The present and the future of antimicrobial resistance surveillance in Catalonia (Spain), 2024: from manual to automatic notification

BACKGROUND: Antimicrobial resistance (AMR) remains a major global public health concern requiring coordinated surveillance and technological innovation. In Catalonia, AMR surveillance is conducted through the Microbiological Reporting System of Catalonia (MRSC) and will be integrated into the Epidemiological Surveillance Information System (SIVEC), enabling automated and real-time monitoring. This study aimed to evaluate the current landscape of AMR surveillance and laboratory capacity across clinical microbiology laboratories (CMLs). METHODS: All CMLs participating in the MRSC were invited to complete a structured survey assessing diagnostic capacity, resistance mechanism (RM) detection, laboratory information systems (LIS), and reporting practices. Surveillance data from invasive isolates (one per patient and episode) collected between 2016 and 2023 were analysed. CMLs were classified by complexity (L1-L3) according to phenotypic, molecular and genomic capabilities. Temporal trends in resistance were assessed using logistic regression models. RESULTS: By 2023, 53 CMLs participated compared with 28 in 2016, reflecting a marked increase in coverage. A total of 87,556 invasive isolates and 694,289 susceptibility tests were reported. Escherichia coli was the most frequently notified microorganism (37,999 isolates), followed by Klebsiella pneumoniae (12,626) and methicillin-susceptible Staphylococcus aureus (10,464). All laboratories followed EUCAST criteria, although only 56.6% had implemented the 2023 version. Most CMLs (92.5%) detected RMs and 73.6% monitored multidrug resistance. Based on complexity, 18.9% were L1, 66.0% L2, and 15.1% L3; most notifications were reported by L2 (57.4%) and L3 laboratories (39.4%). Carbapenem resistance decreased in Pseudomonas aeruginosa (21.7 to 12.9%) and K. pneumoniae (6.3% to 3.2%), whereas E. coli increased (0.07 to 0.52%). Vancomycin resistance increased in Enterococcus faecium (0.27 to 2.30%) and remained low in E. faecalis. Third-generation cephalosporin resistance increased in E. coli (14.4 to 17.8%) and decreased in K. pneumoniae (36.0 to 26.6%), while MRSA declined (33.1 to 20.6%). CONCLUSIONS: AMR surveillance in Catalonia provides robust and representative data across a heterogeneous network. Further efforts are needed to ensure consistent EUCAST implementation and expand RM detection. The implementation of SIVEC will enable integrated, real-time surveillance and support timely, evidence-based public health decision-making.

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Journal
Antimicrobial Resistance and Infection Control
Published
2026-06-30
DOI
https://doi.org/10.1186/s13756-026-01781-0
Primary Topic
Antibiotic Use and Resistance
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article
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article

The present and the future of antimicrobial resistance surveillance in Catalonia (Spain), 2024: from manual to automatic notification

Cristina Pitart, Alba Bellés Bellés, Mariona Xercavins, Marc Bach-Griera et al.
Antimicrobial Resistance and Infection Control
Antibiotic Use and Resistance
article

The present and the future of antimicrobial resistance surveillance in Catalonia (Spain), 2024: from manual to automatic notification

Cristina Pitart, Alba Bellés Bellés, Mariona Xercavins, Marc Bach-Griera, Guillem López de Egea, Yuliya Poliakova, Anna Vilamala, Isabel Pujol, Carles Alonso-Tarrés, Jun Hao Wang-Wang, Virginia Plasencia, Alba Rivera, Aurora Sabrià, Mónica Ballestero-Téllez, Maria Font-Font, Inés Valle T-Figueras, Sandra Esteban-Cucó, Araceli González-Cuevas, Helios Gayà, Frederic Gomez-Bertomeu, Gemma Flores-Mateo, Jacobo Mendioroz, Pilar Ciruela, Esther Clapés, Fina Guimerà, Nieves Larrosa, José Domenico Stavola, Esther Sanfeliu, Natàlia Roca-Bau, Antonio Casabella-Pernas, Luca Basile, Núria Torrellas-Bertran, Manel Monsónis, Glòria Trujillo, Anna Llimós-Fàbregas, Mayuli Armas-Cruz, Karolina Romero-Vanegas, Ester Comellas
article en

