple drug resistance occurred in 4% of these isolates and increased in most countries. Statistically significant increases were reported from Bulgaria, Finland, Hungary, the Netherlands and Sweden. Fluoroquinolone resistance continued to increase in 15 countries and reached statistical significance in 7 (Austria, Bulgaria, Czech Republic, Germany, Spain, Hungary and Sweden). No country showed a significant decrease in resistance proportion.


E. coli is rapidly becoming a ‘difficult-to-treat’ organism in many countries. Next to common resistance to aminopenicillins, resistance rates to fluoroquinolones and to third generation cephalosporins are increasing. Furthermore, co-resistance to several drugs apparently becomes more common in many European countries, including countries with low resistance rates.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Location: Oxford, UK
Presentation type:
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