Care Infections & Antibiotic Resistance in Belgium

This activity report provides an overview of the most recent evolutions in healthcare associated infections and antimicrobial resistance in Belgium.&nbsp;The positive downward trend we have been observing for many years in the incidence of Methicillin Resistant Staphylococcus aureus (MRSA) in&nbsp;acute care hospitals appears to be stabilizing in 2016. The hand hygiene campaigns held biannually since 2005, which reduce -among many other&nbsp;initiatives- the spread of these bacteria through direct contact, contribute to this evolution. Also in intensive care units hand hygiene compliance&nbsp;increased significantly and the incidence of pneumonia following intubation has reduced remarkably. Other resistant bacteria, mainly present as a reservoir in the digestive tract (gut), are however on the rise and can cause severe bloodstream&nbsp;infections. In particular, Carbapenemase-Producing Enterobacteriaceae (CPE) and Vancomycin-Resistant Enterococci (VRE) are increasingly being&nbsp;isolated and have caused outbreaks in several hospitals. The number of Clostridium difficile infections (severe enteritis and colitis) also slightly&nbsp;increased since 2014, although its associated mortality decreased. In long-term care facilities (among others nursing homes), similar evolutions&nbsp;are taking place (decrease in MRSA, increase in multi-resistant gut bacteria). Long term monitoring shows a recent slight decrease in antimicrobial&nbsp;consumption in the ambulant sector but alas not in the hospitals. Antimicrobial use should urgently be further optimized in our healthcare facilities&nbsp;in order to control the selection pressure for antimicrobial resistance. Since 2014 and in collaboration with the inspection services of the competent authorities, assistance is being offered to hospitals and long-term&nbsp;care facilities that suffer from difficult to treat bacteria in the form of an outbreak support team (MDRO – OST; Multi-Drug Resistant Organisms -&nbsp;Outbreak Support Team). In the period 2014-2016, 13 out of 15 reported outbreaks where assistance was granted, containment was achieved within&nbsp;a reasonable time&nbsp;frame.</p