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SDG 3: Antimicrobial resistance

Abstract

BACKGROUND

Hospital-acquired pneumonia is a common nosocomial infection, frequently caused by multidrug-resistant organisms. However, no systematic surveillance data exist on respiratory bacteria in Switzerland.

AIM

This laboratory-based surveillance study analysed temporal trends in the incidence and antimicrobial resistance (AMR) of nosocomial respiratory bacteria in Swiss hospitals.

METHODS

A retrospective analysis using data from the Swiss Centre for Antibiotic Resistance from 2007 to 2024 focused on meticillin-resistant (MRSA), third-generation cephalosporin-resistant (3GCR) Enterobacterales, carbapenem-resistant Enterobacterales, carbapenem-resistant and carbapenem-resistant spp. Data were compared across the periods 2007–2015 and 2016–2024. Temporal trends in pathogen incidence and AMR were assessed using Poisson regression models.

RESULTS

We included 46,374 respiratory isolates. For respiratory bacteria incidence, difficult to treat Enterobacterales such as spp. increased significantly in the later vs the earlier period, as reflected by a higher adjusted incidence rate ratio (aIRR: 1.14, 95% confidence interval (CI): 1.06–1.23, p < 0.001). Regarding important pathogen-specific AMR, MRSA (aIRR: 0.78, 95% CI: 0.66–0.91, p = 0.002) and 3GCR Enterobacterales (aIRR: 0.81, 95% CI: 0.75–0.87, p < 0.001) incidence decreased in the later period. In contrast, carbapenem resistance in Enterobacterales (aIRR: 3.27, 95% CI: 2.43–4.46, p < 0.001), (aIRR: 2.68, 95% CI: 2.33–3.10, p < 0.001) and spp. (aIRR: 1.82, 95% CI: 1.15–2.95, p = 0.01) was higher in the later period.

CONCLUSIONS

While MRSA and 3GCR Enterobacterales incidence declined, carbapenem-resistant Gram-negative bacteria incidence increased, underscoring the need for strengthened surveillance.

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2026-04-30
2026-05-10
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References

