Objectives: In  2017 the WHO published a global priority list of 12  antibiotic-resistant bacteria (ARB) in urgent need of new antibiotics.  We aimed to identify and assess publicly accessible mandatory  surveillance systems and outbreaks reporting for these pathogens in the  28 European Union and four European Free Trade Association member  states.

Methods: Compulsory reporting was mapped  by reviewing national documents without applying language restrictions  and through expert consultation. Information on surveillance targets,  indicators, metrics and dissemination modalities was extracted and a  qualitative assessment was performed for open access systems only.

Results: Twenty-one  countries (66%) had a mandate to survey at least one among the 12 WHO  priority pathogens; 15 provided access to surveillance frameworks. These  systems covered most frequently carbapenem-resistant Enterobacteriales  (12; 38%), methicillin-resistant Staphylococcus aureus (12; 38%), and  vancomycin-resistant enterococci (8; 25%). None of the European  countries required reporting of resistance in Salmonella, Campylobacter,  Helicobacter pylori and Neisseria gonorrhoeae. High heterogeneity was  observed in data collection, reporting and dissemination among countries  with clinical outcomes and risk factors being reported in less than  half (22% and 25%). Only six countries (19%) implemented mandatory  surveillance of outbreaks due to at least one WHO priority pathogen.

Conclusions: Our  review shows that despite the increasing burden of ARB on the European  population, very few countries implemented mandatory surveillance and  outbreak reporting of the WHO priority pathogens. International efforts  are needed to define the effectiveness of implementing mandatory  reporting of these pathogens and to assess their role in reducing the  spread of ARB in health-care and community settings.

Keywords: Antimicrobial resistance; Europe; Mandatory; Public health; Reporting; Surveillance.