Abstract
Antimicrobial resistance (AMR) is one of the biggest issues facing global public health. In 2017, Italy adopted its first National Action Plan on Antimicrobial Resistance 2017–2020, which works through the synergy between national, regional, and local levels. In the framework of a Regional Action Plan on healthcare-associated infections and AMR prevention, the Sicilian Health Authority of the Sicilian Region, Southern Italy, has implemented a surveillance system of antibiotic consumption in hospitals, in the community, and of resistance rates (RRs) in hospital settings. Data on antibiotic consumption and on antibiotic RRs have been collected from 2015 to 2017 from pharmacies and laboratories of participating hospitals and from community, respectively. Data on antibiotic consumption showed that the most consumed antibiotics in hospitals were fluoroquinolones in 2015, penicillin in 2016, and beta-lactams in 2017. From 2015 to 2017, data on Klebsiella pneumoniae showed significant increasing RRs to all antibiotic classes, except to carbapenems. RRs of third-generation cephalosporins and carbapenems Escherichia coli showed significant decreasing trends. RRs of the other microorganisms did not change significantly during the study period. The results from the present study show that in Sicily, the use of antibiotics and RRs for selected microorganisms are at a high level. Immediate strategies are needed to decrease the inappropriate usage of antibiotics and control the spread of AMR.
Highlights
Antimicrobial resistance (AMR) is one of the ten threats identified by the World Health Organization (WHO) in 2019, since it affects modern healthcare and the effective prevention and treatment of an ever-increasing range of infections [1]
Recent estimates of the burden of AMR are very impressive with a total of 671,689 cases of infections with selected antibiotic-resistant bacteria occurring in 2015 in Europe, out of which 63.5% were associated with healthcare
MDR bacteria are usually linked to healthcare-associated infections (HAIs), many resistant microorganisms have been associated with community-acquired infections [5]
Summary
Antimicrobial resistance (AMR) is one of the ten threats identified by the World Health Organization (WHO) in 2019, since it affects modern healthcare and the effective prevention and treatment of an ever-increasing range of infections [1]. Recent estimates of the burden of AMR are very impressive with a total of 671,689 cases of infections with selected antibiotic-resistant bacteria occurring in 2015 in Europe, out of which 63.5% were associated with healthcare. This burden was highest in Italy and Greece than in other European countries [2,3]. The increasing of multidrug-resistant (MDR) microorganisms and of community-acquired and healthcare-associated infections (HAIs) are strictly connected [4]. MDR bacteria are usually linked to HAIs, many resistant microorganisms have been associated with community-acquired infections [5]. A high number of MDR microorganisms have been isolated from common infections
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