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While COVID-19 dominates the world's attention, bacterial antimicrobial resistance (AMR) is a growing cause of morbidity and mortality. Now, the Antimicrobial Resistance Collaborators group, which includes investigators at the Institute of Health Metrics and Evaluation, have estimated the number of deaths related to AMR globally. The group used two counterfactual scenarios to evaluate the impact of AMR:
They estimated deaths attributable to AMR (the comparator was a hypothetical scenario in which drug-resistant infections were replaced by drug-susceptible infections).
They calculated deaths associated with AMR (the comparator was a scenario in which drug-resistant infections were replaced by no infections).
Based on data from around the world and predictive statistical modeling, the number of deaths associated with bacterial AMR in 2019 was 4.95 million, with 1.27 million deaths directly attributable to AMR. The region with the highest death rate attributable to resistance was western sub-Saharan Africa (perhaps because of higher frequency of infections, scarcity of microbiologic testing, and fewer antibiotic options). Lower respiratory tract infections accounted for the greatest number of deaths from infectious syndromes. The pathogens associated with the greatest numbers of deaths associated with resistance were (in descending order) Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa.
Collaborators AR.Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet 2022 Jan 19; [e-pub]. (https://doi.org/10.1016/S0140-6736(21)02724-0)
Comment
The findings of this ambitious analysis highlight the critical need to respond to the threat of antimicrobial resistance as forcefully as we address other pandemics, like COVID-19 and HIV. We have a sense of what it will take, including antimicrobial stewardship, infection control, reducing antibiotic use in animals, and development of new antimicrobials and vaccines. Now, we need to muster the resources and focus to make combating antimicrobial resistance one of our highest healthcare priorities.