Drug-resistant microbes are no longer a distant threat to healthcare systems, but a reality already testing hospitals across Europe. A new report by the European Centre for Disease Prevention and Control (ECDC) on Enterobacterales resistant to carbapenems and/or colistin — two classes of antibiotics used in severe infections — shows that certain resistant strains continue to spread, while new high-risk strains (specifically clones) are also emerging.

The study was based on samples collected in 2019 from 323 hospitals in 36 European countries. In total, researchers analyzed 2,973 strains of Klebsiella pneumoniae and 548 strains of Escherichia coli, along with clinical, epidemiological, and genomic data. In simple terms, scientists did not only record whether a microbe was resistant, but also examined how it spreads, which “family” it comes from, and which resistance genes it carries.

The report’s central message is concerning: Europe is not facing one single “epidemic” of resistant microbes, but multiple separate hotspots, with some countries showing sporadic cases and others where such strains appear more firmly established. This means that responses cannot be broad and vague, but require systematic surveillance, rapid detection, and targeted measures within hospitals.

The worrying situation in Greek hospitals

The report places particular emphasis on Greece, where genomic analysis identified a new branch of Klebsiella pneumoniae ST39 carrying the resistance gene blaKPC-2. This finding is considered significant for public health because the strain shows a troubling resistance profile and, according to researchers, appears to have spread rapidly in recent years, particularly in hospitals across the country.

The report states that 12 out of the 15 Greek hospitals participating in the study had samples belonging to this branch, while subsequent investigations in Greece confirmed that it continues to circulate. ECDC scientists stress that, because of its rapid spread and high resistance levels, close monitoring is required to limit further transmission.

The broader picture in Europe

At the European level, comparison with an earlier 2013–2014 study shows an increasing burden. The combined average incidence of microbes producing carbapenemases — enzymes that make them resistant to critically important antibiotics — rose from 2.5 cases per 100,000 hospitalization days to 6.6 in 2019. The corresponding average frequency per 10,000 hospital admissions increased from 1.3 to 2.5.

What this means for the future

The findings suggest that antimicrobial resistance is not only a matter of developing “new antibiotics,” but also one of organization and preparedness. Hospitals need better surveillance systems, faster genomic analysis, early recognition of potential outbreaks, and stricter measures to prevent spread.

The ECDC emphasizes that repeated genomic investigations have now become a key tool of European surveillance, but faster and more comprehensive systems are still needed, along with stronger national capabilities.

In simple terms, resistant microbes are not “invincible,” but they do require early detection and strict efforts to prevent them from spreading silently. For countries such as Greece, where the report identifies significant findings, the challenge in the coming years will be to make surveillance more immediate, more systematic, and more closely integrated into the daily operation of hospitals.