Table 71.
Country | Ns | Phenotype | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ESBLb | ESBL only CTX/CLA SYNc | ESBL only CAZ/CLA SYNd | AmpCe | AmpC + ESBLf | CPsg | ||||||||
%P | 95% CI | %P | 95% CI | %P | 95% CI | %P | 95% CI | %P | 95% CI | %P | 95% CI | ||
Austria | 306 | 28.4 | (23.4, 33.8) | 7.2 | (4.6, 10.7) | 0.0 | (0.0, 1.2) | 29.4 | (24.4, 34.9) | 5.5 | (3.3, 8.7) | 0.0 | (0.0, 1.2) |
Belgium | 261 | 86.8 | (57.1, 90.8) | 23.2 | (12.5, 29) | 5.8 | (2.1, 7.4) | 13.7 | (6.6, 14.3) | 3.7 | (1.1, 5.4) | 0.0 | (0.0, 1.4) |
Bulgaria | 442 | 49.9 | (15.5, 55) | 34.5 | (10.1, 39) | 0.0 | (0.0, 0.8) | 35.7 | (10.5, 40.4) | 12.5 | (3.0, 15.9) | 0.0 | (0.0, 0.83) |
Croatia | 1,658 | 21.0 | (6.0, 23) | 5.8 | (1.4, 7.0) | 2.3 | (0.4, 3.1) | 33.6 | (10.0, 35.9) | 1.7 | (0.3, 2.4) | 0.0 | (0.0, < 0.01) |
Cyprus | 151 | 65.6 | (16.1, 73) | 27.0 | (5.2, 35) | 3.8 | (0.2, 4.7) | 52.1 | (12.1, 60.5) | 28.9 | (5.7, 37.1) | 0.0 | (0.0, 2.4) |
Czech Republic | 307 | 16.3 | (12.3, 20.9) | 6.5 | (4.0, 9.9) | 3.6 | (1.8, 6.3) | 40.1 | (34.5, 45.8) | 0.3 | (0.0, 1.8) | 0.0 | (0.0, 1.2) |
Denmark | 298 | 6.4 | (3.9, 9.8) | 1.0 | (0.2, 2.9) | 0.0 | (0.0, 1.2) | 9.7 | (6.6, 13.7) | 0.3 | (0.0, 1.9) | 0.0 | (0.0, 1.2) |
Estonia | 73 | 20.6 | (12.0, 31.6) | 5.5 | (1.5, 13.4) | 0.0 | (0.0, 4.9) | 15.1 | (7.8, 25.4) | 0.0 | (0.0, 4.9) | 0.0 | (0.0, 4.9) |
Finland | 306 | 3.6 | (1.8, 6.3) | 0.0 | (0.0, 1.2) | 0.0 | (0.0, 1.2) | 11.1 | (7.8, 15.2) | 0.3 | (0.0, 1.8) | 0.0 | (0.0, 1.2) |
France | 300 | 34.3 | (28.7, 39.7) | 14.8 | (10.9, 19.2) | 0.4 | (0.0, 1.8) | 12.4 | (8.8, 16.6) | 2.7 | (1.2, 5.2) | 0.0 | (0.0, 1.2) |
Germany | 344 | 35.8 | (30.7, 41.1) | 7.2 | (4.8, 10.5) | 0.6 | (0.1, 2.1) | 19.5 | (15.4, 24.1) | 2.9 | (1.4, 5.3) | 0.0 | (0.0, 1.1) |
Greece | 388 | 52.3 | (25.1, 57.3) | 29.5 | (13.2, 34.2) | 0.0 | (0.0, 0.9) | 30.5 | (14.1, 35.3) | 5.9 | (1.8, 5.7) | 0.0 | (0.0, 0.95) |
Hungary | 300 | 19.3 | (15.0, 24.3) | 5.0 | (2.8, 8.1) | 0.7 | (0.1, 2.4) | 59.0 | (53.2, 64.6) | 2 | (0.7, 4.3) | 0.0 | (0.0, 0.01) |
Ireland | 300 | 68.0 | (62.4, 73.2) | 44.4 | (38.6, 50.2) | 3.0 | (1.4, 5.6) | 18.7 | (14.4, 23.5) | 0.0 | (0.0, 1.2) | 0.0 | (0.0, 0.01) |
Italy | 409 | 80.7 | (76.5, 84.4) | 27.2 | (22.9, 31.7) | 3.9 | (2.3, 6.3) | 16.9 | (13.4, 20.9) | 3.2 | (1.7, 5.4) | 0.0 | (0.0, 0.9) |
Latvia | 100 | 90.0 | (82.4, 95.1) | 1.0 | (0.0, 5.4) | 0.0 | (0.0, 3.6) | 1.0 | (0.0, 5.4) | 0.0 | (0.0, 3.6) | 0.0 | (0.0, 3.6) |
Lithuania | 150 | 30.0 | (22.8, 38.0) | 12.7 | (7.8, 19.1) | 0.0 | (0.0, 2.4) | 67.3 | (59.2, 74.8) | 4.0 | (1.5, 8.5) | 0.0 | (0.0, 2.4) |
Luxembourg | 19 | 52.6 | (1.3, 76) | 26.3 | (0.1, 52.2) | 0.0 | (0.0, 17.6) | 0.0 | (0.0, 17.6) | 0.0 | (0.0, 17.6) | 0.0 | (0.0, 17.6) |
Netherlands | 300 | 40.7 | (35.1, 46.5) | 12.0 | (8.5, 16.2) | 0.4 | (0.0, 1.8) | 12.0 | (8.5, 16.2) | 2.7 | (1.2, 5.2) | 0.0 | (0.0, 1.2) |
