[Antimicrobial resistance in Germany. Four years of antimicrobial resistance surveillance (ARS)]

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2012 Nov;55(11-12):1370-6. doi: 10.1007/s00103-012-1559-3.
[Article in German]

Abstract

In 2007, the Robert Koch Institute established the infrastructure for the national Antimicrobial Resistance Surveillance (ARS) system. Laboratories submit data of routine susceptibility testing of clinical samples from hospitals as well as from outpatient care settings in a standardized format to the Robert Koch Institute for central processing. The database for the period 2008-2011 comprises data of about 1.3 million samples from patients in hospital care and almost 800,000 samples from outpatients. Based on SIR interpretations of susceptibility, the trends of methicillin resistance of Staphylococcus aureus (MRSA) and cefotaxime non-susceptibility as an indicator of extended-spectrum beta-lactamases (ESBL) of Escherichia coli and Klebsiella pneumoniae were analyzed for four care settings or categories: hospital care, outpatient care, intensive care units, and isolates from blood cultures. After constant high levels of above 20%, the proportion of MRSA isolates showed a decline for the first time from 2010 to 2011 in hospital care overall, in intensive care units as well as in blood cultures; in outpatient care, MRSA proportions of about 13% were observed. Within the observed period, non-susceptibility to cefotaxime as an indicator of ESBL in E. coli showed an increasing trend in hospital care at a level above 10% in intensive care units, while cefotaxime non-susceptibility in K. pneumoniae was more frequent but without any trend. In outpatient care, the proportions of cefotaxime non-susceptibility increased year by year in both species resulting in nearly a doubling to 6%.

MeSH terms

  • Bacteremia / drug therapy
  • Bacteremia / epidemiology
  • Bacteremia / microbiology
  • Cefotaxime / therapeutic use*
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial*
  • Escherichia coli / drug effects
  • Escherichia coli / enzymology
  • Escherichia coli Infections / drug therapy*
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Germany
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / epidemiology
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae* / drug effects
  • Klebsiella pneumoniae* / enzymology
  • Methicillin-Resistant Staphylococcus aureus*
  • Microbial Sensitivity Tests
  • Sentinel Surveillance*
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • beta-Lactamases / metabolism*

Substances

  • beta-Lactamases
  • Cefotaxime