Clinical
Antibiotic resistant infections up 9pc since 2017
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The growth in antibiotic resistant infections continues to grow. There are now 165 such infections every day, according to the latest figures from Public Health England.
In total there were an estimated 60,788 antibiotic resistant severe infections in 2018-19, according to the English Surveillance Programme for Antimicrobial Utilisation and Resistance. This is a rise of 9 per cent from 2017.
For the seven priority bacterial pathogens covered by the programme, the rate of bloodstream infection (BSI) in 2018 was 145 per 100,000 of the population, a 22 per cent increase from 2014. The proportion of these pathogens that were resistant to key antibiotics rose for Escherichia coli and Klebsiella pneumonia, reduced for Staphylococcus aureus and remained stable for the remainder.
In 2018 E coli was the commonest cause of BSI in England (76 cases per 100,000 population), and children under 1 and adults over 65 years were most at risk. Antibiotic resistance was more frequently detected when infection took place in hospitals, rather than in the community.
Last year more than 1.5 million microbiologically positive urine samples were reported to PHE, almost 60 per cent being E. coli. Nitrofurantoin, despite increased use, was not associated with changes in the proportion of resistance detected.
The number of bacteria detected carrying carbapenemases has increased from 72 to 4,028 over the last 10 years. Carbapenemase-producing enterobacterales (CPE) are bacteria that are likely to be resistant to most antibiotics, and include normally benign Gram-negative bacilli, such as E. coli and Enterobacter. The 30 day all-cause fatality rate for invasive CPE infections is 24 per cent.
Antibiotic consumption peaked in 2014. From 2014 to 2018 it has reduced by 9 per cent and now stands at 18.2 defined daily doses per 1,000 inhabitants per day. The number of antibiotic prescriptions dispensed in the community has dropped by 16.7 per cent over the same period to 624 per 1,000 inhabitants per year.
- The Keep Antibiotics Working campaign was relaunched on November 5 to alert the public to the risks of antibiotic resistance. The messaging for the campaign aims to move patients to a better understanding that taking antibiotics when you don’t need them means they are less likely to work for you in the future. A newly released pharmacy campaign pack is available from the PHE resource centre.