May 02, 2014
In its first global evaluation of surveillance and information on antimicrobial resistance, the World Health Organization (WHO) this week called attention to increasing levels of bacterial resistance to many common drugs. The report, titled Antimicrobial resistance: global report on surveillance, 2014 revealed that antimicrobial resistance has spread to all regions of the world, making it clear that a post-antibiotic era far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century.
The organization analyzed recent information on resistance surveillance and data for a set of nine bacteria-antibacterial drug combinations. Of the 129 Member States surveyed for the report, 114 provided data for at least one of the combinations and 22 provided data for all nine.
An analysis of the data yielded a number of important and worrying findings, including:
- High rates of resistance have been observed in bacteria that cause common infections, such as urinary tract infections and pneumonia, in all six of the WHO s world regions.
- There exist significant gaps in surveillance techniques, and standardized processes for collecting and sharing data and coordinating surveillance efforts have yet to be implemented in many countries.
- Multidrug-resistance tuberculosis is a growing concern, but is underreported.
- Foci of artemisinin resistance in malaria parasites have been identified in several countries, though the spread of resistance could set back recent gains in controlling the disease.
- Increased levels of anti-HIV drug resistance have been detected in patients undergoing antiretroviral treatment.
- While 1 million people in the world are infected with gonorrhea each day, failure to treat the disease with the last-resort method, third-generation cephalosporins, has been reported in at least 10 countries.
The report makes it clear that we are falling behind in the battle against drug-resistant superbugs. Many countries do not have the proper infrastructure in place to reliably and effectively track developments in resistance and surveillance methods. In response to this massive threat to our public health, the WHO will be launching an initiative to standardize data collection tools and methods, improve global surveillance efforts, and encourage collaboration.
In light of these troubling findings, we encourage those who wish to learn more about antimicrobial resistance to consult the following resources:
PROGRAMS AND TOOLS The WHO’s Work on Drug Resistance: An overview of WHO programs, working groups and reports on the topic of animicrobial resistance.
The Global Antibiotic Resistance Partnership (GARP): The Global Antibiotic Resistance Partnership (GARP) was started in 2009 to create a platform for developing actionable policy proposals on antibiotic resistance in low-income and middle-income countries. Working groups are now in place in eight countries (India, Kenya, Mozambique, Nepal, South Africa, Tanzania, Uganda and Vietnam).
European Antimicrobial Resistance Surveillance Network (EARS-Net): Europe-wide network of national surveillance systems, providing European reference data on antimicrobial resistance for public health purposes. EARS-Net is coordinated and funded by the European Centre for Disease Prevention and Control.
ResistanceMap: A collection of tools summarizing national and subnational data on antimicrobial use and resistance in North America and Europe.
The Joint Programming Initiative on Antimicrobial Resistance: A joint effort by 19 EU Member states to coordinate the research, in order to allow greater impact and avoid duplication.
PUBLICATIONS:
Antimicrobial resistance: global report on surveillance, 2014: The WHO s recent report on the status of antibiotic surveillance around the globe
Antibiotic Resistance the need for global solutions: A discussion of the global situation of antibiotic resistance, its major causes and consequences, and key areas requiring action by a group of global health experts, including CDDEP Director Ramanan Laxminarayan. (The Lancet Infectious Diseases)
Antibiotic-resistant infections on the rise among US children: This study found that infections caused by drug-resistant ESBL-producing bacteria are increasing among children in the US. (Journal of the Pediatric Infectious Diseases Society)
Are Physicians Prescribing Decisions Sensitive to Drug Prices? Evidence from a Free-Antibiotics Program: This study indicates that, contrary to previous research, physicians do seem to take their patients ability to pay for medications into account when writing prescriptions. It also shows that free-antibiotics programs may raise total antibiotics prescriptions, which raises concerns about the unintended consequences of antibiotics overuse and increased antimicrobial resistance. (CDDEP)
Antimalarial drug resistance: A review of the biology and strategies to delay emergence and spread: CDDEP Senior Fellow Eili Klein examines how resistance to antimalarial drugs emerges and examines a number of methods for controlling its spread. (CDDEP)
Antibiotic Resistance Threats in the United States, 2013: The CDC found that antibiotic-resistant bacteria causes at least 2 million infections and 23,000 deaths in the US each year. This report discusses the problem and strategies for better antibiotic stewardship and surveillance in the United States.
Policy Package to Combat Antimicrobial Resistance: The WHO presents global strategies for fighting resistant bacteria. (WHO)
CDDEP GRAPHICS:
Countries with the highest levels of MDR-TB in 2012
First reported cases of resistance to key antibiotics
Correlation between salmonella resistance in poultry and antibiotic consumption among food animals
Seasonality of MRSA infections
Image via Sarah McMillan/Flickr
