Antimicrobial Resistance (AMR) in Italy over the Past Five Years: A Systematic Review

Abstract

Antimicrobial Resistance (AMR) has become a global threat to public health systems around the world in recent decades. In 2017, Italy was placed among the worst-performing nations in Europe by the European Centre for Disease Prevention and Control, due to worryingly high levels of AMR in Italian hospitals and regions. The aim of this systematic review was to investigate the state of the art of research on AMR in Italy over the last five years. The PubMed database was searched to identify studies presenting original data. Forty-three of the 9721 records identified were included. Overall, AMR rates ranged from 3% (in a group of sheep farmers) to 78% (in a hospital setting). The methods used to identify the microorganisms, to test their susceptibility and the criteria adopted for the breakpoint were deficient in 7, 7 and 11 studies, respectively. The main findings of our review were that most studies (79.1%) considered hospitalised patients only, 4 studies (9.3%) analysed non-hospitalised populations only. In addition, only 7 studies were multicentric and no scientific literature on the subject was produced in 7 Italian regions. In order to have a solid basis on the topic for the interventions of public health professionals and other stakeholders, studies analysing the phenomenon should be conducted in a methodologically standardised manner, should include all areas of the country and should also focus on out-of-hospital and community-based care and work settings.

Antimicrobial Resistance of Listeria monocytogenes Strains Isolated in Food and Food-Processing Environments in Italy

“…Excluding fosfomycin and flumequine, to which most isolates were inherently resistant, the overall prevalence of strains resistant to at least one antibiotic was 98.14% (N = 264). Antimicrobial resistance arises from the overuse and misuse of antimicrobials in humans and animals, as well as from insufficient infection-prevention measures [ 18 ].…”

Attitudes towards Antibiotic Prescription and Antimicrobial Resistance Awareness among Italian Dentists: What Are the Milestones?

“…Therefore, multiple combined strategies are needed to counteract antimicrobial resistance in dental settings, improving awareness and knowledge of AMR, optimizing antibiotics use, and strengthening surveillance [ 17 , 44 ].…”

“…However, systemically delivered antibiotics were also found to be frequent and excessive in a 2018 Italian survey [ 17 ]. Consistently, antibiotic prescription in dentistry has generally increased in recent years [ 18 ], and dentists are still considered to be among the leading prescribers of systemically administered antibiotics [ 18 ].…”

“…Considering that Italy reached the ninth-highest systemic antibiotic prescription rate in Europe in 2017 [ 19 ], this cross-sectional study primarily aims to investigate, through a web-based survey among Italian dentists, the current antibiotic prescribing habits for prophylactic purposes based on dental procedures, and for therapeutic use according to dental diagnoses, in relation to dentists’ working experience, usual setting, and main practice. Moreover, although following antibiotic prescription guidelines is highly recommended [ 19 ] to help counteract AMR in dentistry [ 16 ], up to 66% of antibiotics prescribed by dentists were found to be not clinically indicated [ 17 ]. While Italy has among the highest levels of antimicrobial resistance for several bacterial species [ 20 ], no data are available concerning antibiotic prescribing attitudes towards the AMR phenomenon in Italian dental settings.…”

Prevalence and Antimicrobial Resistance Patterns of Hospital Acquired Infections through the COVID-19 Pandemic: Real-Word Data from a Tertiary Urological Centre

“…The epidemiology of MDRO infections differs by department, hospital, geographic region, and year [8,9]. These bacteria have developed resistance to multiple classes of antibiotics, rendering treatment more challenging and increasing the risk of severe infections and mortality [10]. The overuse and misuse of antibiotics play a substantial role in the emergence of MDRO.…”