title: Recent trends in antibiotic resistance in European ICUs.
abstract: OBJECTIVE
  Antimicrobial resistance is an emerging problem in ICUs worldwide. As numbers of published results from national/international surveillance studies rise rapidly, the amount of new information may be overwhelming. Therefore, we reviewed recent trends in antibiotic resistance in ICUs across Europe in the past 18 months.
  
  
  RESULTS
  In this period, infections caused by methicillin-resistant Staphylococcus aureus appeared to stabilize (and even decrease) in some countries, and infection rates due to Gram-positive bacteria resistant to vancomycin, linezolid or daptomycin have remained low. In contrast, we are witnessing a continent-wide emergence of infections caused by multiresistant Gram-negative bacteria, especially Escherichia coli and Klebsiella pneumoniae, with easily exchangeable resistance genes located on plasmids, producing enzymes such as extended spectrum β-lactamases and carbapenamases. In the absence of new antibiotics, prevention of infections, reducing unnecessary antibiotic use, optimizing adherence to universal hygienic and infection control measures, and improving implementation of diagnostic tests are our only tools to combat this threat.
  
  
  CONCLUSIONS
  As the epidemiology of antibiotic resistance in ICUs is rapidly changing toward more frequently occurring epidemics and endemicity of multi and panresistant Gram-negative pathogens, better infection control and improved diagnostics will become even more important than before.
authors: Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands. P.J.Duijn-3@umcutrecht.nl
authors: Pleun J
authors: PJ
authors: van Duijn
authors: Mirjam J D
authors: MJ
authors: Dautzenberg
authors: Evelien A N
authors: EA
authors: Oostdijk
mesh_terms: D024901:Drug Resistance, Multiple, Bacterial; D005060:Europe / Q000453:epidemiology; D014943:Global Health; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units / Q000706:statistics & numerical data* / Q000639:trends; D016635:Universal Precautions; D020713:Vancomycin Resistance