When bacteria develop resistance to antibiotics, otherwise harmless infections can become deadly. An international group of experts is trying to quantify the extent of the problem.
According to one estimate, more than 1.2 million people around the world died directly from an infection with an antibiotic-resistant pathogen in 2019.
In almost five million deaths, such an infection was at least partly responsible for death, reports an international group of experts in the specialist magazine “The Lancet”. Antibiotic resistance is one of the most common causes of death worldwide.
The researchers had compiled and analyzed data for 2019 from specialist literature, hospital databases, monitoring systems and other sources. Using statistical modelling, the scientists predicted the disease burden for different regions, including those for which no data were available. There have already been studies on individual regions, specific pathogens or individual antibiotics. The present analysis is the most comprehensive so far. Overall, the researchers looked at 204 countries and regions, 23 pathogenic bacteria and 88 combinations of bacteria and antibiotics.
Deaths avoidable without resistance
Doctors usually speak of antibiotic resistance when patients do not react to an antibiotic, i.e. when the disease-causing bacteria are not destroyed by the antibiotic – contrary to what was hoped.
According to the study, 4.95 million deaths were linked to an antibiotic-resistant bacterial infection, even if the direct cause of death was possibly different. 1.27 million people died directly from an infection with a resistant bacterium – without resistance, these deaths were therefore avoidable. For comparison: An estimated 680,000 people died from HIV/AIDS in 2020, and 627,000 from malaria.
Problems with resistance were therefore particularly common in infections of the lower respiratory tract, such as pneumonia. These alone caused 400,000 deaths. A particularly large number of people died as a result of blood poisoning and appendicitis because the infection could not be controlled with antibiotics due to resistant pathogens.
Dreaded hospital germ MRSA
The germs most commonly causing resistance problems included Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae and Streptococcus pneumoniae. The dreaded hospital germ MRSA – methicillin-resistant Staphylococcus aureus – alone caused 100,000 deaths.
According to the study, countries in western sub-Saharan Africa were hardest hit. There were almost 24 deaths for every 100,000 people that could be directly attributed to an infection with a resistant pathogen. In rich countries, the rate was 13 deaths per 100,000 people. Children under the age of five are most at risk.
“These new data reveal the true extent of the antimicrobial resistance problem worldwide and are a clear signal that we must act now,” said co-author Chris Murray of the University of Washington, according to a statement from the journal. “We must use this data to correct course and drive innovation if we are to stay ahead in the race against antibiotic resistance.”
Goal: avoid infections
The aim must be to avoid infections as far as possible through improved hygiene or vaccinations. In addition, the inappropriate use of antibiotics – such as viral infections that do not respond to antibiotics – must be reduced. New antibiotics would have to be developed and brought to market.
The researchers cite the limited availability of data in some parts of the world and the different sources of the data, which can lead to bias, as weaknesses in their study.
Ramanan Laxminarayan of the Center for Disease Dynamics describes the problem of antibacterial resistance as an “overlooked pandemic” in a comment on the study. Although many more people would die from such infections than, for example, from HIV, far more donations went into the fight against HIV and AIDS. That has to change. “A clearer picture of the burden of antimicrobial resistance is now finally emerging from an unrecognized and hidden problem.” dpa
