Table. Annual carbapenem-resistant Acinetobacter species bloodstream infections and carbapenem susceptibility testing results for Acinetobacter species bloodstream infections, in all laboratories that reported data to EARS-Net and in those that continuously reported data, EU/EEA countries, 2017–2021 (n = 31,242 infections).
| Carbapenem susceptibility test result | 2017 | 2018 | 2019 | 2020 | 2021 | Number of cases in 2020–2021 vs 2018–2019 |
Number of cases in 2020 vs average 2017–2019 |
Number of cases in 2021 vs average 2017–2019 |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | % Change | p valuec | % Change | p valuec | % Change | p valuec | |
| All laboratories (annual mean = 826 laboratories)a | ||||||||||||||||
| R | 2,831 | 59.2 | 3,105 | 60.1 | 2,629 | 56.5 | 4,379 | 65.2 | 7,396 | 74.5 | +105.4 | <0.001d | +53.4 | <0.001d | +159.1 | <0.001d |
| S/I | 1,950 | 40.8 | 2,063 | 39.9 | 2,028 | 43.5 | 2,333 | 34.8 | 2,528 | 25.5 | +18.8 | <0.001 | +15.9 | <0.001 | +25.5 | <0.001 |
| All | 4,781 | 100.0 | 5,168 | 100.0 | 4,657 | 100.0 | 6,712 | 100.0 | 9,924 | 100.0 | +69.3 | <0.001 | +37.9 | <0.001 | +103.8 | <0.001 |
| Continuously reporting laboratories (n = 255 laboratories)a,b | ||||||||||||||||
| R | 1,237 | 48.5 | 1,293 | 48.3 | 1,354 | 48.4 | 1,891 | 57.6 | 3,767 | 70.8 | +113.8 | <0.001d | +46.1 | <0.001d | +191.0 | <0.001d |
| R (Group 1 countriese) | 30 | 3.6 | 37 | 4.4 | 17 | 1.9 | 29 | 3.3 | 23 | 2.3 | −3.7 | 0.85 | +3.6 | 0.90 | −17.9 | 0.49 |
| R (Group 2 countriese) | 60 | 35.3 | 38 | 21.5 | 26 | 20.6 | 30 | 22.7 | 104 | 49.8 | +109.4 | <0.001d | −27.4 | 0.18 | +151,6 | <0.001d |
| R (Group 3 countriese) | 1,147 | 74.6 | 1,218 | 73.5 | 1,311 | 72.9 | 1,832 | 80.6 | 3,640 | 88.3 | +116.4 | <0.001d | +49.5 | <0.001d | +197.1 | <0.001d |
| S/I | 1,314 | 51.5 | 1,382 | 51.7 | 1,444 | 51.6 | 1,390 | 42.4 | 1,554 | 29.2 | +4.2 | 0.12 | +0.7 | 0.85 | +12.6 | 0.001 |
| S/I/R | 2,551 | 100.0 | 2,675 | 100.0 | 2,798 | 100.0 | 3,281 | 100.0 | 5,321 | 100.0 | +57.2 | <0.001 | +22.7 | <0.001 | +98.9 | <0.001 |
EARS-Net: European Antimicrobial Resistance Surveillance Network; EEA: European Economic Area; EU: European Union; I: susceptible, increased exposure; R: resistant; S: susceptible, standard dosing regimen.
a Data for France and the United Kingdom were excluded.
b Only includes EU/EEA laboratories that were identifiable as having reported ≥ 1 Acinetobacter spp. isolate with carbapenem susceptibility data every year in 2017–2021.
c Poisson regression model to assess the statistical significance of changes in the numbers of bloodstream infections.
d The chi-squared test comparing the percentage of carbapenem resistance in 2020–2021 vs 2018–2019 also had p < 0.001.
e The reporting countries were grouped according to the mean of their crude, national, annual percentage of Acinetobacter spp. resistance to carbapenems in 2018 and 2019. These were Group 1 (< 10% carbapenem resistance in 2018–2019): Austria, Belgium, Denmark, Estonia, Finland, Germany, Iceland, Ireland, Luxembourg, Malta, the Netherlands, Norway and Sweden; Group 2 (10% to < 50% carbapenem resistance in 2018–2019): Czechia, Portugal, and Slovenia; Group 3 (≥ 50% carbapenem resistance in 2018–2019): Bulgaria, Croatia, Cyprus, Greece, Hungary, Italy, Latvia, Lithuania, Poland, Romania, Slovakia and Spain. Percentages in these rows refer to carbapenem-resistant isolates among all isolates analysed for the countries in a given group. The raw data for the group level are provided in the Supplement.