While the Covid-19 rages, the pAndemia of antimicrobial resistance (AMR, for its acronym in English) remains in the shadows. Their consequences for patients and their families are largely invisiblebut are reflected in Prolonged bacterial infections that lengthen stays in hospitals and sanatoriums and cause unnecessary deaths.
Nearly 1.27 million people died worldwide in 2019 from common bacterial infections that have become resistant to antibiotics, according to a very recently published study by The Lancet.
The research, carried out with data from 204 countriesreveals that the AMR has become one of the leading causes of death on the planet, even being located above diseases like AIDS and malaria. Expert analysis indicates that this resistance caused 1.27 million deaths in 2019, but also that antimicrobial-resistant infections were linked to 4.95 million deaths.
Antimicrobial resistance occurs when microorganisms (bacteria, fungi, viruses and parasites) undergo changes when exposed to drugs (antibiotics, antifungals, antivirals, antimalarials or anthelmintics, for example). The Antibiotic resistance is a natural phenomenonbut misuse of medications in humans and animals is speeding up the process.
From using them so much, especially when they are not necessary (somehow the belief spread that antibiotics in particular cure everything, when they are not), microorganisms become resistant. And when that resistance spreads to most antimicrobials, they already become ultra resistant. As a result, medications become ineffective and infections persist in the body of the sick person.
Chris Murray, from the Institute for Health Metrics and Evaluation of the University of Washington (United States) and co-author of the work published in The Lancetpoints out that “the new data we obtained reveals the true magnitude of antimicrobial resistance around the world, and is a clear signal that we must act now to combat the threat.”
And he adds: “Previous estimates foresaw 10 million annual deaths from antimicrobial resistance by 2050but now we know for sure that we are already much closer to that number than we thought.”
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The new global research on antimicrobial resistance, the largest study of its kind to date, estimates deaths related to 23 different bacteria and 88 pathogen-drug combinations in 204 countries.
To do this, the authors used 471 million individual records obtained from different data sources. In addition, they divided the deaths into two types: deaths caused directly by antimicrobial resistance, that is, those that would not have occurred if the infections were susceptible to drugs; and those linked to AMR, which are those that were caused by a drug-resistant infection, but for which it is not certain whether this resistance was the direct cause of death.
According to the results of the analysis, in 2019 AMR directly caused 1.27 million deaths worldwideY was associated with approximately 4.95 million deaths. AIDS and malaria are estimated to have caused 860,000 and 640,000 deaths, respectively, that same year. Bacterial resistance to antibiotics is now the third leading cause of death worldwide.
The drug-resistant infections that caused more deaths were the respiratory (such as pneumonia), with more than 400,000 direct and linked to more than 1.5 million; those of the bloodstream, which caused around 370,000 deaths and were associated with almost 1.5 million deaths; and the intra-abdominal (case of appendicitis), which directly produced some 210,000 deaths and were related to another 800,000.
“There is an increasing number of infections, for example, pneumonia, tuberculosis, gonorrhea and salmonellosis, whose treatment becomes more difficult due to the loss of efficacy of antibiotics,” warn experts from the World Health Organization (WHO). ).
Antibiotic resistance is reaching such dangerous levels that the WHO estimates that by 2050 deaths from antibiotic-resistant bacterial infections will exceed those caused by cancer. If the trend continues, in thirty years around 10 million people could die each year due to bacterial resistance to drugs. This has led to consider the resistance of bacteria to antibiotics as one of the three greatest threats to human health in the coming decades.
Children and poor countries
Although bacterial drug resistance poses a threat to people of all ages, children are at particularly high risk: One in five deaths attributable to AMR occurs in children under the age of five.
Deaths caused directly by AMR are estimated to be highest in sub-Saharan Africa and South Asia, with 24 and 22 deaths per 100,000 inhabitants, respectively. Furthermore, it was associated with 99 deaths per 100,000 population in sub-Saharan Africa and 77 per 100,000 population in South Asia.
In high-income countries, antibiotic resistance directly caused 13 deaths per 100,000 population and was associated with 56 deaths per 100,000 population.
Of the 23 pathogens studied, the drug resistance of six of them (E. coli, S. aureus, K. pneumoniae, S. pneumoniae, A. baumannii, and P. aeruginosa) directly caused 929,000 deaths and was associated with 3.57 million.
However, the impact of these pathogens varies by location. Deaths in sub-Saharan Africa were most often caused by S. pneumonia (16%) or K. pneumonia (20%), while about half of MRA-attributable deaths in high-income countries were caused by S. aureus (26%) or E. coli (23%).
“Given the resistance varies so substantially by country and regionimproved data collection around the world is essential to help us better track resistance levels and equip clinicians and policymakers with the information they need to address the most pressing challenges posed by drug resistance. antimicrobials,” says study co-author Christiane Dolecek of the Center for Tropical Medicine and Global Health at the University of Oxford and Mahidol Oxford Tropical Medicine Research Unit in the UK.
“Even the lower figure of 911,000 deaths estimated by Murray and his colleagues is higher than that of HIV, which costs about $50 billion a year. However, global spending to tackle AMR is probably much lower than that,” says Ramanan Laxminarayan of the Center for Disease Dynamics, Economics & Policy (in the United States).
“We’ve long been pointing out the threat posed by antimicrobial resistance. And also what needs to be done to address it: increase public awareness, improve surveillance and diagnostics, make more rational use of antibiotics, provide access to clean water and sanitation, and invest more in antimicrobials and vaccines. But the action has been episodic and uneven, resulting in global inequalities,” summarizes an editorial from The Lancet that accompanies the published research.
And they conclude: “Innovation has been extremely slow. Vaccines are available for only one of the six main pathogens described in the study. clinical portfolio of antibiotics is too small to address the growing emergence and spread of antimicrobial resistance.
Courtesy SINC Agency
by SINC Agency
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