The levels of antibiotic resistance have remained stable in Finland and Europe 

The levels of antibiotic resistance, i.e. antibiotic resistant bacteria, have remained relatively stable both in Finland and in Europe, but the situation still varies greatly between different countries. Nonetheless, fewer findings were made in 2020. In Finland the situation is still good. The data can be found in recent surveillance reports. 

Yet the increase in bacteria resistant to many different antibiotics in Europe, which has been going on for years, is worrying. Resistance to carbapenems is high especially in Pseudomonas aeruginosa and the genus Acinetobacter, but also for Klebsiella pneumoniae. 

In Finland, the carbapenem resistance of these bacteria has been low in recent years, but outbreaks caused by them in health care facilities are detected annually. Bacteria resistant to carbapenem are problematic, for example, for intensive care patients. They can cause serious infections that are very difficult to treat.

The growth in the proportion of VRE bacteria, or vancomycin-resistant enterococci, which had continued for years, decelerated in Europe in 2020. Last year  the range of VRE prevalence in different European countries ranged from zero to 56.6%. In Finland, the growth of VRE bacteria decelerated already in 2019. VRE causes infections in patients with particularly weakened immune systems. 

In 2020, growth in the share of extended-spectrum beta-lactamase (ESBL) producing Eschericia coli bacteria decelerated in bacteria isolated from both blood and urine samples in Finland. Instead, the proportion of ESBL producing K. pneumoniae bacteria has again increased slightly. E. coli and K. pneumoniae cause, among other things, urinary tract infections and their ESBL production reduces their treatment options.

The coronavirus pandemic has influenced the monitoring of antibiotic resistance

The coronavirus pandemic also has manifold effects on the monitoring of antibiotic resistance. Recommendations and restrictions brought on by the pandemic have reduced social contacts, and simultaneously severe bacterial infections spread through airborne transmission have also been reduced. In addition, patients have been seeking hospital treatment in different ways than normally, as non-urgent treatments have been postponed and fewer screenings may have been performed.  Laboratory capacity may also have been allocated to coronavirus testing.

In 2020, the reported testing rates for different bacterial strains decreased. At European level, a clear decrease in testing rates was observed especially for the Escherichia coli and Streptococcus pneumoniae bacteria. In Finland, the sharpest decline in test rates was for ampicillin resistant strains of Haemophilus infuenzae in infants. The amount of these tests decreased by more than 80% compared to the previous year. 

The decrease in tourism may also have had an impact on the resistance situation. For example, the majority of Campylobacter infections in Finland come from abroad. In 2020, testing rates for ciprofloxacin in Campylobacter jejuni decreased by 54% and a clear decrease in the resistance to ciprofloxacin was observed. In 2020, it accounted for 41%, compared with 70% in 2019. 

"However, antibiotic resistance remains a serious problem and a major threat to public health both in Europe and globally. Many infections can be prevented by i.a. good hand hygiene and vaccinations. At the same time, the potential need for antibiotic therapy and thus antibiotic resistance will be reduced,” says Kati Räisänen, Senior Researcher at the National Institute for Health and Welfare. 

Antibiotic or antimicrobial resistance refers to the ability of a bacterium to defeat the antibiotic that has been earlier used for treating an infection caused by the said bacterium. Resistance weakens the efficacy of antibiotics, which may make it more difficult to treat even ordinary infections and makes treatments longer and more expensive.

European Antibiotic Awareness Day is on 18 November.

Further information

Finres 2020 report
(Finnish Institute for Health and Welfare)

Surveillance of antimicrobial resistance in Europe, 2020 data  Executive summary 
(ECDC)

Surveillance Atlas of Infectious Diseases
(ECDC)

Antibiotic resistance 
(Finnish Institute for Health and Welfare)

Surveillance of antimicrobial resistance 
(Finnish Institute for Health and Welfare)

Kati Räisänen
Senior Researcher
Finnish Institute for Health and Welfare
Tel. +358 29 524 7094
[email protected]