AMR Surveillance in the Hospital Sector (EARS-Net) |
|---|
2025 |
Introduction
Antimicrobial Resistance Surveillance
Antimicrobial resistance (AMR) surveillance is essential for monitoring and evaluating emerging resistance patterns and trends. It provides the evidence base needed to guide public health action, infection prevention and control measures, antimicrobial stewardship initiatives, and policy development. Timely data collection, validation, analysis, feedback, and reporting are therefore critical components of an effective surveillance system. Through AMR surveillance, we can describe the burden and epidemiology of resistant pathogens, monitor resistance trends over time, detect the emergence and spread of novel resistance mechanisms, inform national and international policy decisions, and assess the impact of interventions aimed at reducing antimicrobial resistance.
Surveillance data provide a basis for taking action to control AMR and the importance of data is highlighted in the European One Health Action Plan against Antimicrobial Resistance. * Surveillance of AMR is listed as a special health issue in the Regulation (EU) 2022/2371 of the European Parliament and of the Council of 23 November 2022 on serious cross-border threats to health.*
In addition, surveillance data is used by WHO to prepare a list of ‘priority pathogens’ that have developed resistance to key antibiotics used to treat the infections they cause and for which new antibiotics are urgently required. The main international AMR surveillance system in the EU/EAA countries is the European Antimicrobial Resistance Surveillance Network (EARS-Net). Many of the pathogens (drug-bug combinations) that are under EARS-Net surveillance are listed among the “high” or “critical” group by WHO.
Figure 1: WHO Bacterial Priority Pathogens List, 2024*
EARS-Net Background
The European Antimicrobial Resistance Surveillance System (EARSS), established in 1998, was the predecessor of EARS-Net. EARSS was initially funded by the European Commission’s Directorate General for Health and Consumer Affairs and the Dutch Ministry of Health, Welfare and Sports. The network steadily grew and involved an increasing number of European countries. On 1 January 2010, the administration and coordination of EARSS was transferred to the European Centre for Disease Prevention and Control (ECDC). The network was renamed the ‘European Antimicrobial Resistance Surveillance Network (EARS-Net)’. EARS-Net is the largest publicly funded system for antimicrobial resistance (AMR) surveillance in Europe.
The objectives of EARS-Net are to:
- collect comparable, representative and accurate AMR data;
- analyse temporal and spatial trends of AMR in Europe;
- provide timely AMR data for policy decisions;
- encourage the implementation, maintenance and improvement of national AMR surveillance programmes; and
- support national systems in their efforts to improve diagnostic accuracy by offering annual external quality assessments (EQA).
More information on EARS-Net can be found on ECDC’s website.
Methodology
EARS-Net collects antimicrobial resistance data on the first invasive isolate (from blood or cerebrospinal fluid) for each of the eight EARS-Net pathogens listed below, per patient, per year:
- Escherichia coli
- Staphylococcus aureus
- Klebsiella pneumoniae
- Enterococcus faecium
- Streptococcus pneumoniae
- Enterococcus faecalis
- Pseudomonas aeruginosa
- Acinetobacter species
Routinely-generated qualitative (RIS) and quantitative (MIC) data from laboratories on key antibiotics for eight pathogens under surveillance data is sent to HPSC. In addition, HPSC collects data on 3 non-EARS-Net pathogens. These are invasive isolates of Group A Streptococcus, Group B Streptococcus and Candida species.
Nationally, data are stored in WHONET format, a free WHO software package that provides a versatile platform for the collection, storage and analysis of AMR data, and in an Access database at HPSC. Data analysis and reporting are conducted using R and RStudio, a programming language and integrated development environment for statistical computing, data analysis, and graphics. Following data collection and analysis, each participating laboratory and hospital receives an individual feedback report. National surveillance data are published annually on the HPSC website.
HPSC submits Irish data annually to EpiPulse Cases. ECDC analyses the data submitted by EU/EEA countries and publishes its Annual Epidemiological Report each November in advance of European Antibiotic Awareness Day. In addition, EARS-Net laboratories are required to participate in the annual EARS-Net External Quality Assessment (EQA) exercise.
Even though the data is submitted to ECDC by HPSC, there may be small differences in how antimicrobial resistance data are interpreted by HPSC and ECDC. For example, ECDC may use a single predefined indicator agent to determine resistance to a particular antimicrobial class, whereas HPSC may use results from other agents within the same class when the preferred indicator is unavailable. As a result, small differences may occur in the reported proportions of resistant isolates between HPSC and ECDC analyses.
National Results
Key Points
Participation by laboratories and population coverage
EARS-Net 2025 data were reported by 28 laboratories, representing approximately 76% of the Irish population, a decrease from 82% in the previous year. There has been a substantial decline in EARS-Net data reporting over the last two years. Population coverage ranged from 96% to 100% between 2021 and 2023, compared with 82% in 2024 and 76% in 2025.
Five laboratories, including two tertiary (HSE Model 4) hospitals, did not submit data for 2025. The primary reason reported for non-submission was staffing shortages.
In 2025, there were three hospitals that were still using CLSI guidelines instead of EUCAST guidelines. Data from CLSI laboratories were no longer collected in 2025; therefore, data from these laboratories were not analysed as per ECDC mandate below.
Use of recommended EUCAST guidelines
As of 2022, ECDC mandated that all laboratories submitting data to EARS-Net use EUCAST breakpoints and methods for antimicrobial susceptibility testing. Of the three Irish laboratories were still reporting using CLSI guidelines, one of these laboratories reported that it is in the process of transitioning to EUCAST guidelines; while, the other two laboratories did not make any changes to their reporting practices. Consequently, there are slight differences between the data presented in this national report and the data submitted by Ireland to EARS-Net at ECDC for historical years.
Overall numbers of cases reported
Data were received on 5,741 invasive isolates for the eight EARS-Net pathogens, which is lower than in 2024 when 6,136 isolates were reported (32 laboratories; 82% coverage). However, when comparing the data for the 28 labs reporting in both years, there was a 4% increase in the numbers (2024, n=5,519).
When comparing the data for the 28 labs , there was an increase in the number of isolates reported for six of the eight pathogens, with the biggest increase seen for Acinetobacter species (+32.1%) followed by Enterococcus faecalis (+14.1%), Staphylococcus aureus (+11.8%), Pseudomonas aeruginosa (+9.2%), Streptococcus pneumoniae (+3.1%) and Escherichia coli (+1.2%). Two pathogens saw decreasing numbers and these were Enterococcus faecium (-2.8%) and Klebsiella pneumoniae (-0.7%).
