The World Health Organization (WHO) has reported that resistance to antibiotics is on the rise, making the treatment of bacterial infections more difficult.
According to the report, high levels of resistance in bacteria are causing life-threatening bloodstream infections and resistance to treatment in common bacterial infections is becoming more prevalent.
These findings come as the result of a community based on data reported by 87 countries in 2020.
The Global Antimicrobial Resistance and Use Surveillance System (GLASS) report provides analyses on antimicrobial resistance (AMR) rates in the context of national testing coverage for the first time. Glass also reports on AMR trends since 2017, and data on antimicrobial consumption in humans across 27 countries.
The data on AMR
A total of 127 countries contributed to the GLASS report, equating to 72% of the world population.
There are numerous examples of common bacterial infections becoming increasingly resistant to treatment. For example, over 60% of Neisseria gonorrhoea isolates, a common sexually transmitted disease, have shown resistance to ciprofloxacin, one of the most used antibacterial treatments. Over 20% of E.coli isolates are now resistant to both first-line drugs (ampicillin and co-trimoxazole) and second-line treatments (fluoroquinolones).
“Antimicrobial resistance undermines modern medicine and puts millions of lives at risk,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“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,” he added.
Most bacterial resistance trends have remained stable over the past years. However, bloodstream infections Escherichia coli and Salmonella spp. and resistant gonorrhoea infections have increased by at least 15% since 2017.
WHO have called for more research to identify the reasons behind the increase in AMR. They also want to understand to what extent increased AMR is related to raised hospitalisations and increased antibiotic treatments during the COVID-19 pandemic.
The pandemic also meant that several countries were unable to report data for 2020.
The new analyses show that countries with lower testing coverage are more likely to report higher AMR rates for most “bug-drug” combinations. Most countries with low testing coverage are low- or middle-income countries (LMICs). Many LMICs had a limited number of referral hospitals reporting to GLASS, which may explain these statistics.
Working to improve the treatment of bacterial infections
A total of 27 reporting countries met WHO’s target of ensuring that at least 60% of the antimicrobials consumed were sourced from the ‘ACCESS’ group of antibiotics. The ‘ACCESS’ group is made up of antibiotics which are deemed by WHO to be “effective in a wide range of common infections and have a relatively low risk of creating resistance”.
Due to poor testing coverage and laboratory capacity in LMICs, rates of AMR remain difficult to interpret. To overcome this, WHO will adopt a two-pronged approach based on short-term evidence generation through surveys and long-term capacity building for routine surveillance.
WHO will introduce representative national AMR prevalence surveys to generate AMR baseline and trend data. This data will contribute to policy development and the monitoring of interventions, as well as increasing quality-assured laboratories.
WHO believes that increasing the collection of standardised quality AMR and AMC data will enable the next phase of GLASS to underpin effective data-driven action to stop the rise of AMR and ensure the efficacy of antimicrobial medicines.