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Briefing on 4th Meeting of Antimicrobial
Resistance National Focal Points
Ljubljana (Slovenia), 13 March 2008
Dominique L. Monnet
Senior Expert, Antimicrobial Resistance
& Healthcare-Associated-Infections
Scientific Advice Unit, ECDC
Antimicrobial Resistance:
What Does It Represent?
• Several inter-related compartments of healthcare
(food animals, food, general population and patients in the
community, hospitals, nursing homes and long-term care
facilities)
• Many types of infection (bloodstream, respiratory tract,
skin and soft tissue, urinary tract, surgical site, related to
medical devices, etc.)
• Many bacteria/microorganisms
• Many antimicrobials and mechanisms of resistance
• A “topic” rather than a disease
Burden of HCAI and Multidrug-Resistant
(MDR) Bacteria in the European Union
• Approximately 3 million HCAI and 50,000 deaths
attributable these infections each year in EU-25
Source: ECDC Annual Epidemiological Report 2006.
• 1/4 to 1/2 of these deaths (EU-25) are due to the most
common MDR bacteria, i.e. MRSA, VRE, 3GC-R E.
coli/Klebsiella sp./Enterobacter sp., MDR P. aeruginosa,
carbapenem-R Acinetobacter sp., in the 4 main types of
HCAI: BSI, pneumonia, SSTI, UTI)
D.L. Monnet, unpublished based on EARSS and other published studies
• These are conservative estimates, i.e. underestimates!
Antimicrobial Resistance in
Europe and the ECDC
• ECDC opened in May 2005
• Antimicrobial resistance (AMR) and healthcareassociated infections is one of the seven priority
topics/disease area for action
• Basis: Council Recommendation of 15 November 2001
on the prudent use of antimicrobial agents in human
medicine (2002/77/EC)
• One AMR National Focal Point designated by each
Member States and EEA/EFTA country
• Four meetings of AMR National Focal Points since 2006
• Eight country visits to discuss AMR issues based on the
Council Recommendation
4th Meet. of AMR National Focal Points,
Ljubljana, 13 March 2008
• 23 Member States + 1 EEA/EFTA country represented
• European Commission: DG SANCO, DG RTD
• Discussions on visuals, slogan and key messages for
the European Antibiotic Day (toolkit for MS)
• Review of the progress of Member States on two key
elements of Council Recommendation (2002/77/EC):
 ”Intersectoral Coordination Mechanism”, i.e. national,
multidisciplinary coordination group
 National strategy and corresponding action plan
• Plans for European Antibiotic Day
”Intersectoral Coordination
Mechanism” (ICM)
• National, multidisciplinary coordination group to plan
and coordination prevention and control of antimicrobial
resistance
• 19 (63%) have an ICM in place
 Large variation in the level of implementation and the range of
activities
 Several countries, only implemented since the past 2-3 years
• 7 countries do not have an ICM
 2 had one ICM, but activity has stopped
 2 are preparing their ICM
• 4 countries did not report
National AMR Strategy and
Action Plan
• Strategy for the prevention and control of AMR and a
corresponding multi-year action plan (activities, timeline)
• 8 (27%) have a written national strategy and/or an action
plan
• 18 countries do not have a written national strategy or
action plan
 3 countries are preparing a second action plan
 1 country (only available for one region, plans to expand)
 5 countries are preparing their first strategy/action plan
• 4 countries did not report