The World Health Organization (WHO) warns of high levels of resistance in bacteria that cause sepsis, in addition to increasing resistance to treatments of several bacteria that cause common infections among the population.
The new WHO report is based on data reported by 87 countries in 2020. In six years, the report reached the participation of 127 countries with 72% of the world’s population.
For the first time, the Global Antimicrobial Resistance Report and Antimicrobial Use Surveillance System provides analysis of antimicrobial resistance rates in the context of national testing coverage, trends since 2017, and data on antimicrobial consumption in humans in 27 countries.
High levels of resistance (above 50%) have been described and reported in bacteria that are a frequent cause of sepsis in hospitals, such as Klebsiella pneumoniae or Acinetobacter spp.
Last resort antibiotics such as carbapenems are needed to treat these serious infections. According to reported data, however, 8% of sepsis caused by Klebsiella pneumoniae were resistant to carbapenems, increasing the possibility of death from an intractable infection.
In recent years, the WHO has warned that common bacterial infections are becoming increasingly resistant to treatments.
More than 60% of isolated strains of Neisseria gonorrheawhich causes a frequent sexually transmitted infection, showed resistance to one of the most widely used oral antibacterials, ciprofloxacin.
Furthermore, more than 20% of isolated strains of Escherichia coli – the most common agent in urinary tract infections – were 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 Tedros Adhanom, 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 microbiological testing and provide quality-assured data in all countries, not just the richest.”
While most resistance trends have remained stable over the past four years, bloodstream infections due to E coli and Salmonella spp. resistant and resistant gonorrhea infections have increased by at least 15% compared to rates in 2017.
Experts point out that more research is needed to identify the reasons behind the observed increase in resistance and the extent to which it is related to increased hospitalizations and increased antibiotic treatments during the Covid-19 pandemic. The pandemic also meant that several countries were unable to report data for 2020.
New analyzes show that countries with lower test coverage, mostly low- and middle-income countries, are more likely to report significantly higher resistance rates. This can be, in part, attributed to the fact that in many low- and middle-income countries there are only a few referral hospitals that report data to the WHO. These hospitals often serve the sickest patients who may have received prior antibiotic treatment.
As for antimicrobial consumption in humans, 65% of the 27 reporting countries have met the WHO target of ensuring that at least 60% of antimicrobials consumed are from the group of antibiotics that are effective in a wide range of common infections and have a relatively low risk of creating resistance.
Due to insufficient coverage of analytical tests and low laboratory capacity, especially in low- and middle-income countries, it remains difficult to interpret antimicrobial resistance rates.
To overcome this gap, WHO will follow a two-pronged line of work: in the short term, collect evidence through surveys; in the long term, build capacity for systematic surveillance.
(With information from the Pan American Health Organization)
Source: CNN Brasil
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