WHO’s first global report on antibiotic resistance reveals serious, worldwide threat to public health
Antibiotic resistance is now a major threat
to public health – this is the essence of a new,
hard-hitting, report by the World Health
Organization (WHO) released on April 30.
It is the global organisation’s first to look at
antimicrobial resistance, including antibiotic
resistance, globally and reveals that this
serious threat is no longer a prediction for
the future, it is happening right now in every
region of the world and has the potential to
affect anyone, of any age, in any country.
“Without urgent, coordinated action by
many stakeholders, the world is headed
for a post-antibiotic era, in which common
infections and minor injuries which
have been treatable for decades can once
again kill,” says Dr Keiji Fukuda, WHO’s
Assistant Director-General for Health Security.
“Effective antibiotics have been one
of the pillars allowing us to live longer, live
healthier, and benefit from modern medicine.
Unless we take significant actions to
improve efforts to prevent infections and
also change how we produce, prescribe and
use antibiotics, the world will lose more and
more of these global public health goods
and the implications will be devastating.”
The report, Antimicrobial resistance: global report
on surveillance, notes that resistance is occurring
across many different infectious agents
but the report focuses on antibiotic resistance
in seven different bacteria responsible for
common, serious diseases such as bloodstream
infections (sepsis), diarrhoea, pneumonia, urinary
tract infections and gonorrhoea. The results
are cause for high concern, documenting
resistance to antibiotics, especially “last resort”
antibiotics, in all regions of the world.
Key findings from the report
- Resistance to the treatment of last resort
for life-threatening infections caused
by a common intestinal bacteria, Klebsiella
pneumonia – carbapenem antibiotics
– has spread to all regions of the world. K.
pneumoniae is a major cause of hospitalacquired
infections such as pneumonia,
bloodstream infections, infections in newborns
and intensive-care unit patients.
In some countries, because of resistance,
carbapenem antibiotics would not work
in more than half of people treated for K.
- Resistance to one of the most widely
used antibacterial medicines for the treatment
of urinary tract infections caused by E.
coli – fluoroquinolones – is very widespread.
In the 1980s, when these drugs were first
introduced, resistance was virtually zero.
Today, there are countries in many parts of
the world where this treatment is now ineffective
in more than half of patients.
- Treatment failure to the last resort of
treatment for gonorrhoea – third generation
cephalosporins – has been confirmed
in Austria, Australia, Canada, France,
Japan, Norway, South Africa, Slovenia,
Sweden and the United Kingdom. More
than 1 million people are infected with
gonorrhoea around the world every day.
- Antibiotic resistance causes people
to be sick for longer and increases the risk
of death. For example, people with MRSA
(methicillin-resistant Staphylococcus aureus)
are estimated to be 64% more likely to die
than people with a non-resistant form of
the infection. Resistance also increases the
cost of health care with lengthier stays in
hospital and more intensive care required.
Addressing the problem
The report reveals that key tools to tackle
antibiotic resistance – such as basic systems
to track and monitor the problem – show
gaps or do not exist in many countries.
While some countries have taken important
steps in addressing the problem, every
country and individual needs to do more.
Other important actions include preventing
infections from happening in the first
place – through better hygiene, access to
clean water, infection control in healthcare
facilities, and vaccination – to reduce
the need for antibiotics. WHO is also calling
attention to the need to develop new
diagnostics, antibiotics and other tools
to allow healthcare professionals to stay
ahead of emerging resistance.
This report is kick-starting a global effort
led by WHO to address drug resistance.
This will involve the development of tools
and standards and improved collaboration
around the world to track drug resistance,
measure its health and economic impacts,
and design targeted solutions.
People can help tackle resistance by:
- using antibiotics only when prescribed
by a doctor
- completing the full prescription, even if
they feel better
- never sharing antibiotics with others or
using leftover prescriptions.
Health workers and pharmacists can help
tackle resistance by:
- enhancing infection prevention and control
- only prescribing and dispensing antibiotics
when they are truly needed
- prescribing and dispensing the right
antibiotic(s) to treat the illness.
The report – which also includes information
on resistance to medicines for treating
other infections such as HIV, malaria, tuberculosis
and influenza – provides the most
comprehensive picture of drug resistance to
date, incorporating data from 114 countries.
WHO’s Global Report on Surveillance
of Antimicrobial Resistance
Report highlights for WHO
Eastern Mediterranean Region
Data in the report show extensive antibiotic
resistance across the WHO
Eastern Mediterranean Region. In particular,
there are high levels of E. coli
resistance to third generation cephalosporins
and fluoroquinolones – two
important and commonly used types of
antibacterial medicine. Resistance to
third generation cephalosporins in K.
pneumoniae is also high and widespread.
In some parts of the Region, more than
half of Staphylococcus aureus infections
are reported to be methicillin-resistant
(MRSA), meaning that treatment with
standard antibiotics does not work. The
report reveals major gaps in tracking
of antibiotic resistance in the Region.
WHO’s Regional Office for the Eastern
Mediterranean has identified strategic
actions to contain drug resistance and
is supporting countries to develop comprehensive
national policies, strategies
of upload: 12th May 2014