Bacterial antimicrobial resistance (AMR) has become one of the main public health threats of the 21st century. This is the main idea of a new study on drug resistance, published in the scientific journal The Lancet. 'Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis' estimates that more than 1.2 million people died that year from drug-resistant bacterial infections. antibiotics, which represents a higher number of deaths compared to those associated with other diseases such as AIDS or malaria. The research shows that AIDS and malaria caused 860,000 and 640,000 deaths, respectively, during the year under study.
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Bacterial antimicrobial resistance occurs "when changes in bacteria make drugs used to treat infections less effective." The consequence of drug resistance (to antibiotics and other drugs) is that certain infections are increasingly difficult to treat.
Until now, the study indicates, it was estimated that bacterial resistance to antimicrobials could cause the death of 10 million people in the year 2050. Although these predictions have been questioned, The OMS and numerous groups of researchers "agree that the spread of AMR is an urgent problem that requires a global and coordinated plan of action." If left unchecked, the researchers warn, its spread "could make many bacterial pathogens much more deadly in the future" than they already are today.
"These new data reveal the true magnitude of antimicrobial resistance around the world and are a clear signal that we must combat the threat," said study co-author Professor Chris Murray of the Institute for Health Metrics and Evaluation. from the University of Washington. "Previous estimates predicted 10 million annual AMR deaths by 2050, but we now know for sure that we are already much closer to that number than we thought," adds Murray. The scientist has asked to take advantage of the data available to "correct course" and also to promote innovation in this field of study.
The new Global Research on Antimicrobial Resistance (GRAM) report estimates deaths related to 23 pathogens and 88 pathogen-drug combinations in 204 countries and territories in 2019. To do this, statistical models have been used to produce estimates of the impact of RAM in all places – also in the places for which they have no data. On the one hand, the investigation calculates that resistance to these types of drugs has directly caused 1.27 million deaths during the course of 2019; on the other, it also indicates that resistant infections played some kind of role in 4.95 million deaths.
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All these estimates have been made for 204 countries, so the article also concludes that, although it is true that this threat hits low-income countries hardest, it also greatly affects countries with higher incomes.
The places where the highest number of deaths directly related to AMR have been detected are located in sub-Saharan Africa and South Asia, with 24 deaths per 100,000 inhabitants and 22 deaths per 100,000 inhabitants, respectively. The disease was associated with 99 deaths per 100,000 inhabitants in sub-Saharan Africa and 77 in Asia.
The study also concludes another point to take into account and that is the difference in the number of deaths that exists between rich and poor countries. In high-income countries, AMR caused 13 deaths per 100,000 population and was associated with 56 deaths per 100,000 people.
"Since resistance varies so much by country and region, it is essential to improve data collection around the world to help us better track resistance levels," said study co-author Professor Christiane Dolecek. , scientific director of the GRAM, based at the Center for Tropical Medicine and Global Health at the University of Oxford. "We have found serious data gaps in many low-income countries, highlighting the need to increase laboratory and data collection capacity in these locations." The lack of available data in some parts of the world, the study authors themselves acknowledge, may limit the accuracy of the estimates for those sites.
On the other hand, and although resistance to this type of drug is considered a threat for all ages, "young children are at especially high risk, since one in five deaths attributable to AMR occurs in younger children of five years". Pneumonia, bloodstream infections -which are the ones that give rise to a life-threatening condition, sepsis- and intra-abdominal infections -normally derived from appendicitis- are the ailments that present the most drug resistance, adds the study.
For the epidemiologist Ramanan Laxminarayan, from the Center for Disease Dynamics, Economics & Policy, in the USA, AMR has gone from being an unknown disease to a public health problem. "From being an unrecognized and hidden problem, a clearer picture of the burden of AMR is finally emerging. Even the lowest figure of 911,000 deaths estimated by Murray and colleagues is higher than that of HIV (860,000). However However, global spending to deal with AMR is probably much lower" than the 50,000 million dollars a year dedicated to AIDS, compares the scientist in statements included in the press release. Laxminarayan calls for increased spending to prevent antimicrobial resistance, for spending to be directed at infection prevention and to ensure that the antibiotics used today are used appropriately. Finally, he asks that health professionals and politicians take seriously the importance of dealing with the disease and that "access to affordable and effective antibiotics" be improved.