Of the three additional pathogens (not part of ECDC’s EARS-Net surveillance), there was an increase in the numbers of Candida species (+7.9%) compared with a decrease for Group A streptococci (-20.8%). The number of Group B streptococci reported was unchanged in the last two years.
Key resistance findings
In 2025, the proportion of S. aureus that was meticillin-resistant (%MRSA) decreased to 10.0% (2024, 10.7%). However, the MRSA incidence rate increased slightly to 0.032 cases per 1,000 patient days (2024, 0.031). The primary reason for the decrease in MRSA proportion was due to the increase in MSSA numbers. The incidence rates of MSSA increased sharply to 0.284 cases per 1,000 patient days (2024, 0.255) and overall S. aureus BSI incidence increased to 0.316 cases per 1,000 patient days (2024, 0.286).
The proportion of vancomycin-resistant E. faecium (%VREfm) increased slightly to 23.1% in 2025 (2024, 21.8%). The VREfm incidence rate slightly increased to 0.031 cases per 1,000 patient days (2024, 0.030). The VSEfm and total E. faecium incidence rates decreased over the same period. The incidence rate for VSEfm and E. faecium was 0.106 and 0.136 in 2024 respectively and decreased to 0.103 and 0.135 in 2025.
Carbapenem resistance remains at low levels among E. coli (0.2%) and K. pneumoniae (1.1%). There has been slight increases in carbapenem resistance among P. aeruginosa at 6.3% (2024, 4.9%) and Acinetobacter spp. at 1.4% (2024, 0%). The EU/EEA population-weighted mean carbapenem resistance in 2024 for these pathogens were 0.3%, 11.3%, 15.9% and 31.6%, respectively. Carbapenem-resistant K. pneumoniae and Acinetobacter spp. remain major threats to public health in Europe, with WHO listing both as pathogens of critical priority in its global bacterial priority pathogen list 2024.
Among the Candida spp. reported, there were no Candida auris isolates, which are typically resistant to fluconazole.
Table 1: Number of Laboratories Participating Over the Latest 5-Year Period and Population Coverage | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Number of Laboratories | 37 | 36 | 36 | 36 | 36 |
Number of Participating Laboratories | 37 | 35 | 34 | 32 | 28 |
Population Coverage (%) | 100 | 97 | 96 | 82 | 76 |
EU/EEA Targets on Antimicrobial Resistance
In 2023, following a proposal from the European Commission, the Council of the European Union set targets to reduce the total EU incidence of the following AMR organisms from bloodstream infections across the EU/EEA by 2030 compared with the baseline year of 2019*:
Meticillin-resistant S. aureus (MRSA) by 15%
3rd-generation cephalosporin-resistant E. coli by 10%
Carbapenem-resistant K. pneumoniae by 5%
For Ireland, the target reductions were set at 6%, 10% and 2%, respectively.
* The ‘Council recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health Approach’ (2023/C220/01) includes 2030 EU targets, with 2019 as the baseline year.
Table 2: Estimated incidencea of isolates from bloodstream infections with resistance phenotype (n per 100 000 population) | ||||||||
|---|---|---|---|---|---|---|---|---|
Bacterial species | Antimicrobial group/agent | 2019 (Baseline) | 2021 | 2022 | 2023 | 2024 | 2025 | Trend 2021–2025b |
E. coli | Third-generation cephalosporin (cefotaxime/ceftriaxone/ceftazidime) resistance | 8.28 | 6.01 | 6.18 | 6.70 | 7.54 | 8.88 | ↑ |
K. pneumoniae | Carbapenem (imipenem/meropenem) resistance | 0.11 | 0.06 | 0.06 | 0.04 | 0.02 | 0.02 | - |
S. aureus | MRSAc | 3.06 | 2.68 | 2.61 | 2.47 | 2.57 | 2.73 | - |
a Incidence was estimated using the EARS-Net data reported to EpiPulse Cases. Each de-duplicate isolate from a blood sample (>99% data) or cerebrospinal fluid sample (<1% data) was considered a proxy for a bloodstream infection. Population data obtained from Eurostat were used as the denominator for incidence calculations. | ||||||||
b ↑ and ↓ indicate statistically significant (negative binomial regression) increasing and decreasing trends, respectively; ̶ indicates no statistically significant trend. | ||||||||
c MRSA is based on AST results for cefoxitin or, if unavailable, oxacillin. AST results reported for cloxacillin, dicloxacillin, flucloxacillin or meticillin are accepted as a marker for oxacillin resistance if oxacillin is not reported. If no phenotypic results are available, data from molecular confirmation tests (detection of mecA gene PCR or a positive PBP2A-agglutination test), are accepted as a marker for MRSA. | ||||||||
The 2025 data shows that Ireland has already met two (MRSA and carbapenem resistant K. pneumoniae) of the three targets on AMR as set by the European Commission. However, third-generation cephalosporin resistance in E. coli has been steadily increasing over the last 5 years and the rate increased to 8.88 per 100,000 population in 2025, which is higher than the baseline value in 2019.
Even though Ireland met the target for MRSA rate every year since 2020, there has been a sharp increase in the MRSA rate in 2025. The rate increased from 2.57 per 100,000 population to 2.73 per 100,000 population. Meanwhile carbapenem resistant K. pneumoniae rate stayed the same.
General Epidemiology
Breakdown by Pathogen
Nationally, E. coli was responsible for almost half of the bloodstream infections among EARS-Net pathogens in 2025 (47%), followed by S. aureus (20%), E. faecium (8%) and K. pneumoniae (8%). E. faecalis and P. aeruginosa accounted for approximately 5% of the total isolates while Acinetobacter spp. accounted for just over 1% of the infections.
Among EARS-Net pathogens, there was an increase in the number of cases reported in 2025 for Acinetobacter spp., S. pneumoniae, E. coli, E. faecalis, S. aureus and P. aeruginosa. In contrast, K. pneumoniae and E.faecium infections decreased in 2025 compared to the previous year.
Demographics
Gender and Age Distribution
More bloodstream infections occurred in male patients than female patients. The only exception was E. coli infections, where just over 50% of the infections occurred in females. Regarding age groups, the burden was always the highest among the older population (>65 years old) for all pathogens.
