Antibiotic resistance remains a major threat to public health around the world, and for the large part, the cause is misuse of antibiotics, says the European Centre for Disease Prevention and Control (ECDC).

The ECDC put out the message in a statement released on Sunday to coincide with the fifth European Antibiotic Awareness Day.

Antibiotic resistance is a major health concern because it increases healthcare costs, causes people to stay in hospital for longer, results in treatment failures, and sometimes death.

An estimated 25,000 people die each year in the EU from antibiotic-resistant bacterial infections, Professor Peter Hawkey, a clinical microbiologist and chair of the UK government’s antibiotic-resistance working group, told the press earlier this year.

The ECDC, whose task is to identify, assess and communicate threats to human health from infectious diseases, has also released new data from across the member states about antibiotic resistance and consumption.

The new ECDC data shows a significant rise over the last four years of combined resistance to multiple antibiotics in Klebsiella pneumoniae and E. coli, in more than one-third of the EU and European Economic Area (EEA) countries. (The EEA is all the EU countries plus Iceland, Liechtenstein and Norway).

In several of the member states, between 25 and over 60% of K pneumoniae from bloodstream infections show combined resistance to multiple antibiotics.

K pneumoniae is a Gram-negative bacterium, that normally lives harmlessly in the gut, but is increasingly showing up as a harmful “superbug” causing urinary, respiratory tract and bloodstream infections, particularly in hospital settings where it spreads rapidly among patients via the hands of healthcare workers and is a frequent cause of hospital outbreaks.

E coli also occurs naturally in the human gut, but certain strains can lead to infections. It is the leading cause of community- and hospital-acquired urinary tract infections, and also one of the most common food-borne pathogens worldwide.

Any person can become infected with these superbugs, but those with weakened immune systems are the most vulnerable.

Once people acquire these infections, few treatment options remain: there are only a handful of last-line antibiotics capable of tackling these superbugs.

The ECDC data shows that consumption of carbapenems, a major class of last-line antibiotics, went up significantly in EU/EEA countries between 2007 and 2010.

The report suggests this is most likely due to increasing multidrug resistance in Gram-negative infections, such as pneumonia or bloodstream infections, which are often treated with carbapenems.

This is a worrying trend because the proportion of carbapenem-resistant K pneumoniae is already high and increasing in some countries in the EU, says ECDC Director Marc Sprenger.

However speaking at a press event organised by ECDC and the European Commission in Brussels, Sprenger says:

“There are, in contrast, some good news: in the past few years, meticillin-resistant Staphylococcus aureus (MRSA), has shown either a decrease or a stabilisation in most EU countries.”

However, he urges all to “remain vigilant” because “the percentage of Staphylococcus aureus resistant to meticillin remains above 25% in more than one fourth of the reporting countries, mainly in Southern and Eastern Europe”.

Robert-Jan Smits, Director-General for Research & Innovation at the European Commission says the worrying rise in antibiotic resistance shown in the ECDC figures calls for a “dedicated research effort”.

“We therefore have invested this year more money than ever into research on antimicrobial resistance, to keep our ability to fight deadly infections,” he adds.

Sprenger notes that a multi-faceted approach is already under way in the Action Plan (pdf) that was launched in the EU last year.

“We must continue working on those actions together,” urges Sprenger, “Furthermore, it is crucial to join forces around the world and mark global solidarity against this threat,” he adds.

This year the World Health Organization in Europe is supporting the plan, and a range of activities will be going on this week also in the United States, Canada and Australia, to coincide with European Antibiotic Awareness Day.

In the UK, the Health Protection Agency has issued a leaflet (resource no longer available at to raise awareness of inappropriate use of antibiotics and how to use them responsibly.

The leaflet urges patients visiting their doctor with cold and flu symptoms not to ask for antibiotics for their treatment, and reminds them that colds and most coughs, sinusitis, earache and sore throats often get better without antibiotics.

Written by Catharine Paddock PhD