Antimicrobial Resistance and Healthcare-associated Infections Programme

Networks and partnerships

The programme on Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) covers two major public health issues:  

  • Antimicrobial Resistance (AMR), i.e. the ability of microorganisms to become resistant to one or several antimicrobial agents used for therapy or prophylaxis;
  • Healthcare-Associated Infections (HAI), i.e. all infections associated with patient care, in particular hospitals and long-term care facilities. 

The ARHAI programme focuses on 4 areas of public health: surveillance, response and scientific advice, training and communication to address the threat of antimicrobial resistance and healthcare-associated infections.

Antimicrobial resistance (AMR) and healthcare-associated infections (HAI) are among the most serious public health problems, globally and in Europe. ECDC estimated that approximately 4 million patients acquire a HAI each year in all EU Member States and that approximately 37,000 deaths directly result from these infections. A large proportion of these deaths are due to the most common multidrug-resistant bacteria, i.e. Staphylococcus aureus, Enterobacteriaceae, Pseudomonas aeruginosa for which the number of directly attributable deaths is currently estimated at 25,000. The issues of AMR and HAI overlap widely, but are not synonymous. HAI are often due to antibiotic-resistant bacteria, but not always. Inversely, antibiotic-resistant bacteria, including multidrug resistant types, are not only responsible for HAI but are also responsible for infections in outpatients and found as part of the flora of healthy individuals, in pet animals and in the environment. They are also isolated from food-producing animals and sometimes from food products.
In November 2001, the EU Health Ministers adopted the Council Recommendation on the prudent use of antimicrobial agents in human medicine (2002/77/EC). In June 2009 they adopted the Council Recommendation on patient safety, including the prevention and control of healthcare associated infections (2009/C 151/01). These Recommendations ask Member States to adopt and implement specific strategies for the prudent use of antimicrobial agents - aiming at containing antimicrobial resistance, and for the prevention and control of healthcare-associated infections - aiming at improving patient safety. 


  • Head of programme: Dominique L. Monnet
  • Programme manager: Egle Obcarskaite

Disease networks

European Antimicrobial Resistance Surveillance Network (EARS-Net)

The EARS-Net is a network of national surveillance systems providing reference data on antimicrobial resistance in invasive bacterial pathogens from clinical laboratories in the EU/EEA.

European Surveillance of Antimicrobial Consumption Network (ESAC-Net)

ESAC-Net (formerly ESAC) is a Europe-wide network of national surveillance systems, providing European reference data on antimicrobial consumption.

Healthcare-associated Infections Surveillance Network (HAI-Net)

Outsourced microbiological support to hospital-based surveillance of CDI aims to increase the capacity of laboratories in EU/EEA Member States to perform diagnostic practices with high diagnostic accuracy and acquire comparable typing data from C. difficile isolates.

Related diseases/public health areas

Disease / public health area

Antimicrobial resistance

Antimicrobial resistance is the ability of a microorganism (e.g., a bacterium, a virus) to resist the action of an antimicrobial agent. The major cause of antimicrobial resistance remains the use of antimicrobials in human medicine.

Disease / public health area

Healthcare-associated infections

Approximately 4 100 000 patients are estimated to acquire a healthcare-associated infection in the EU each year. The number of deaths occurring as a direct consequence of these infections is estimated to be at least 37 000 and these infections are thought to contribute to an additional 110 000 deaths each year.

Disease / public health area

Antimicrobial consumption

The major cause of antimicrobial resistance in microorganisms from humans remains the use of antimicrobials in human medicine, in the community and in hospitals and other healthcare settings.