HAI Status
Healthcare-Associated Infection (HAI) was defined as an infection where the specimen date was more than two days after the admission date (i.e., more than 48 hours after admission). Community-Acquired Infection (CAI) was defined as an infection where the specimen date was less than or equal to two days before the admission date (i.e., within 48 hours of admission). Unfortunately, the admission date was missing for many patients (40%), preventing their categorization as either CAI or HAI.
When isolates with missing admission dates are excluded, CAIs were most common in S. pneumoniae, E. coli, and S. aureus infections. In contrast, E. faecium, E. facealis and P. aeruginosa infections had the highest proportions of HAIs.
Table 3: HAI Status of Cases In the Latest Year by Organism in Ireland | ||||||||
|---|---|---|---|---|---|---|---|---|
ac- | eco | efa | efm | kpn | pae | sau | spn | |
CAI | 59.0% | 81.1% | 63.0% | 35.2% | 66.7% | 63.8% | 71.9% | 96.2% |
HAI | 41.0% | 18.9% | 37.0% | 64.8% | 33.3% | 36.2% | 28.1% | 3.8% |
Location Within Hospital
Just over 73% of the patients had their department information completed. The majority of specimens were taken when the patients were in the emergency wards (57%), followed by medical wards (15%). ICU, hematology/oncology, surgical and other ward types were accounted for appproximately 5% of the wards each. The breakdown of departments by pathogens can be found in the figure below.
Resistance Data by Individual Pathogen
1. Escherichia coli
In 2025, a total of 2,703 Escherichia coli isolates were reported, representing a 10.0% decrease from 3,004 isolates in 2024. The primary reason for the decrease was due to the low population coverage in 2025. However, when data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, there was a 1.2% increase in the number of isolates reported.
Despite the lower number of isolates, several key resistance indicators increased. Resistance to third-generation cephalosporins continued to increase in 2025. Overall 3GC resistance reached 13.6%, up from 11.7% in 2024 and was the highest level reported during the five-year period. Similarly, resistance to cefotaxime/ceftriaxone increased to 12.6% and resistance to ceftazidime increased to 11.0%, both also reaching their highest recorded levels. Consistent with these findings, the proportion of ESBL-producing isolates increased to 11.0%, continuing the upward trend observed in recent years.
Resistance to ciprofloxacin remained relatively stable at 15.6%, while gentamicin resistance was unchanged at 8.3% compared with 2024. Aminoglycoside resistance increased slightly to 10.0%, returning to the level observed in 2021. The proportion of multidrug-resistant (MDR) isolates increased to 4.3%, representing the highest level recorded in the last five years.
Carbapenem resistance remained very low at 0.2%; however, the number of carbapenemase-producing E. coli increased substantially, rising from five isolates in 2024 to 12 isolates in 2025, the highest number reported during the five-year period. The CPE increase is driven primarily by increases in OXA-244 (n=4) and OXA-48/OXA-48-like carbapenemases (n=6), while single isolates producing NDM and an unknown carbapenemase were also identified. The increase in carbapenemase-producing E. coli isolates observed in 2025 is concerning and reflects broader European trends. ECDC has reported a worsening epidemiological situation for carbapenem-resistant Enterobacterales across the EU/EEA, including increasing detection of carbapenemase-producing E. coli, and has identified their continued spread as a major public health threat. *
Overall, the 2025 data indicate increasing resistance to third-generation cephalosporins, a growing prevalence of ESBL-producing isolates, and a rise in MDR and CPE isolates, highlighting continued concerns regarding resistance to critically important antimicrobials.
Key Resistance Indicators
Table 4: Key Resistance Indicators for Escherichia coli in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 3073 | 3181 | 3312 | 3004 | 2703 |
Ampicillin R | 63.0% | 62.1% | 62.9% | 63.7% | 65.8% |
Amoxicillin/Clavulanic Acid R | 48.7% | 45.1% | 47.7% | 47.2% | 47.5% |
Piperacillin/Tazobactam R | 12.5% | 11.6% | 12.7% | 12.9% | 13.1% |
Cefoxitin R | 4.6% | 4.8% | 4.8% | 5.8% | 5.4% |
Cefotaxime/Ceftriaxone R | 9.1% | 10.0% | 9.9% | 11.4% | 12.6% |
Ceftazidime R | 10.0% | 8.3% | 8.8% | 10.5% | 11.0% |
3GC R | 10.3% | 9.7% | 10.3% | 11.7% | 13.6% |
ESBL Producers | 7.8% | 9.1% | 8.7% | 9.9% | 11.0% |
Ciprofloxacin R | 16.0% | 15.7% | 15.8% | 15.0% | 15.6% |
Gentamicin R | 8.8% | 7.7% | 7.7% | 8.3% | 8.3% |
Aminoglycoside R | 10.0% | 9.1% | 9.0% | 9.6% | 10.0% |
MDR | 4.2% | 3.7% | 3.3% | 3.9% | 4.3% |
Carbapenem R | 0.1% | 0.3% | 0.1% | 0.1% | 0.2% |
CPE (n) | 0 | 4 | 3 | 5 | 12 |
Third-Generation Cephalosporin Resistance
Table 5: Third-Generation Cephalosporin Resistance for Escherichia coli in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 3,073 | 315 | 10 | 2,744 | 10.3% |
2022 | 3,181 | 310 | 9 | 2,861 | 9.7% |
2023 | 3,312 | 341 | 13 | 2,954 | 10.3% |
2024 | 3,004 | 351 | 16 | 2,630 | 11.7% |
2025 | 2,703 | 367 | 2 | 2,332 | 13.6% |
Extended Spectrum Beta-Lactamase Production
Table 6: Extended Spectrum Beta-Lactamase Production for Escherichia coli in Ireland | ||||
|---|---|---|---|---|
Year | Total Cases | Pos | Neg | ESBL Positivity |
2021 | 3,073 | 226 | 2,656 | 7.8% |
2022 | 3,181 | 271 | 2,694 | 9.1% |
2023 | 3,312 | 285 | 2,996 | 8.7% |
2024 | 3,004 | 283 | 2,563 | 9.9% |
2025 | 2,703 | 279 | 2,263 | 11.0% |
Fluoroquinolone Resistance
