From the Guidelines
The global prevalence of antimicrobial resistance (AMR) pathogens is a significant and growing concern, with approximately 1.27 million people dying from AMR in 2019, and this number is expected to rise to 10 million deaths per year by 2050 if current trends continue. The most recent evidence suggests that AMR is a major health challenge, with substantial morbidity and mortality worldwide 1. The primary drivers of AMR include:
- Inappropriate antibiotic prescribing
- Poor infection control practices
- Limited diagnostic capabilities
- Agricultural antibiotic use
- Inadequate surveillance systems
The most concerning AMR pathogens include:
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin-resistant Enterococci (VRE)
- Carbapenem-resistant Enterobacteriaceae (CRE)
- Extended-spectrum beta-lactamase (ESBL) producing organisms
- Multidrug-resistant tuberculosis (MDR-TB)
Regional variations exist, with higher AMR rates typically found in low and middle-income countries, particularly in parts of Asia, Africa, and Latin America, where antibiotic use is less regulated 1. Healthcare-associated infections show particularly high resistance rates, with some intensive care units reporting over 50% resistance rates for common pathogens. To address this crisis, healthcare providers should implement antimicrobial stewardship programs, use narrow-spectrum antibiotics when possible, obtain appropriate cultures before starting antibiotics, adhere to recommended treatment durations, and follow local resistance patterns when selecting empiric therapy. The use of genomics for AMR surveillance has been recommended as an essential part of routine surveillance programs, as it can provide a high-resolution picture of the transmission dynamics and evolution of microbial pathogens 1.
From the Research
Prevalence of AMR Pathogens Globally
- The prevalence of Antimicrobial Resistance (AMR) pathogens is a significant concern globally, with approximately 5 million deaths associated with bacterial AMR in 2019 2.
- It is estimated that 700,000 people die from AMR every year, and this number is predicted to increase to 10 million by 2050 if immediate action is not taken 3.
- The burden of AMR is disproportionately higher in Low Middle Income Countries (LMICs) due to various factors such as environmental, social, healthcare, and cultural barriers 3.
- AMR is a global problem that affects multiple domains, including healthcare, agriculture, aquaculture, and more, and is predicted to have profound consequences if not addressed adequately 4.
Global AMR Trends
- Historical trends reveal antibiotic discoveries, resistance periods, resistance genes, and multidrug-resistant pathogens, providing insights into the evolution of the crisis and the emergence of multidrug-resistant pathogens 3.
- The current state of AMR reflects the negative consequences of AMR for clinical medicine and healthcare systems, and emphasizes the need for immediate action to mitigate its impact 3.
- Future trends anticipate the trajectories of AMR and discuss innovative approaches to combat resistance, including the exploration of alternative therapies and the implementation of stewardship programs 3.
Factors Contributing to AMR
- The overuse and misuse of antimicrobials, particularly the inappropriate usage of antibiotics, are prominent causes contributing to the current AMR crisis 4.
- The global consumption and usage of antibiotics are closely monitored, and strategies such as the "One Health Approach" are being implemented to address the problem of antibiotic resistance 4.
- Public awareness and health literacy of lay audiences are essential components of global and local action plans to address AMR 4.