  1. Candel FJ, Salavert M, Estella A, Ferrer M, Ferrer R, Gamazo JJ, et al. Ten Issues to Update in Nosocomial or Hospital-Acquired Pneumonia: An Expert Review. J Clin Med. 2023;12(20):6526.  https://doi.org/10.3390/jcm12206526  PMID: 37892664 
  2. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014;370(13):1198-208.  https://doi.org/10.1056/NEJMoa1306801  PMID: 24670166 
  3. Eder M, Sommerstein R. Swissnoso Annual Report HAI 2022. Epidemiology of healthcare-associated infections in Switzerland 2022. Bern: Swissnoso; 2023. Available from: https://www.swissnoso.ch/guidelines-publikationen/jaehrliche-epidemiologische-berichte-1
  4. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals 2022-2023. Stockholm: ECDC; 2024. Available from: https://www.ecdc.europa.eu/en/publications-data/point-prevalence-survey-healthcare-associated-infections-and-antimicrobial-use-european-acute-care-hospitals-2022-2023
  5. Giuliano KK, Baker D, Quinn B. The epidemiology of nonventilator hospital-acquired pneumonia in the United States. Am J Infect Control. 2018;46(3):322-7.  https://doi.org/10.1016/j.ajic.2017.09.005  PMID: 29050905 
  6. Zaragoza R, Vidal-Cortés P, Aguilar G, Borges M, Diaz E, Ferrer R, et al. Update of the treatment of nosocomial pneumonia in the ICU. Crit Care. 2020;24(1):383.  https://doi.org/10.1186/s13054-020-03091-2  PMID: 32600375 
  7. Micek ST, Chew B, Hampton N, Kollef MH. A Case-Control Study Assessing the Impact of Nonventilated Hospital-Acquired Pneumonia on Patient Outcomes. Chest. 2016;150(5):1008-14.  https://doi.org/10.1016/j.chest.2016.04.009  PMID: 27102181 
  8. Munro SC, Baker D, Giuliano KK, Sullivan SC, Haber J, Jones BE, et al. Nonventilator hospital-acquired pneumonia: A call to action. Infect Control Hosp Epidemiol. 2021;42(8):991-6.  https://doi.org/10.1017/ice.2021.239  PMID: 34103108 
  9. Depuydt PO, Vandijck DM, Bekaert MA, Decruyenaere JM, Blot SI, Vogelaers DP, et al. Determinants and impact of multidrug antibiotic resistance in pathogens causing ventilator-associated-pneumonia. Crit Care. 2008;12(6):R142.  https://doi.org/10.1186/cc7119  PMID: 19014695 
  10. Gouda AM, Sileem AE, Elnahas HM, Tawfik AE, Eid RA, Shati AA, et al. Exploring Ventilator-Associated Pneumonia: Microbial Clues and Biomarker Insights from a Retrospective Study. Medicina (Kaunas). 2024;60(8):1346.  https://doi.org/10.3390/medicina60081346  PMID: 39202627 
  11. Cabrera-Tejada GG, Chico-Sánchez P, Gras-Valentí P, Jaime-Sánchez FA, Galiana-Ivars M, Balboa-Esteve S, et al. Estimation of Additional Costs in Patients with Ventilator-Associated Pneumonia. Antibiotics (Basel). 2023;13(1):2.  https://doi.org/10.3390/antibiotics13010002  PMID: 38275312 
  12. Kaier K, Heister T, Götting T, Wolkewitz M, Mutters NT. Measuring the in-hospital costs of Pseudomonas aeruginosa pneumonia: methodology and results from a German teaching hospital. BMC Infect Dis. 2019;19(1):1028.  https://doi.org/10.1186/s12879-019-4660-5  PMID: 31795953 
  13. Bassetti M, Mularoni A, Giacobbe DR, Castaldo N, Vena A. New Antibiotics for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia. Semin Respir Crit Care Med. 2022;43(2):280-94.  https://doi.org/10.1055/s-0041-1740605  PMID: 35088403 
  14. Modi AR, Kovacs CS. Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention. Cleve Clin J Med. 2020;87(10):633-9.  https://doi.org/10.3949/ccjm.87a.19117  PMID: 33004324 
  15. Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61-111.  https://doi.org/10.1093/cid/ciw353  PMID: 27418577 
  16. Luyt CE, Hékimian G, Koulenti D, Chastre J. Microbial cause of ICU-acquired pneumonia: hospital-acquired pneumonia versus ventilator-associated pneumonia. Curr Opin Crit Care. 2018;24(5):332-8.  https://doi.org/10.1097/MCC.0000000000000526  PMID: 30036192 
  17. Barnsteiner S, Baty F, Albrich WC, Babouee Flury B, Gasser M, Plüss-Suard C, et al. Antimicrobial resistance and antibiotic consumption in intensive care units, Switzerland, 2009 to 2018. Euro Surveill. 2021;26(46):2001537.  https://doi.org/10.2807/1560-7917.ES.2021.26.46.2001537  PMID: 34794535 
  18. Gasser M, Cassini A, Lo Fo Wong D, Gelormini M, Nahrgang SA, Zingg W, et al. Associated deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in Switzerland, 2010 to 2019. Euro Surveill. 2023;28(20):2200532.  https://doi.org/10.2807/1560-7917.ES.2023.28.20.2200532  PMID: 37199988 
  19. Ramette A, Gasser M, Nordmann P, Zbinden R, Schrenzel J, Perisa D, et al. Temporal and regional incidence of carbapenemase-producing Enterobacterales, Switzerland, 2013 to 2018. Euro Surveill. 2021;26(15):1900760.  https://doi.org/10.2807/1560-7917.ES.2021.26.15.1900760  PMID: 33860749 
  20. Mitchell BG, Russo PL, Cheng AC, Stewardson AJ, Rosebrock H, Curtis SJ, et al. Strategies to reduce non-ventilator-associated hospital-acquired pneumonia: A systematic review. Infect Dis Health. 2019;24(4):229-39.  https://doi.org/10.1016/j.idh.2019.06.002  PMID: 31279704 