Table 7: Fluoroquinolone Resistance for Escherichia coli in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 3,073 | 492 | 41 | 2,530 | 16.1% |
2022 | 3,181 | 498 | 42 | 2,632 | 15.7% |
2023 | 3,312 | 515 | 40 | 2,697 | 15.8% |
2024 | 3,004 | 448 | 42 | 2,499 | 15.0% |
2025 | 2,703 | 420 | 41 | 2,220 | 15.7% |
Aminoglycoside Resistance
Table 8: Aminoglycoside Resistance for Escherichia coli in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 3,073 | 307 | 0 | 2,764 | 10.0% |
2022 | 3,181 | 289 | 1 | 2,887 | 9.1% |
2023 | 3,312 | 297 | 0 | 3,004 | 9.0% |
2024 | 3,004 | 289 | 1 | 2,712 | 9.6% |
2025 | 2,703 | 269 | 0 | 2,419 | 10.0% |
Carbapenem Resistance
Table 9: Carbapenem Resistance for Escherichia coli in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 3,073 | 4 | 0 | 3,054 | 0.1% |
2022 | 3,181 | 10 | 0 | 3,168 | 0.3% |
2023 | 3,312 | 4 | 1 | 3,302 | 0.1% |
2024 | 3,004 | 2 | 0 | 3,000 | 0.1% |
2025 | 2,703 | 6 | 1 | 2,689 | 0.2% |
Table 10: Carbapenemase Production for Escherichia coli in Ireland | |||||||
|---|---|---|---|---|---|---|---|
Year | KPC | NDM | OXA-244 | OXA-48 | OXA-48 Like | Unknown | Total |
2021 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
2022 | 0 | 0 | 0 | 4 | 0 | 0 | 4 |
2023 | 0 | 1 | 0 | 2 | 0 | 0 | 3 |
2024 | 1 | 1 | 0 | 3 | 0 | 0 | 5 |
2025 | 0 | 1 | 4 | 4 | 2 | 1 | 12 |
Multi-Drug Resistance
Table 11: Multi Drug Resistance for Escherichia coli in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | MDR | Incomplete | Non-MDR | % MDR |
2021 | 3,073 | 130 | 13 | 2,930 | 4.2% |
2022 | 3,181 | 116 | 14 | 3,051 | 3.7% |
2023 | 3,312 | 108 | 70 | 3,134 | 3.3% |
2024 | 3,004 | 116 | 19 | 2,869 | 3.9% |
2025 | 2,703 | 114 | 24 | 2,565 | 4.3% |
2. Staphylococcus aureus
In 2025, a total of 1,121 S. aureus isolates were reported, representing a slight increase from 1,102 isolates in 2024. When data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, the increase was more pronounced, with an 11.8% increase in the number of isolates reported.
The proportion of methicillin-resistant Staphylococcus aureus (MRSA) was 10.0%, a decrease from 10.7% in 2024 and broadly consistent with levels observed over the past five years. However, this decrease in the proportion of MRSA was primarily driven by an increase in methicillin-susceptible S. aureus (MSSA) infections rather than a reduction in the number of MRSA cases. When incidence rates were adjusted for hospital activity, the overall S. aureus bacteraemia (SAU) rate increased from 0.286 to 0.316 per 1,000 patient days between 2024 and 2025, reaching the highest level reported during the five-year period. This increase was driven primarily by a rise in the MSSA bacteraemia rate, which increased from 0.255 to 0.284 per 1,000 patient days. In contrast, the MRSA bacteraemia rate remained relatively stable at 0.032 per 1,000 patient days in 2025, compared with 0.031 in 2024.
Ciprofloxacin resistance increased to 11.8%, the highest level reported during the 2021 to 2025 period. Resistance to rifampicin remained low at 0.2%, while no resistance to linezolid or vancomycin was detected in 2025.
Overall, the 2025 data indicate that while the proportion and rate of MRSA bacteraemia remained relatively stable, the burden of S. aureus bacteraemia increased, driven by a rise in MSSA infections. The increase in ciprofloxacin resistance also warrants continued monitoring.
Key Resistance Indicators
Table 12: Key Resistance Indicators for Staphylococcus aureus in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 1262 | 1250 | 1307 | 1102 | 1121 |
MRSA | 10.9% | 10.6% | 9.6% | 10.7% | 10.0% |
Ciprofloxacin R | 9.8% | 11.7% | 9.9% | 10.0% | 11.8% |
Linezolid R | 0.0% | 0.1% | 0.2% | 0.0% | 0.0% |
Rifampicin R | 0.6% | 1.0% | 0.7% | 0.3% | 0.2% |
Vancomycin R | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% |
Meticillin-Resistant Staphylococcus aureus Proportions
Table 13: Meticillin Resistance for Staphylococcus aureus in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 1,262 | 138 | 0 | 1,124 | 10.9% |
2022 | 1,250 | 132 | 0 | 1,118 | 10.6% |
2023 | 1,307 | 126 | 0 | 1,181 | 9.6% |
2024 | 1,102 | 118 | 0 | 984 | 10.7% |
2025 | 1,121 | 112 | 0 | 1,008 | 10.0% |
Meticillin-Resistant Staphylococcus aureus Incidence Rates
Table 14: Invasive Staphylococcus aureus Incidence Rates in Ireland | ||||
|---|---|---|---|---|
Year | Bed Days Used | SAU Rate per 1000 Patient Days | MRSA Rate per 1000 Patient Days | MSSA Rate per 1000 Patient Days |
2021 | 4,038,076 | 0.313 | 0.034 | 0.278 |
2022 | 4,209,051 | 0.297 | 0.031 | 0.266 |
2023 | 4,391,891 | 0.298 | 0.029 | 0.269 |
2024 | 3,859,031 | 0.286 | 0.031 | 0.255 |
2025 | 3,546,728 | 0.316 | 0.032 | 0.284 |
3. Klebsiella pneumoniae
In 2025, a total of 453 isolates were reported, representing a decrease from 511 isolates in 2024 and the lowest number reported during the 2021 to 2025 period. Similarly, when data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, there was a slight decrease in the number of K. pneumoniae isolates reported (-0.7%).
Resistance to amoxicillin/clavulanic acid increased to 36.2%, the highest level reported during the five-year period, while piperacillin/tazobactam resistance also increased to 26.3%, continuing the fluctuating but generally upward trend observed in recent years.
Resistance to third-generation cephalosporins (3GCs) remained relatively stable at 15.0% in 2025, compared with 14.8% in 2024. Similarly, resistance to cefotaxime/ceftriaxone (13.3%) and ceftazidime (15.4%) showed little change. The proportion of ESBL-producing isolates increased from 10.6% to 12.2%, although it remained below the peak observed in 2021.
