According to a report published in the medical journal Lancet, at least 1.2 million people died in 2019 as a direct result of antibiotic-resistant bacterial illnesses. This is by far the most detailed estimate of antimicrobial resistance’s global impact.

The study, which included 204 nations and territories, discovered that antimicrobial resistance (AMR) was now the top cause of death worldwide, surpassing HIV/AIDS and malaria. As a result of medication resistance in the bacteria that cause common, formerly treatable diseases such as lower respiratory and bloodstream infections, hundreds of thousands of people die each year.

The report emphasizes the urgent need for policymakers to take immediate action to combat AMR and outline immediate actions that will help save lives and protect health systems. These include maximizing the use of existing antibiotics, increasing efforts to monitor and control infections, and increasing financing for the development of new antibiotics and treatments.

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“These new findings expose the full global scope of antimicrobial resistance and serve as a strong signal that we must act now to address the threat.” Previous predictions indicated that antimicrobial resistance would kill 10 million people per year by 2050, but we now know that we are now much closer to that statistic than we expected. “If we want to stay ahead in the race against antimicrobial resistance, we need to use this data to course-correct behavior and encourage innovation,” said research co-author Chris Murray of the University of Washington’s Institute for Health Metrics and Evaluation.

Estimates of the health implications of AMR have been published for various countries and regions, as well as for a small number of pathogen-drug combinations in a larger variety of locales. However, according to the researchers, no estimations have previously covered all regions as well as a wide range of infections and therapy combinations.

The new Global Research on Antimicrobial Resistance (GRAM) report estimates mortality linked to 23 infections and 88 pathogen-drug combinations in 204 countries and territories in 2019.

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“Using 471 million individual records gathered from comprehensive literature reviews, hospital systems, surveillance systems, and other data sources, statistical modeling was applied to create estimates of the impact of AMR in all sites – including those with no data,” according to the research.

The disease burden was calculated in two ways: deaths directly caused by AMR (deaths that would not have happened if the infections had been drug-susceptible and thus more curable) and deaths associated with AMR (ie where a drug-resistant infection was implicated in deaths, but resistance itself may or may not have been the direct cause). AMR-related deaths were calculated for 204 countries and territories and reported for 21 worldwide regions and seven super-regions.

According to the data, AMR was directly responsible for an estimated 1.27 million deaths worldwide in 2019 and was related to an estimated 4.95 million deaths. In 2019, HIV/AIDS and malaria are expected to have killed 860,000 and 640,000 people, respectively.

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Drug resistance in lower respiratory diseases, such as pneumonia, had the highest impact on AMR disease burden, causing over 400,000 fatalities and being linked to over 1.5 million deaths. Drug resistance in bloodstream infections, which can lead to the life-threatening illness sepsis, was responsible for almost 370,000 deaths and was linked to roughly 1.5 million deaths. Drug resistance in intra-abdominal infections, most usually caused by appendicitis, was directly responsible for approximately 210,000 deaths and was related to approximately 800,000.

While AMR is a concern to people of all ages, small children were shown to be more vulnerable, with approximately one in every five AMR-related deaths happening in children under the age of five.

Direct AMR-related mortality was estimated to be highest in Sub-Saharan Africa and South Asia, with 24 and 22 deaths per 100,000 people, respectively. AMR was linked to 99 fatalities per 100,000 people in Sub-Saharan Africa and 77 deaths per 100,000 people in South Asia. AMR caused 13 fatalities per 100,000 people in high-income nations and was linked to 56 deaths per 100,000 people.

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Drug resistance in six infections alone (E Coli, S aureus, K pneumoniae, S pneumoniae, A baumannii, and P aeruginosa) was directly responsible for 929,000 deaths and was related to 3.57 million deaths. In 2019, one pathogen-drug combination — methicillin-resistant Staphylococcus aureus, or MRSA – directly caused more than 100,000 deaths, while six others each caused 50,000 to 100,000 deaths.

Resistance to two types of medications commonly regarded as a first-line defense against serious infections – fluoroquinolones and beta-lactam antibiotics – accounted for more than 70% of AMR deaths across all pathogens.

The health impact of pathogens varied greatly depending on location, with S pneumonia (16 percent of deaths) or K pneumonia (20 percent of deaths) accounting for the majority of AMR deaths in Sub-Saharan Africa, while Slead-based aureus (26 percent) and E. coli (20 percent) accounted for roughly half of AMR deaths in high-income countries (23 percent ).

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“Because resistance varies so greatly by country and region, improving data collection globally is critical to assisting us in better tracking levels of resistance and equipping clinicians and policymakers with the information they need to address the most pressing challenges posed by antimicrobial resistance.” “We discovered significant data gaps in many low-income nations, emphasizing the importance of increasing laboratory capacity and data collection in these areas,” stated research co-author Christiane Dolecek.