Progress is being made in Tuscany in the battle against antibiotic-resistant bacteria and particular attention to the effects that climate change and rising temperatures may have, making the situation worse.
The regional health agency has published the seventh edition of the annual report on antimicrobial resistance and antibiotic consumption in Tuscany: this is the first data for 2023 to come out in Italy, an analysis conducted at district and individual hospital level and available online on the agency website.
The resistance of organisms such as Klebsiella pneumoniae and Escherichia coli, often responsible for serious and dangerous infections, has halved its incidence in the last five years and the consumption of antibiotics is lower in the region, lower than the European average and much lower than national.
“Antimicrobial resistance is one of the challenges of the future for public health systems and for people’s health – comments the councilor for the right to health Simone Bezzini, expressing appreciation for the work carried out by Ars –. If steps forward have been made in our region it is also thanks to studies and research like these which are the basis of our choices. In Tuscany we have made antibiotic resistance a real priority on our political agenda, investing in the training of hospital staff and in the prevention and surveillance of healthcare-related infections”.
In 2023, the SMART network on microbiological and antimicrobial resistance surveillance, coordinated by the agency, collected 8,888 blood cultures and 99,429 urine cultures: compared to 2022, positive blood cultures decreased by 6.1 percent, while positive urine cultures increased by 13 .9 percent. In blood cultures, in 35.6 percent of cases a gram positive bacterium (such as staphylococcus or enterococcus) was isolated, in 55.1 percent a gram negative bacterium (such as enterobacteria and pseudomonas) and in 9.3 percent candida. Escherichia coli is the most frequent species (29 percent of cases). The trend of decrease in methicillin-resistant staphylococcus continues. The percentage of Kklebsiella resistant to carbapenem antibiotics is lower than the national average (24.7 percent in 2022, decreasing trend since 2016) with decreasing data from 2017 to 2023 (19.9 percent).
As for the use of antibiotics, the trend over the last five years has been fluctuating. Before the pandemic, there was a decrease in consumption in Tuscany, especially at a territorial level. In 2020 and 2021 the strong decline spread to the hospital sphere. Then in 2022 the consumption of systemic antibiotics began to grow again with 2023 marking a further increase at a territorial level but a decrease in hospitals, which recorded the lowest value since the start of monitoring.
The focus of this year’s report and of the conference organized in recent days to illustrate the results was climate change, with a study that involved an environmental microbiologist, a clinical microbiologist, an infectious disease specialist, a hygienist and a climate expert and health.
The conclusion is that there is a clear link between rising temperatures and the onset of antibiotic resistance. Heat waves, for example, can lead to extreme weather events, such as floods, which promote the spread of waterborne infections due to sewer system overflows or contamination by animals. Furthermore, warming can favor reproductive aspects of pathogens and greater virulence, as well as increasing human susceptibility to infectious diseases.
“This awareness – concluded Councilor Bezzini – must lead us to increase efforts to combat antimicrobial resistance, motivating and training operators, correctly informing the population, further developing infection control techniques and measures. The contribution of research and the scientific community, which I want to thank, is fundamental to achieving this common and collective goal.”