Resistance to ciprofloxacin increased to 12.6% in 2025 from 9.6% in 2024. Gentamicin resistance also increased from 4.8% to 8.2%, resulting in an increase in overall aminoglycoside resistance from 5.9% to 8.8%. The proportion of multidrug-resistant (MDR) isolates more than doubled, increasing from 2.8% in 2024 to 6.3% in 2025, although this remained below the 2021 level of 8.0%.
In contrast, carbapenem resistance remained low at 1.1%, continuing the gradual decline observed since 2021. The number of carbapenemase-producing Enterobacterales (CPE) decreased from six isolates in 2024 to four isolates in 2025, representing the lowest number reported during the five-year period. This contrasts with the substantial increase in carbapenemase-producing E. coli observed in 2025. All four carbapenemase-producing Enterobacterales (CPE) isolates identified in 2025 harboured the OXA-48 carbapenemase enzyme.
Overall, the 2025 data show stable levels of third-generation cephalosporin resistance but increasing resistance to amoxicillin/clavulanic acid, piperacillin/tazobactam, ciprofloxacin, and aminoglycosides. The increase in MDR isolates warrants continued monitoring, although carbapenem resistance and CPE numbers remained low.
Key Resistance Indicators
Table 15: Key Resistance Indicators for Klebsiella pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 515 | 492 | 604 | 511 | 453 |
Ampicillin R | 99.8% | 100.0% | 99.7% | 98.8% | 100.0% |
Amoxicillin/Clavulanic Acid R | 32.5% | 29.3% | 34.2% | 29.7% | 36.2% |
Piperacillin/Tazobactam R | 21.3% | 21.9% | 25.3% | 21.5% | 26.3% |
Cefoxitin R | 5.8% | 5.7% | 8.3% | 9.1% | 4.5% |
Cefotaxime/Ceftriaxone R | 14.9% | 11.2% | 14.3% | 13.4% | 13.3% |
Ceftazidime R | 16.1% | 12.8% | 15.2% | 13.8% | 15.4% |
3GC R | 15.5% | 13.2% | 15.9% | 14.8% | 15.0% |
ESBL Producers | 14.4% | 10.8% | 12.6% | 10.6% | 12.2% |
Ciprofloxacin R | 16.2% | 9.6% | 15.7% | 9.6% | 12.6% |
Gentamicin R | 9.3% | 7.3% | 8.6% | 4.8% | 8.2% |
Aminoglycoside R | 11.1% | 7.5% | 9.1% | 5.9% | 8.8% |
MDR | 8.0% | 3.3% | 5.7% | 2.8% | 6.3% |
Carbapenem R | 2.0% | 1.2% | 1.5% | 1.2% | 1.1% |
CPE (n) | 8 | 5 | 10 | 6 | 4 |
Third-Generation Cephalosporin Resistance
Table 16: Third-Generation Cephalosporin Resistance for Klebsiella pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 515 | 80 | 1 | 434 | 15.5% |
2022 | 492 | 65 | 1 | 426 | 13.2% |
2023 | 604 | 96 | 3 | 503 | 15.9% |
2024 | 511 | 75 | 0 | 432 | 14.8% |
2025 | 453 | 68 | 0 | 385 | 15.0% |
Extended Spectrum Beta-Lactamase Production
Table 17: Extended Spectrum Beta-Lactamase Production for Klebsiella pneumoniae in Ireland | ||||
|---|---|---|---|---|
Year | Total Cases | Pos | Neg | ESBL Positivity |
2021 | 515 | 70 | 415 | 14.4% |
2022 | 492 | 47 | 390 | 10.8% |
2023 | 604 | 74 | 515 | 12.6% |
2024 | 511 | 51 | 428 | 10.6% |
2025 | 453 | 52 | 373 | 12.2% |
Fluoroquinolone Resistance
Table 18: Fluoroquinolone Resistance for Klebsiella pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 515 | 83 | 12 | 418 | 16.2% |
2022 | 492 | 47 | 8 | 434 | 9.6% |
2023 | 604 | 93 | 10 | 490 | 15.7% |
2024 | 511 | 48 | 11 | 441 | 9.6% |
2025 | 453 | 56 | 13 | 377 | 12.6% |
Aminoglycoside Resistance
Table 19: Aminoglycoside Resistance for Klebsiella pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 515 | 57 | 0 | 458 | 11.1% |
2022 | 492 | 37 | 0 | 455 | 7.5% |
2023 | 604 | 55 | 0 | 548 | 9.1% |
2024 | 511 | 30 | 0 | 476 | 5.9% |
2025 | 453 | 40 | 0 | 412 | 8.8% |
Carbapenem Resistance
Table 20: Carbapenem Resistance for Klebsiella pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 515 | 10 | 0 | 501 | 2.0% |
2022 | 492 | 6 | 0 | 485 | 1.2% |
2023 | 604 | 9 | 1 | 593 | 1.5% |
2024 | 511 | 6 | 0 | 502 | 1.2% |
2025 | 453 | 5 | 0 | 446 | 1.1% |
Table 21: Carbapenemase Production for Klebsiella pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
Year | KPC | NDM | OXA-48 | OXA-48/NDM | Total |
2021 | 3 | 1 | 4 | 0 | 8 |
2022 | 1 | 0 | 4 | 0 | 5 |
2023 | 0 | 0 | 9 | 1 | 10 |
2024 | 1 | 0 | 5 | 0 | 6 |
2025 | 0 | 0 | 4 | 0 | 4 |
Multi Drug Resistance
Table 22: Multi Drug Resistance for Klebsiella pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | MDR | Incomplete | Non-MDR | % MDR |
2021 | 515 | 41 | 2 | 472 | 8.0% |
2022 | 492 | 16 | 3 | 473 | 3.3% |
2023 | 604 | 34 | 12 | 558 | 5.7% |
2024 | 511 | 14 | 13 | 484 | 2.8% |
2025 | 453 | 28 | 7 | 418 | 6.3% |
4. Enterococcus faecium
In 2025, a total of 478 Enterococcus faecium isolates were reported, representing a decrease from 523 isolates in 2024 and the lowest number reported during the 2021 to 2025 period. Similarly, when data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, there was a slight decrease in the number of E. faecium isolates reported (-2.8%). Despite the decline in isolate numbers, vancomycin resistance increased slightly from 21.8% in 2024 to 23.1% in 2025, although it remained below the levels observed in 2021 and 2022. High-level gentamicin resistance decreased slightly from 65.9% to 63.5%, remaining common among invasive isolates. Resistance to linezolid remained rare at 0.2%. The proportion of multidrug-resistant (MDR) isolates increased to 18.2% in 2025, up from 14.2% in 2024 and returning to levels similar to those observed in 2021.
