Antimicrobial resistance in urology – joint session cautions “prudence”

The worrying problem of urinary infection came under the spotlight at the well-attended opening day joint session on antimicrobial resistance given by the European Association of Urology and the European Centre for Disease Control (ECDC). The ECDC was established by the European Union institution in Stockholm in 2005, with the mission to “to identify, assess and communicate current and emerging threats to human health posed by infectious diseases”.

Infection is a subject which is high on the EAU agenda, and so this cooperation with the ECDC istimely.

The session was chaired by Dr. Dominique Monnet for the ECDC, and Prof. Truls Erik Bjerklund Johansen forthe EAU. Outlining the scale of the problem, Professor Johansen said: “This joint session was necessary to highlight allaspects of increasing resistance in hospital acquired urinary tract infections.The rate of hospital acquired infections in urology departments is high. Every week 500 patients die of hospital acquired infections in Europe. Patients whoare carriers of resistant bacteria like ESBL producers are causing increasing concerns in our everyday hospital practice”.

Dr. Anna-Pelagia Magiorakos from the ECDC opened the session with an overview of just how high the stakes are: failure of standard antibiotics, inappropriate antibiotic choice, no new antibiotics in the pipeline for Gram-negative bacteria. Carl Suetens summarised the ECDC “snapshot” review of hospital infection rates, with of course particular emphasis on urology infections. The ECDC surveyed antibiotic use and resistance across around 1000 European hospitals. Within urology they foundthat 5.5% of patients had a healthcare associated infection (slightly lowerthan the 6% average). As against that, urology patients were receivingantibiotics at 1.7 times the general average. Florian Wagenlehner pointed out that the Global Prevalence of Infection in Urology survey figures were higher(9.4% of patients with an HAI), but this may reflect different methodology and the global reach of the GPIU.

“In the end”, as Dominique Monnet said “we are running out of time. Antimicrobial resistance is an increasing problem in hospitals, and there are no new antimicrobials in development. The message is,we need to be more prudent with antimicrobial use.”