Poland | 299 | 34.5 | (29.1, 40.1) | 9.4 | (6.3, 13.2) | 0.4 | (0.0, 1.8) | 33.1 | (27.8, 38.8) | 10.7 | (7.4, 14.8) | 0.0 | (0.0, 1.2) |
Portugal | 161 | 39.1 | (31.5, 47.1) | 3.7 | (1.4, 7.9) | 0.0 | (0.0, 2.3) | 9.9 | (5.8, 15.6) | 2.5 | (0.7, 6.2) | 0.0 | (0.0, 2.3) |
Romania | 840 | 31.2 | (28.1, 34.4) | 15.1 | (12.8, 17.7) | 1.4 | (0.7, 2.5) | 34.5 | (31.3, 37.8) | 0.9 | (0.4, 1.9) | 0.0 | (0.0, 0.44) |
Slovakia | 429 | 47.1 | (10.8, 51.9) | 7.8 | (1.1, 10.6) | 2.4 | (0.1, 4.2) | 36.1 | (8.0, 40.9) | 1.6 | (0.1, 1.7) | 0.0 | (0.0, 0.9) |
Slovenia | 149 | 31.5 | (24.2, 39.7) | 4.0 | (1.5, 8.6) | 6.7 | (3.3, 12) | 61.8 | (53.4, 69.6) | 0.0 | (0.0, 2.4) | 0.0 | (0.0, 2.4) |
Spain | 300 | 79.3 | (74.3, 83.8) | 24.6 | (19.9, 29.9) | 1.7 | (0.5, 3.8) | 16.3 | (12.3, 21) | 3.0 | (1.4, 5.6) | 0.0 | (0.0, 1.2) |
Sweden | 301 | 30.9 | (25.7, 36.5) | 20.9 | (16.5, 26.0) | 0.0 | (0.0, 1.2) | 13.0 | (9.4, 17.3) | 0.6 | (0.1, 2.4) | 0.0 | (0.0, 1.2) |
United Kingdom | 382 | 19.1 | (15.3, 23.4) | 10.2 | (7.4, 13.7) | 0.0 | (0.0, 1.0) | 10.5 | (7.6, 14.0) | 0.5 | (0.1, 1.9) | 0.0 | (0.0, 1.2) |
Total (27 MSs) | 9,273 | 35.4 | (34.4, 36.4) | 13.1 | (12.4, 13.8) | 1.3 | (1.1, 1.6) | 24.4 | (23.6, 25.3) | 2.6 | (2.2, 2.9) | 0.0 | (0.0, < 0.001) |
Iceland | 160 | 1.3 | (0.2, 4.4) | 0.6 | (0.0, 3.4) | 0.0 | (0.0, 2.3) | 1.9 | (0.4, 5.4) | 0.0 | (0.0, 2.3) | 0.0 | (0.0, 2.3) |
Norway | 188 | 0.5 | (0.0, 2.9) | 0.5 | (0.0, 2.9) | 0.0 | (0.0, 1.9) | 10.6 | (6.6, 16) | 0.5 | (0.0, 2.9) | 0.0 | (0.0, 1.9) |
Switzerland | 307 | 23.9 | (19.1, 28.9) | 11.2 | (7.8, 15.1) | 2.6 | (1.1, 5.1) | 25.9 | (20.9, 31) | 0.7 | (0.1, 2.3) | 0.0 | (0.0, 1.2) |
ESBL: extended‐spectrum β‐lactamase; SYN: synergy; CTX: cefotaxime; CAZ: ceftazidime; CLA: clavulanate. MSs: Member States; CPs: carbapenemase producers.
According to EUCAST Guidelines (EUCAST, 2013), only isolates showing an MIC > 1 mg/L for cefotaxime and/or ceftazidime (screening breakpoint) were considered (see Materials and Methods, Chapter 2).
All isolates showing clavulanate synergy with CTX or CAZ or synergy with both compounds, suggesting the presence of an ESBL (independently of the presence of other mechanisms).
Isolates showing synergy with cefotaxime only, suggesting the presence of an ESBL with cefotaximase activity.
Isolates showing synergy with ceftazidime only, suggesting the presence of an ESBL with ceftazidimase activity.
Isolates with microbiological resistance to cefoxitin, suggesting the presence of an AmpC enzyme (independently of the presence of other mechanisms).
Isolates showing synergy with CTX or CAZ and with microbiological resistance to cefoxitin, suggesting the presence of ESBL and AmpC enzymes in the same isolate. These isolates are also included in the ESBL and AmpC columns.
Isolates with microbiological meropenem resistance.