When adjusted for hospital activity, the overall E. faecium bacteraemia incidence rate remained relatively stable at 0.135 per 1,000 patient days in 2025, compared with 0.136 in 2024. Similarly, the vancomycin-resistant E. faecium (VRE) bacteraemia rate remained stable at 0.031 per 1,000 patient days, while the vancomycin-susceptible E. faecium (VSE) bacteraemia rate decreased slightly from 0.106 to 0.103 per 1,000 patient days. VRE, especially among E. faecium, is a growing problem throughout the EU/EEA area; Ireland is one of a few countries where there has been relatively decreasing trend in the % VREfm in recent years.
Overall, the 2025 data indicate a stable incidence of invasive E. faecium infections, accompanied by a modest increase in vancomycin resistance and a notable increase in multidrug-resistant isolates, highlighting the continued importance of surveillance and infection prevention measures.
Key Resistance Indicators
Table 23: Key Resistance Indicators for Enterococcus faecium in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 619 | 634 | 639 | 523 | 478 |
Vancomycin R | 27.2% | 27.8% | 21.4% | 21.8% | 23.1% |
Ampicillin R | 94.8% | 96.6% | 96.0% | 94.3% | 95.0% |
High Level Gentamicin R | 60.2% | 60.8% | 62.2% | 65.9% | 63.5% |
Linezolid R | 0.3% | 0.6% | 0.2% | 0.6% | 0.2% |
MDR | 18.1% | 17.2% | 16.9% | 14.2% | 18.2% |
Vancomycin-Resistant Enterococcus faecium Proportions
Table 24: Vancomycin Resistance for Enterococcus faecium in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 619 | 168 | 0 | 450 | 27.2% |
2022 | 634 | 176 | 0 | 456 | 27.8% |
2023 | 639 | 136 | 0 | 500 | 21.4% |
2024 | 523 | 114 | 0 | 409 | 21.8% |
2025 | 478 | 110 | 0 | 366 | 23.1% |
Vancomycin-Resistant Enterococcus faecium Incidence Rates
Table 25: Invasive Enterococcus faecium Incidence Rates in Ireland | ||||
|---|---|---|---|---|
Year | Bed Days Used | EFM Rate per 1000 Patient Days | VRE Rate per 1000 Patient Days | VSE Rate per 1000 Patient Days |
2021 | 4,038,076 | 0.153 | 0.042 | 0.111 |
2022 | 4,209,051 | 0.151 | 0.042 | 0.108 |
2023 | 4,391,891 | 0.145 | 0.031 | 0.114 |
2024 | 3,859,031 | 0.136 | 0.030 | 0.106 |
2025 | 3,546,728 | 0.135 | 0.031 | 0.103 |
5. Pseudomonas aeruginosa
In 2025, a total of 273 Pseudomonas aeruginosa isolates were reported, a slight increase from 268 isolates in 2024. When data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, the increase was more pronounced, with a 9.2% increase in the number of isolates reported.
Resistance to piperacillin/tazobactam increased from 5.4% in 2024 to 9.6% in 2025, although it remained below levels reported between 2021 and 2023. Similarly, resistance to ceftazidime increased to 5.2% and resistance to imipenem/meropenem increased to 6.3%, following declines observed in previous years.
In contrast, ciprofloxacin resistance decreased substantially to 4.4%, the lowest level reported during the 2021 to 2025 period. Resistance to tobramycin remained low and stable at 1.6%. The proportion of multidrug-resistant (MDR) isolates increased slightly from 2.2% in 2024 to 2.9% in 2025 but remained less than half the level observed in 2021.
Overall, the 2025 data indicate a modest increase in resistance to piperacillin/tazobactam, ceftazidime and carbapenems compared with 2024; however, resistance levels remained relatively low by historical standards. The marked reduction in ciprofloxacin resistance and the persistently low prevalence of MDR isolates are encouraging findings.
Key Resistance Indicators
Table 26: Key Resistance Indicators for Pseudomonas aeruginosa in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 294 | 319 | 297 | 268 | 273 |
Piperacillin/Tazobactam R | 14.6% | 9.9% | 10.9% | 5.4% | 9.6% |
Ceftazidime R | 10.7% | 9.1% | 6.6% | 3.8% | 5.2% |
Imipenem/Meropenem R | 7.8% | 8.2% | 6.4% | 4.9% | 6.3% |
Ciprofloxacin R | 9.6% | 8.6% | 8.0% | 7.1% | 4.4% |
Tobramycin R | 3.5% | 2.1% | 0.8% | 1.7% | 1.6% |
MDR | 6.0% | 4.8% | 4.7% | 2.2% | 2.9% |
Multi Drug Resistance
Table 27: Multi Drug Resistance for Pseudomonas aeruginosa in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | MDR | Incomplete | Non-MDR | % MDR |
2021 | 294 | 14 | 59 | 221 | 6.0% |
2022 | 319 | 10 | 107 | 199 | 4.8% |
2023 | 297 | 11 | 62 | 224 | 4.7% |
2024 | 268 | 5 | 38 | 225 | 2.2% |
2025 | 273 | 7 | 32 | 234 | 2.9% |
6. Enterococcus faecalis
In 2025, a total of 307 Enterococcus faecalis isolates were reported, representing a slight increase from 300 isolates in 2024. When data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, the increase was more pronounced, with an 14.1% increase in the number of isolates reported.
Resistance levels for most antimicrobial agents remained low. Vancomycin resistance remained rare at 0.3%, unchanged from 2024. Similarly, linezolid resistance remained uncommon at 0.4%.
In contrast, high-level gentamicin resistance increased substantially from 11.9% in 2024 to 17.6% in 2025, reaching its highest level during the 2021 to 2025 period. No multidrug-resistant (MDR) isolates were identified in 2025, continuing the generally low prevalence of MDR E. faecalis observed over the five-year period.
Overall, the 2025 data indicate that invasive E. faecalis isolates in Ireland remained largely susceptible to key antimicrobial agents, including vancomycin. However, the notable increase in high-level gentamicin resistance warrants continued monitoring due to its potential impact on treatment options for severe enterococcal infections.