Abstract

BACKGROUND: Antimicrobial resistance (AMR) remains a major global public health concern requiring coordinated surveillance and technological innovation. In Catalonia, AMR surveillance is conducted through the Microbiological Reporting System of Catalonia (MRSC) and will be integrated into the Epidemiological Surveillance Information System (SIVEC), enabling automated and real-time monitoring. This study aimed to evaluate the current landscape of AMR surveillance and laboratory capacity across clinical microbiology laboratories (CMLs). METHODS: All CMLs participating in the MRSC were invited to complete a structured survey assessing diagnostic capacity, resistance mechanism (RM) detection, laboratory information systems (LIS), and reporting practices. Surveillance data from invasive isolates (one per patient and episode) collected between 2016 and 2023 were analysed. CMLs were classified by complexity (L1-L3) according to phenotypic, molecular and genomic capabilities. Temporal trends in resistance were assessed using logistic regression models. RESULTS: By 2023, 53 CMLs participated compared with 28 in 2016, reflecting a marked increase in coverage. A total of 87,556 invasive isolates and 694,289 susceptibility tests were reported. Escherichia coli was the most frequently notified microorganism (37,999 isolates), followed by Klebsiella pneumoniae (12,626) and methicillin-susceptible Staphylococcus aureus (10,464). All laboratories followed EUCAST criteria, although only 56.6% had implemented the 2023 version. Most CMLs (92.5%) detected RMs and 73.6% monitored multidrug resistance. Based on complexity, 18.9% were L1, 66.0% L2, and 15.1% L3; most notifications were reported by L2 (57.4%) and L3 laboratories (39.4%). Carbapenem resistance decreased in Pseudomonas aeruginosa (21.7 to 12.9%) and K. pneumoniae (6.3% to 3.2%), whereas E. coli increased (0.07 to 0.52%). Vancomycin resistance increased in Enterococcus faecium (0.27 to 2.30%) and remained low in E. faecalis. Third-generation cephalosporin resistance increased in E. coli (14.4 to 17.8%) and decreased in K. pneumoniae (36.0 to 26.6%), while MRSA declined (33.1 to 20.6%). CONCLUSIONS: AMR surveillance in Catalonia provides robust and representative data across a heterogeneous network. Further efforts are needed to ensure consistent EUCAST implementation and expand RM detection. The implementation of SIVEC will enable integrated, real-time surveillance and support timely, evidence-based public health decision-making.

Antimicrobial Resistance and Infection Control
Universitat Autònoma de Barcelona (ES), Hospital Sant Joan de Déu Barcelona (ES), Generalitat de Catalunya (ES), Instituto de Salud Carlos III (ES), Hospital de Sant Pau (ES), Bellvitge University Hospital (ES), Hospital Universitari Arnau de Vilanova (ES), Servei de Salut de les Illes Balears (ES), Althaia (ES), Clínica Girona (ES), Hospital Terrassa (ES), University Hospital Mútua de Terrassa (ES), Hospital de Viladecans (ES), Institut de Recerca Biomèdica Catalunya Sud (ES), Hospital General de Granollers (ES), Centre for Biomedical Network Research on Rare Diseases (ES), Hospital Clínic de Barcelona (ES), Corporació Sanitària Parc Taulí (ES), Hospital Sant Pau i Santa Tecla (ES), Agència de Salut Pública de Catalunya (ES), Hospital de Sabadell (ES), Vall d'Hebron Hospital Universitari (ES), Parc Sanitari Sant Joan de Déu (ES), Fundació Salut i Envelliment UAB (ES), Catalonian Research and Innovation Centre (ES), Hospital de Mataró (ES), Institute of Research and Innovation Parc Tauli (ES), Puigvert Foundation (ES), Hospital Sant Jaume de Calella (ES), Hospital Universitari de Vic (ES), CS Diagnostics (DE), Hospital Universitari Sant Joan de Reus (ES), Hospital Universitari Joan XXIII de Tarragona (ES), Hospital Universitari Germans Trias i Pujol (ES), Hospital Comarcal de Inca (ES), Consorci Sanitari Garraf (ES), Hospital de Palamós (ES)
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