Resistance itself caused 1.27 million deaths in 2019 but antimicrobial resistant infections were implicated in 4.95 million total deaths. These estimates, made for 204 countries and territories confirm that AMR is a global health threat, with the worst impacts in low- and middle-income countries although high-income countries also face the emergence of bacteria antibiotic resistant. “We now see the true extent of antimicrobial resistance worldwide and we must act now to combat the threat. Previous estimates had predicted 10 million annual deaths linked to antimicrobial resistance by 2050, but we now know for sure that we are already much closer to that figure than we thought,” says Professor Chris Murray, from the Institute for Health Metrics and Evaluation at the University of Washington, co-author of the study.
AMR has become the world’s number one public health threat
More than 1.2 million people and “probably” millions more, write these experts, have died in one year directly from antibiotic-resistant bacterial infections, concludes this large analysis of microbial resistance carried out on 204 countries and territories. The analysis reveals that many hundreds of thousands of deaths now occur due to common, until recently treatable infections, including lower respiratory tract and bloodstream infections.
The background and the study:
The bacteria that cause these infections the most common became resistant to treatment. The report estimated deaths from 23 pathogens and 88 pathogen-drug combinations using data from 471 million individual records from systematic literature reviews, hospital systems, surveillance systems and other sources. data. The disease burden was estimated in two ways:
- deaths caused directly by AMR,
- AMR-associated deaths (i.e. when a drug-resistant infection is involved in the death, but AMR is not necessarily the direct cause).
The analysis shows that:
- AMR is directly responsible for approximately 1.27 million deaths worldwide and associated with approximately 4.95 million deaths in 2019. These data are to be compared to HIV/AIDS and malaria-related mortality, respectively 860,000 and 640,000 deaths (in 2019);
- antibiotic resistance in infections of the lower respiratory tract (particularly pneumonia) has the greatest impact on the burden of disease linked to AMR: more than 400,000 direct deaths and associated with more than 1.5 million deaths;
- in blood infections (particularly sepsis), AMR accounts for 370,000 direct deaths and is associated with nearly 1.5 million deaths;
- in intra-abdominal infections (notably appendicitis) AMR accounts for around 210,000 direct deaths and is associated with around 800,000 deaths;
- if patients of all ages are concerned, young children are more vulnerable, with 1 in 5 AMR-related deaths occurring at young age;
- the death rate associated with AMR is highest in sub-Saharan Africa and South Asia, respectively 99 deaths per 100,000 in sub-Saharan Africa and 77 deaths per 100,000 in South Asia (compared to 56 deaths per 100,000 in the rich countries) ;
- of the 23 pathogens studied, drug resistance in 6 of them (E. coli, S. aureus, K. pneumoniae, S. pneumoniae, A. baumannii and P. aeruginosa) is directly responsible for 929,000 deaths and is associated with 3.57 million deaths;
- the pathogen combination S. methicillin-resistant aureus, or MRSA/drug directly caused more than 100,000 deaths in 2019;
- 2 classes of antibiotics often considered the first line of defense once morest serious infections (fluoroquinolones and beta-lactams) are implicated in more than 70% of AMR deaths.
Report highlights urgent need to scale up action to tackle antimicrobial resistance and outlines immediate actions for policy makers that will help save lives and protect health systems. Rapid investment in new treatments, improved infection control measures and optimized use of antibiotics are among the measures that can help countries protect their health systems once morest AMR.
In conclusion, AMR remains and constitutes more than ever a major challenge and a still neglected public health problem. New resources must be allocated to the fight once morest resistance and directed towards the prevention of infections first, then towards the proper use of antibiotics and the development of new antibacterials “affordable and effective”.