Key Resistance Indicators
Table 28: Key Resistance Indicators for Enterococcus faecalis in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 365 | 375 | 389 | 300 | 307 |
Vancomycin R | 0.3% | 1.3% | 0.5% | 0.3% | 0.3% |
Ampicillin R | 0.8% | 1.1% | 0.5% | 0.7% | 0.0% |
High Level Gentamicin R | 16.7% | 16.4% | 17.2% | 11.9% | 17.6% |
Linezolid R | 0.6% | 0.0% | 0.3% | 0.4% | 0.4% |
MDR | 0.0% | 0.7% | 0.0% | 0.0% | 0.0% |
High Level Gentamicin Resistance
Table 29: High Level Gentamicin Resistance for Enterococcus faecalis in Ireland | |||||
|---|---|---|---|---|---|
Year | Total Cases | R | I | S | % R |
2021 | 365 | 46 | 0 | 229 | 16.7% |
2022 | 375 | 45 | 0 | 230 | 16.4% |
2023 | 389 | 55 | 1 | 264 | 17.2% |
2024 | 300 | 24 | 0 | 178 | 11.9% |
2025 | 307 | 39 | 0 | 182 | 17.6% |
7. Acinetobacter species
In 2025, a total of 74 invasive Acinetobacter spp. isolates were reported, representing an increase from 59 isolates in 2024 and the highest number reported since 2022. When data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, Acinetobacter spp. showed the largest increase among the eight EARS-Net pathogens, with a 32.1% increase in the number of isolates reported. Despite this increase, overall resistance levels remained low across the antimicrobial classes monitored.
In contrast, resistance to gentamicin increased markedly from 1.7% in 2024 to 7.4% in 2025, representing the highest level reported during the 2021 to 2025 period. Carbapenem resistance remained uncommon at 1.4%, with only a single resistant isolate identified in 2025. Although carbapenem resistance remained low in invasive Acinetobacter spp. isolates in Ireland in 2025, carbapenem-resistant Acinetobacter is recognised as a major healthcare-associated pathogen due to limited treatment options and its ability to cause outbreaks. ECDC surveillance data indicate that carbapenem-resistant Acinetobacter is almost 100% in several European countries, highlighting the importance of continued monitoring and infection prevention efforts in Ireland.
No multidrug-resistant (MDR) Acinetobacter spp. isolates were reported in 2025, continuing the pattern observed throughout the five-year period. Overall, the 2025 data indicates that antimicrobial resistance among invasive Acinetobacter spp. remained low in Ireland, although the increase in gentamicin and aminoglycoside resistance warrants continued monitoring.
Key Resistance Indicators
Table 30: Key Resistance Indicators for Acinetobacter species in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 73 | 80 | 71 | 59 | 74 |
Fluoroquinolone R | 3.1% | 1.4% | 1.4% | 5.6% | 3.0% |
Gentamicin R | 3.1% | 1.6% | 0.0% | 1.7% | 7.4% |
Aminoglycoside R | 3.0% | 1.5% | 1.5% | 1.7% | 7.4% |
Imipenem/Meropenem R | 1.5% | 2.5% | 0.0% | 0.0% | 1.4% |
MDR | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% |
8. Streptococcus pneumoniae
In 2025, a total of 332 invasive S. pneumoniae isolates were reported, representing a decrease from 369 isolates in 2024. In contrast, when data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, there was a slight increase in the number of S. pneumoniae isolates reported (+3.1%).
Of these, 252 isolates (75.9%) were serotyped, a decrease in typing coverage compared with previous years. Serotype 8 was the most common serotype, accounting for 11% of all typed isolates, followed by serotypes 19A, 3, 9N and 4, each of which accounted for approximately 9% of typed isolates.
The proportion of penicillin non-wild-type (non-WT) isolates remained stable at 20.7%, compared with 20.8% in 2024. While the overall proportion of penicillin non-WT isolates changed little, the proportion classified as penicillin resistant increased substantially from 2.7% in 2024 to 6.0% in 2025, the highest level reported during the 2021 to 2025 period. In contrast, the proportion classified as penicillin susceptible at increased exposure (I) decreased from 17.9% to 14.5%.
Erythromycin resistance increased to 17.0% in 2025, up from 12.9% in 2024 and the highest level reported during the five-year period. Overall, the 2025 data indicate stable levels of penicillin non-susceptibility among invasive S. pneumoniae isolates but increasing proportions of penicillin-resistant and erythromycin-resistant isolates.
Key Resistance Indicators
Table 31: Key Resistance Indicators for Streptococcus pneumoniae in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 179 | 305 | 361 | 369 | 332 |
Typed Isolates (n) | 154 | 276 | 335 | 330 | 252 |
Typed Isolates (%) | 86.0% | 90.5% | 92.8% | 89.4% | 75.9% |
Penicillin Non-WT (n) | 34 | 72 | 61 | 76 | 68 |
Penicillin Non-WT (%) | 19.0% | 23.6% | 17.4% | 20.8% | 20.7% |
Penicillin R (Pen Non-WT) | 1.1% | 2.0% | 1.7% | 2.7% | 6.0% |
Penicillin I (Pen Non-WT) | 17.9% | 21.6% | 15.2% | 17.9% | 14.5% |
Erythromycin R (%) | 12.2% | 16.5% | 14.1% | 12.9% | 17.0% |
9. Invasive Group A Streptococcus (iGAS)
In 2025, a total of 61 invasive Group A Streptococcus (iGAS) isolates were reported, representing a decrease from 91 isolates in 2024. It should be noted that the EARS-Net case definition for iGAS differs from the national notification case definition, as EARS-Net antimicrobial resistance surveillance only includes isolates recovered from blood or cerebrospinal fluid (CSF).
Of these, 56 isolates (91.8%) were typed, maintaining a high level of typing coverage. The most common emm type was emm-type 28.0, accounting for 16% of typed isolates, followed by emm-type 89.0, emm-type 49.8 and emm-type 4.0, each representing 10% of typed Group A Streptococcus isolates.
Erythromycin resistance increased substantially to 19.7% in 2025, up from 8.3% in 2024 and the highest level reported during the 2021 to 2025 period. Overall, the number of iGAS isolates decreased in 2025 following the increase observed during 2022 and 2023.