  21. Sommerstein R, Atkinson A, Lo Priore EF, Kronenberg A, Marschall J, Burnens A, et al. Characterizing non-linear effects of hospitalisation duration on antimicrobial resistance in respiratory isolates: an analysis of a prospective nationwide surveillance system. Clin Microbiol Infect. 2018;24(1):45-52.  https://doi.org/10.1016/j.cmi.2017.05.018  PMID: 28559001 
  22. Vuichard-Gysin D, Senn L, Tschudin-Sutter S, Kuster S, Buetti N, Eder M, et al. Prävention und Kontrolle von multiresistenten Erregern (MRE) im Nicht-Ausbruch-Setting [Prevention and control of multidrug-resistant organisms (MDRO) in the non-outbreak setting]. Bern: Swissnoso; 2021. German. Available from: https://www.swissnoso.ch/fileadmin/swissnoso/Dokumente/5_Forschung_und_Entwicklung/8_Swissnoso_Publikationen/211115_StAR_Teil_II_DE_MDRO-non-outbreak_FINAL.pdf
  23. Clinical and Laboratory Standards Institute (CLSI). Global Laboratory Standards for a Healthier World.Malvern: CLSI. [Accessed: 18 Nov 2024]. Available from: https://clsi.org
  24. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Antimicrobial susceptibility testing. Växjö: EUCAST. [Accessed: 18 Nov 2024]. Available from: https://www.eucast.org/ast_of_bacteria
  25. Bundesamt für Gesundheit (BAG). Kennzahlen der Schweizer Spitäler. [Key figures for Swiss hospitals]. Bern: BAG. [Accessed: 16 Dec 2025]. German. Available from: https://www.bag.admin.ch/de/kennzahlen-der-schweizer-spitaeler
  26. R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2020. Available from: http://www.Rproject.org/
  27. Federal Office of Public Health (FOPH) and Federal Food Safety and Veterinary Office. (FSVO). Swiss Antibiotic Resistance Report 2022. Usage of Antibiotics and Occurrence of Antibiotic Resistance in Switzerland. Bern: FOPH and FSVO; 2022. Available from: https://www.anresis.ch/de/publication-category/sarr-de/
  28. Kronenberg A, Hilty M, Endimiani A, Muhlemann K. Temporal trends of extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates in in- and outpatients in Switzerland, 2004 to 2011. Euro Surveill. 2013;18(21):20484.  https://doi.org/10.2807/ese.18.21.20484-en  PMID: 23725981 
  29. Renggli L, Burri A, Ehrhard S, Gasser M, Kronenberg A, Swiss Centre for Antibiotic Resistance. Incidence and resistance rates of Pseudomonas aeruginosa bloodstream infections in Switzerland: a nationwide surveillance study (2010-2022). Infection. 2025;53(4):1373-81.  https://doi.org/10.1007/s15010-024-02452-1  PMID: 39883261 
  30. Federal Office of Public Health and Federal Food Safety and Veterinary Office. Swiss Antibiotic Resistance Report 2024. Usage of antibiotics and occurrence of antibiotic resistance in Switzerland. Bern: FOPH and FSVO; 2024. Available from: https://www.anresis.ch/de/publication-category/sarr-de/
  31. Pickens CI, Wunderink RG. Methicillin-Resistant Staphylococcus aureus Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia. Semin Respir Crit Care Med. 2022;43(2):304-9.  https://doi.org/10.1055/s-0041-1740583  PMID: 35170002 
  32. European Centre for Disease Prevention and Control (ECDC). Antimicrobial resistance in the EU/EEA (EARS-Net) - Annual Epidemiological Report for 2024. Stockholm: ECDC; 2025. Available from: https://www.ecdc.europa.eu/en/publications-data/antimicrobial-resistance-eueea-ears-net-annual-epidemiological-report-2024
  33. Raman G, Avendano EE, Chan J, Merchant S, Puzniak L. Risk factors for hospitalized patients with resistant or multidrug-resistant Pseudomonas aeruginosa infections: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2018;7(1):79.  https://doi.org/10.1186/s13756-018-0370-9  PMID: 29997889 
Surveillance of temporal trends and antimicrobial resistance in nosocomial respiratory pathogens, Switzerland, 2007 to 2024
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Christian+Bischof&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bischof Christian</a>, <a href="/search?value1=Andreas+Kronenberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kronenberg Andreas</a>, <a href="/search?value1=Rami+Sommerstein&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sommerstein Rami</a>, <a href="/search?value1=on+behalf+of+the+Swiss+Centre+for+Antibiotic+Resistance+%28ANRESIS%29&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the Swiss Centre for Antibiotic Resistance (ANRESIS)</a></span>. Surveillance of temporal trends and antimicrobial resistance in nosocomial respiratory pathogens, Switzerland, 2007 to 2024. <a href="/content/ecdc">Euro Surveill.</a> 2026;31(17):pii=2500683. <a href="https://doi.org/10.2807/1560-7917.ES.2026.31.17.2500683" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2026.31.17.2500683</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 01 Sept 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 30 Dec 2025 </span> </p>
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