Background Antimicrobial resistance (AMR) compromises the treatment of patients with serious infections in intensive care units (ICUs), and intensive care physicians are increasingly facing patients with bacterial infections with limited or no adequate therapeutic options. A survey was conducted to assess the intensive care physicians' perception of the AMR situation in the European Union/European Economic Area (EU/EEA). Methods Between May and July 2017, physicians working in European ICUs were invited to complete an online questionnaire hosted by the European Society of Intensive Care Medicine. The survey included 20 questions on hospital and ICU characteristics, frequency of infections with multidrug-resistant (MDR) bacteria and relevance of AMR in the respondent's ICU, management of antimicrobial treatment as well as the use of last-line antibiotics in the six months preceding the survey. For the analysis of regional differences, EU/EEA countries were grouped into the four sub-regions of Eastern, Northern, Southern and Western Europe. Results Overall, 1062 responses from four European sub-regions were analysed. Infections with MDR bacteria in their ICU were rated as a major problem by 257 (24.2%), moderate problem by 360 (33.9%) and minor problem by 391 (36.8%) respondents. Third-generation cephalosporin-resistant Enterobacteriaceae were the most frequently encountered MDR bacteria followed by, in order of decreasing frequency, meticillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa and vancomycin-resistant enterococci. Perception of the relevance of the AMR problem and the frequency of specific MDR bacteria varied by European sub-region. Bacteria resistant to all or almost all available antibiotics were encountered by 132 (12.4%) respondents. Many physicians reported not having access to specific last-line antibiotics. Conclusions The percentage of European ICU physicians perceiving AMR as a substantial problem in their ICU is high with variation by sub-region in line with epidemiological studies. The reports of bacteria resistant to almost all available antibiotics and the limited availability of last-line antibiotics in ICUs in the EU/EEA are of concern.

中文翻译：

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欧洲重症监护医师对抗生素耐药菌感染的经验。

背景技术抗菌素耐药性（AMR）损害了重症监护病房（ICU）中严重感染患者的治疗，而重症监护医生正日益面临细菌感染患者，而治疗选择有限或没有足够的治疗选择。进行了一项调查，以评估重症监护医师对欧盟/欧洲经济区（EU / EEA）中AMR情况的看法。方法在2017年5月至2017年7月之间，邀请了在欧洲重症监护病房（ICU）工作的医生填写由欧洲重症监护医学会主办的在线问卷。问卷调查涉及20个问题，涉及医院和ICU的特征，多药耐药（MDR）细菌的感染频率以及受访者的ICU中AMR的相关性，在调查前的六个月内进行抗菌治疗的管理以及最后一线抗生素的使用。为了分析区域差异，将欧盟/欧洲经济区国家划分为东欧，北部，南部和西欧的四个子区域。结果总体上，分析了来自四个欧洲次区域的1062份响应。在ICU中，有MDR细菌感染的受访者被评为257（24.2％）为主要问题，被360（33.9％）为中度问题，被391（36.8％）为次要问题。第三代头孢菌素耐药性肠杆菌科细菌是最常遇到的MDR细菌，其次是按频率递减的顺序依次为：耐甲氧西林金黄色葡萄球菌，耐碳青霉烯的肠杆菌科，耐碳青霉烯的铜绿假单胞菌和耐万古霉素的肠球菌。对AMR问题的相关性和特定MDR细菌的发生率的看法因欧洲次区域而异。132名（12.4％）受访者遇到了对全部或几乎所有可用抗生素具有抗药性的细菌。许多医生报告说无法获得特定的最后一线抗生素。结论根据流行病学研究，欧洲ICU医师认为AMR是其ICU中的实质性问题的比例很高，并且按次区域不同存在差异。关于对几乎所有可用抗生素具有抗药性的细菌的报道，以及欧盟/欧洲经济区的加护病房中最后一道抗生素的有限使用的报道。许多医生报告说无法获得特定的最后一线抗生素。结论根据流行病学研究，欧洲ICU医师认为AMR是其ICU中的实质性问题的比例很高，并且按次区域不同存在差异。关于对几乎所有可用抗生素具有抗药性的细菌的报道，以及欧盟/欧洲经济区的加护病房中最后一线抗生素的有限供应的报道令人关注。许多医生报告说无法获得特定的最后一线抗生素。结论根据流行病学研究，欧洲ICU医师认为AMR是其ICU中的实质性问题的百分比很高，而且按次区域的不同而有所差异。关于对几乎所有可用抗生素具有抗药性的细菌的报道，以及欧盟/欧洲经济区的加护病房中最后一线抗生素的有限供应的报道令人关注。