Table 1 Basic characteristics and general resistance findings of the final 17 scientific papers (in alphabetical order)

Auer et al 2010 [30]

Hospital (2%) and primary health care (98%) - results reported together

Salzburg, Upper Austria, Styria (Austria)

2004-2008

100

ESBL-producing E. coli

FOF, MEL, ETP, NIT, SXT, GEN, CIP

3% FOF, 6% NIT, 15% MEL, 0% ETP, 22% GEN, 73% SXT, 78% CIP^a

Badura et al 2007 [37]

Hospital and primary health care- results reported together

Southeast Austria

1997-2006

690,967 collectively

E. coli, S. aureus, Klebsiella spp.

Various for each bacteria

The data show insignificant changes in prevalence of MRSA and vancomycin-resistant enterococci in southeast Austria during the past decade (1997-2006) but an alarming increase of ESBL-producing E. coli isolates in recent years.

Buxbaum et al 2003 [32]

Hospital and primary health care- results reported together

Austria

2001-2002

542

S. pneumoniae,

PEN, TEL, ERY, CLR,

2.2% PEN, 0% TEL, 8.5% ERY, 10.3% CLR, 7% AZM

223

S. pyogenes,

same

0% PEN, 0% TEL, 8% ERY, 6.7% CLR, 8.1% AZM

183

S. aureus,

same

73.2% PEN, 2.2 TEL, 17% ERY, 16.4% CLR, 16.4% AZM

67

H. influenzae

AMP instead of PEN

1.5% AMP, 0% TEL, ERY, CLR, AZM

Canton et al 2002 [21]

Primary health care

25 countries worldwide incl. Austria

1999-2000

25

S.pyogenes,

ERY, LVX, PEN, TEL

No special results for Austria. But compared to the other countries Austria had one of the lowest resistance rates.

20

S.aureus

TEL

0% TEL

Cizman 2003 [22]

Primary health care

21 countries in Europe incl. Austria

1997-1999

1997-2000

n/a

H. influenzae,

PEN

The antibiotic resistance rates were set in correlation with the mean national outpatient consumption. Compared to the other countries Austria had a low total outpatient consumption of 13.80 DDD/1000 inhabitants/day in 1997 and a penicillin resistance rate of S. pneumoniae of 12.4%. With the consumption of macrolides Austria was ranked in the middle field with a resistance rate for S. pneumoniae of 11.4%.

S. pneumoniae,

PEN, ERY

S. pyogenes

ERY

Felmingham et al 2002 [23]

Primary health care

25 countries worldwide incl. Austria

1999-2000

57

S. pneumoniae

PEN, ERY

5.3% PEN, 12.3% ERY

Compared to the other countries Austria had one of the lowest resistance rates.

Graninger 2003 [24]

Primary health care

16 European countries incl. Austria and Canada

1999-2000

n/a

E. coli

n/a

The publication highlights the effectiveness of MEL compared to other antibiotics

Hoban et al 2002 [25]

Primary health care

25 countries worldwide incl. Austria

1999-2000

40

19

H.influenzae

M. catarrhalis

n/a

2.5% ß-lactamase +

89.5% ß-lactamase +

Hönigl et al 2010 [33]

Hospital (63%) and primary health care (37%)- results reported together

Southeast Austria

1997-2008

1997: (n = 113) 2008: (n = 218)

S. pneumoniae

PEN, ERY, CLI, TET, SXT, quinolones

1997: 3.5% ERY, 1.8% CLI, 1.8% TET, 7.1% SXT, 0.9% QUIN

2008: 14.7% ERY, 10.6% CLI, 11% TET, 9.2% SXT, 0.5% quinolones

Kahlmeter 2003 [26]

Primary health care

17 countries in Europe incl. Austria

1999-2000

126

E. coli

AMP, AMC, MEC,

CFR, TMP, SUL, SXT, NAL, CIP, NIT, FOF, GEN

Compared to the other 16 European countries Austria had one of the lowest resistance rates for E. coli: 17.5% AMP, 2.4% AMC, 1.6% MEC, 0.8% CFR, 9.5% TMP, 25.4% SUL, 9.5% SXT, 2.4% NAL, 0% CIP, 0.8% NIT, 0% FOF, 0.8% GEN

Kahlmeter et al 2003 [29]

Primary health care

17 countries in Europe including Austria

1999-2000

126

E. coli

AMP, AMC, MEC,

CFR, TMP, SUL, SXT, NAL, CIP, NIT, FOF, GEN

17.5% AMP, 2.4% AMC, 1.6 MEC, 0.8% CFR, 9.5% TMP, 25.4 SUL, 9.5% SXT, 2.4% NAL, 0% CIP, 0.8% NIT, 0% FOF, 0.8 GEN

Krziwanek et al 2008 [35]

Hospital and primary health care- results reported together

Austria

1996-2006

1,439

MRSA

n/a

In Carinthia, 73% of all MRSA belonged to ST228. In the Austrian region "Salzkammergut", the proportion of ST5 increased from 26% in 2004 to 89% in 2006. In eastern Upper Austria and western Lower Austria, the ST8 Austrian clone was predominant.

Krziwanek et al 2009 [36]

Hospital and primary health care- results reported together

Upper Austria

2006-2008

1,098

MRSA

n/a

Out of the 1,098 MRSA samples from humans, 21 were MRSA type ST398 that is usually associated with animals. Most of these 21 patients were farmers (n = 16). Increasing prevalence from 1.3% in 2006 to 2.5% in 2008 shows emergence of MRSA ST398 in humans in Austria.

Prelog et al 2008 [31]

Hospital and primary health care- results reported together

Western Austria

2006

2,042

E. coli

n/a

20 out of the 2,042 E. coli isolates demonstrated alleles encoding CTX-M enzymes belonging to phylogentic group 1.

Schito et al 2000 [27]

Primary health care

14 countries in Europe incl. Austria

1992-1998

185

S. pneumoniae

PEN, ERY

4.8% PEN, 11.4%

153

H. influenzae

DOX, SXT, CIP

1.3% DOX, 13.7% SXT, 0.0% CIP

n/a

M. catarrhalis

n/a

Schito et al 2002 [34]

Hospital and primary health care- results reported together

Italy, Spain, Austria

1999-2000

3,593 collectively in all three countries

S. pneumoniae,

M. catherrralis,

H. influenzae

K. pneumoniae

S. pyogenes,

S. aureus

AMP, AMC, CEC, CXM, CFM, CTB, CPD, AZM, CLR

for all bacteria

The results show a substantial prevalence of macrolide resistance of the bacteria analysed in Italy, Spain and Austria.

Schito et al 2009 [28]

Primary health care

9 European countries including Austria and in addition Brazil

2003-2006

3,018 collectively in all nine countries

E. coli, K. pneumoniae, P. mirabilis, S. saphrophyticus

AMP, AMC, MEC, CFX, NAL, CIP, SXT, NIT, FOF

Mean resistance rates for E.coli between 2003 and 2006 for Austria were e.g.: 48.3% AMP 8.1% NAL and 29.0% SXT. Compared to the other countries Austria with 48.3% resistance against AMP had one of the highest resistance rates; against the other antibiotics one of the lowest rates.