European Antimicrobial Resistance Surveillance System (EARSS)

  Published: 14.06.05 Updated: 16.06.2005 11:20:39

Nienke Bruinsma
EARSS management team
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

EARSS is the largest publicly funded surveillance system for antimicrobial resistance worldwide. It is able to provide official, validated and comparable data on the antimicrobial resistance of five major indicator bacteria. The surveillance network does not by itself prevent or control antimicrobial resistance, but provides the transparency and trend analysis that are needed to raise public awareness to a problem that could reverse some of the major accomplishments in modern medicine. EARSS is funded by the Directorate General for Health and Consumer Protection (DG SANCO) of the European Commission and the Dutch Ministry of Health, Welfare and Sports.

During the past six years (19992004), EARSS has collected antimicrobial susceptibility test results of invasive isolates of five bacterial species that serve as indicators for the development of antimicrobial resistance in Europe: Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, and Enterococcus faecium. From 2005, Klebsiella pneumoniae and Pseudomonas auruginosa will also be included.

The number of laboratories and countries participating in EARSS has been growing steadily. At the end of 2003, the EARSS database contained information on 178,040 isolates from 791 laboratories serving 1300 hospitals in 28 countries. EARSS results showed that

  1. The proportion of Streptococcus pneumoniae penicillin non-susceptibility tends to be decreasing, whereas erythromycin resistance is increasing, in line with previously described trends (1),
  2. MRSA proportions are still increasing in many countries, whereas proportions are still decreasing in Slovenia (2),
  3. Resistance among Escherichia coli to fluoroquinolones as well as to third generation cephalosporins is increasing.

The 2003 EARSS annual report provides more information on the current dimension and trends of antimicrobial resistance in Europe.

One of the newly launched initiatives is the EARSS internet-based information system (ibis). EARSS-ibis is a professional internet-based communication tool. With EARSS-ibis rapid communication between laboratories on the isolation of bacterial pathogens with unexpected antimicrobial resistance, virulence or transmissibility becomes possible. This improves the early recognition of these agents by all network participants. Sharing the experience and diagnostic detail with other laboratories will increase awareness and diagnostic accuracy. In addition, this communication will be of immediate benefit to the treatment of patients and strengthen the ability of the entire network to assess the risk imposed by potentially harmful bacterial pathogens to populations. Laboratories entitled to participate will have access to the EARSS-ibis report system and to their national and European database. This system is intended to provide relevant, accurate and, above all, timely information.

For more information about EARSS, including annual reports and a description of EARSS-ibis, please go to


  1. Bruinsma N, Kristinsson KG, Bronzwaer S et al. Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe. J Antimicrob Chemother  2004; 54: 1045-50.
  2. Tiemersma EW, Bronzwaer SL, Lyytikainen O et al. Methicillin-resistant Staphylococcus aureus in Europe, 1999-2002. Emerg Infect Dis 2004; 10: 1627-34.