Key Resistance Indicators
Table 32: Key Resistance Indicators for Invasive Group A Streptococcus in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 26 | 71 | 243 | 91 | 61 |
Typed Isolates (n) | 22 | 71 | 243 | 91 | 56 |
Typed Isolates (%) | 84.6% | 100.0% | 100.0% | 100.0% | 91.8% |
Erythromycin R | 16.7% | 9.2% | 3.5% | 8.3% | 19.7% |
10. Invasive Group B Streptococcus (iGBS)
In 2025, a total of 124 invasive Group B Streptococcus (iGBS) isolates were reported, representing a slight decrease from 136 isolates in 2024. When data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, the number of group B Streptococcus isolates didn’t change and stayed the same in the last year.
Erythromycin resistance decreased from 46.5% in 2024 to 40.5% in 2025 but remained high and was broadly consistent with levels observed over the five-year period.
Key Resistance Indicators
Table 33: Key Resistance Indicators for Invasive Group B Streptococcus in Ireland | |||||
|---|---|---|---|---|---|
2021 | 2022 | 2023 | 2024 | 2025 | |
Total Isolates | 139 | 138 | 125 | 136 | 124 |
Typed Isolates (n) | 44 | 20 | 68 | 136 | 6 |
Typed Isolates (%) | 31.7% | 14.5% | 54.4% | 100.0% | 4.8% |
Erythromycin R | 42.9% | 40.9% | 41.4% | 46.5% | 40.5% |
11. Candida species
A total of 205 Candida bloodstream isolates were reported in 2025, representing a slight decrease from 211 isolates in 2024 and continuing the downward trend observed since the peak of 313 isolates in 2023. But the decrease in 2025 was due to the lower number of laboratory participation. When data from the 28 laboratories that submitted data in both 2024 and 2025 were compared, there was actually an increase with a 7.9% increase in the number of isolates reported.
Candida albicans remained the most frequently identified species, accounting for 89 isolates (43.4%), followed by Candida glabrata with 71 isolates (34.6%). Together, these two species accounted for over three-quarters of all Candida bloodstream isolates reported in 2025.
Compared with 2024, the number of C. glabrata isolates increased from 56 to 71, while C. albicans decreased from 98 to 89 isolates. The number of Candida parapsilosis isolates also declined substantially, from 40 isolates in 2024 to 24 in 2025. Other Candida species were reported infrequently, with Candida dubliniensis and Candida tropicalis each accounting for nine isolates.
Species identification of Candida isolates remains important as antifungal susceptibility can vary considerably between species, influencing the selection of appropriate antifungal therapy. In 2025, all Candida isolates submitted to HPSC was speciated.
No cases of Candida auris were identified in 2025. The absence of C. auris is reassuring, as this emerging multidrug-resistant pathogen has been associated with healthcare-associated outbreaks worldwide and can be difficult to eradicate from healthcare environments. Continued species-level surveillance is therefore important to facilitate the early detection of C. auris and other emerging Candida species of public health concern.
Table 34: Breakdown of Candida Species Causing Bloodstream Infections in Ireland | |||||
|---|---|---|---|---|---|
Organism | 2021 | 2022 | 2023 | 2024 | 2025 |
Candida albicans | 125 | 129 | 136 | 98 | 89 |
Candida glabrata | 78 | 84 | 81 | 56 | 71 |
Candida parapsilosis | 51 | 49 | 59 | 40 | 24 |
Candida dubliniensis | 10 | 4 | 9 | 6 | 9 |
Candida tropicalis | 17 | 9 | 6 | 6 | 9 |
Candida metapsilosis | 0 | 1 | 4 | 3 | 2 |
Candida nivariensis | 0 | 0 | 0 | 0 | 1 |
Candida spp. | 0 | 1 | 0 | 1 | 0 |
Candida guilliermondii | 1 | 3 | 1 | 0 | 0 |
Candida krusei | 6 | 1 | 6 | 0 | 0 |
Candida lipolyticas | 1 | 0 | 0 | 0 | 0 |
Candida lusitaniae | 2 | 4 | 5 | 0 | 0 |
Candida pelliculosa | 0 | 0 | 1 | 0 | 0 |
Candida orthopsilosis | 1 | 0 | 1 | 1 | 0 |
Candida duobushaemolonii | 0 | 0 | 2 | 0 | 0 |
Candida fermentati | 0 | 0 | 2 | 0 | 0 |
Candida auris | 0 | 0 | 0 | 0 | 0 |
Total | 292 | 285 | 313 | 211 | 205 |
Abbreviations
3GC | Third Generation Cephalosporins |
|---|---|
ac - | Acinetobacter species |
AMR | Antimicrobial Resistance |
BSI | Bloodstream Infection |
CAI | Community Acquired Infection |
CLSI | Clinical and Laboratory Standards Institute |
CPE | Carbapenemase Producing Enterobacterales |
EARS | European Antimicrobial Resistance Surveillance |
ECDC | European Centre for Disease Prevention and Control |
eco | Escherichia coli |
EEA | European Economic Area |
efa | Enterococcus faecalis |
efm | Enterococcus faecium |
EQA | External Quality Assessment |
ESBL | Extended Spectrum Beta Lactamase |
EU | European Union |
EUCAST | European Committee on Antimicrobial Susceptibility Testing |
HAI | Healthcare Associated Infection |
HPSC | Health Protection Surveillance Centre |
iGAS | Invasive Group A Streptococcus |
iGBS | Invasive Group B Streptococcus |
KPC | Klebsiella pneumoniae carbapenemase |
kpn | Klebsiella pneumoniae |
MDR | Multi Drug Resistant |
MIC | Minimum Inhibitory Concentration |
MRSA | Meticillin Resistant Staphylococcus aureus |
MSSA | Meticillin Susceptible Staphylococcus aureus |
NDM | New Delhi Metallo Beta Lactamase |
NWT | Non Wild Type |
OXA | Oxacillinase |
pae | Pseudomonas aeruginosa |
RIS | Resistance, Susceptible at Increased Exposure, Susceptible |
sau | Staphylococcus aureus |
spn | Streptococcus pneumoniae |
VREfm | Vancomycin Resistant Enterococcus faecium |
VSEfm | Vancomycin Susceptible Enterococcus faecium |
WHO | World Health Organization |
WT | Wild Type |
Acknowledgements
Sincere thanks are extended to all microbiology laboratories for their continued support for EARS-Net and for providing data for this report, ARHAI Team at HPSC, EARS-Net Steering Group, Irish Meningitis and Sepsis Reference Laboratory (IMSRL), National Carbapenemase-Producing Enterobacteriaceae Reference Laboratory Service (CPEaRLS) and EARS-Net at ECDC for providing the European data.