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Over 50 per cent of life-threatening bacterial
infections are becoming resistant to treatment, a new World
Health Organization (WHO) report published on Friday
reveals.
Moreover, the high levels of
resistance to treatment are reported in bacteria frequently
causing bloodstream infections in hospitals the Global
Antimicrobial Resistance and Use Surveillance System
(GLASS) report states, based on 2020 data from 87
countries.
“Antimicrobial resistance
undermines modern medicine and puts millions of
lives at risk”, said WHO chief
Tedros Adhanom Ghebreyesus.
Tracking
resistance
Within the context of national testing
coverage, the report, for the first time, analyses
antimicrobial resistance (AMR) rates, tracking trends in 27
countries since 2017.
It reveals high levels of
bacteria resistance, frequently causing life-threatening
bloodstream infections in hospitals, such as Klebsiella
pneumoniae and Acinetobacter spp, which require
treatment with last-resort antibiotics, such as
carbapenems.
However, eight per cent of those
infections caused by Klebsiella pneumoniae were
resistant to carbapenems, increasing the risk of
death.
Drugs rendered ineffective
Bacterial
infections are becoming increasingly resistant to
treatments, with over 60 per cent of Neisseria
gonorrhoea infections, a common sexually transmitted
disease, showing resistance to ciprofloxacin, one of the
most widely used oral antibacterials.
And over 20 per
cent of E.coli isolates, the most common pathogen in
urinary tract infections, were resistant to ampicillin and
co-trimoxazole, first-line drugs, as well as second-line
treatments known as fluoroquinolones.
Deeper dive
needed
Although most antimicrobial resistance trends
have remained stable over the past four years, bloodstream
infections due to resistant E.coli,
Salmonella, and gonorrhoea infections, have
jumped by at least 15 per cent compared to 2017
rates.
More research is needed to discover why AMR has
increased and the extent to which infections are related to
hospitalizations and antibiotic treatments during the COVID-19
pandemic.
The pandemic also meant that several
countries were unable to report data for
2020.
We must scale up
microbiology testing – WHO
chief
“To truly understand
the extent of the global threat and mount an effective
public health response to AMR, we must scale up microbiology
testing and provide quality-assured data across all
countries, not just wealthier ones”, pressed
Tedros.
‘Bug-drug’ combos
New analyses
show that countries with lower testing coverage – mostly
low and middle-income countries (LMICs) – are more likely
to report significantly higher AMR rates for so-called
“bug-drug” combinations.
This may be partly
because only a limited number of referral hospitals in many
LMICs provide data for the GLASS report.
These
hospitals often care for the sickest patients who may have
received previous antibiotic treatment.
Meanwhile, in
terms of antibiotic consumption, 65 per cent of 27 reporting
countries met WHO’s target of ensuring that at least 60
per cent of antimicrobials are first or second-line
treatments.
These ‘ACCESS’ antibiotics are
effective in a wide range of infections with a relatively
low risk of creating resistance.
However, insufficient
testing coverage and weak laboratory capacity, particularly
in LMICs, make AMR rates difficult to
interpret.
Moving forward
WHO will follow a
two-pronged approach to overcome this critical gap, by
gathering short-term evidence through surveys and creating
long-term capacity building for routine
surveillance.
This will entail national AMR prevalence
surveys to generate a baseline of data, and enable tracking
trends for policy development, intervention monitoring and
increasing quality-assured laboratories to report data
throughout all levels of health systems.
Responding to
antimicrobial resistance trends requires high country-level
commitment to boost surveillance and provide quality data as
well as action by all people and communities, said
WHO.
By strengthening standardized data collection,
the next phase of GLASS will underpin quality data-driven
action to stem the emergence and spread of AMR and protect
antimicrobial medicines for future
generations.
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