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Antibiotic-resistance, alarming data from the WHO

On 29 January 2018 the first WHO surveillance data on antibiotic resistance were released, revealing high levels of resistance to a series of serious bacterial infections in high and low income countries.

WHO's new global antimicrobial surveillance system (GLASS) reveals a widespread antibiotic resistance event among 500,000 people with suspected bacterial infections in 22 countries.

The most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Streptococcus pneumoniae, followed by Salmonella. The system does not include data on the resistance of Mycobacterium tuberculosis, which causes tuberculosis (TB), since the WHO has been monitoring it since 1994 and provides annual updates in the global tuberculosis report.

Among patients with suspected bloodstream infection, the proportion of bacteria resistant to at least one of the most commonly used antibiotics varied widely between countries, from zero to 82%. Penicillin resistance - the medicine used for decades around the world to treat pneumonia - ranged from zero to 51% among the reporting countries. While it ranged between 8% and 65% for Escherichia coli associated with urinary tract infections that presented resistance to ciprofloxacin, an antibiotic commonly used to treat this condition.

"The report confirms the serious situation of antibiotic resistance all over the world", says dr. Marc Sprenger, Director of the WHO Anti-microbial Resistance Secretariat.

"Some of the most common infections in the world - and potentially more dangerous - are proving to be drug-resistant," adds Sprenger. "And especially worrying, pathogens do not respect national borders, which is why WHO is encouraging all countries to set up good surveillance systems to detect drug resistance that can provide data to this global system."

To date, 52 countries (25 high-income, 20 middle-income and 7 low-income) are enrolled in the WHO global antimicrobial surveillance system. For the first report, 40 countries provided information on their national surveillance systems and 22 countries also provided data on antibiotic resistance levels.

"The report is a critical first step to improving our understanding of the extent of antimicrobial resistance: surveillance is in its infancy, but it is crucial to develop it if we want to anticipate and tackle one of the biggest threats to global public health," says Dr. Carmem Pessoa-Silva, who coordinates the new WHO surveillance system.

For these reasons, WHO is supporting more countries to establish national antimicrobial resistance surveillance systems capable of producing reliable and meaningful data. GLASS is helping to standardize the way countries collect data and provide a more complete picture of antimicrobial resistance patterns and trends.

Solid surveillance programs on drug resistance in tuberculosis, HIV and malaria have been operating for many years and have contributed to estimating the burden of disease, planning diagnostic and therapeutic services, monitoring the effectiveness of control interventions and designing therapeutic regimens. effective in dealing with and preventing future resistance. GLASS is expected to perform a similar function for common bacterial pathogens.

The launch of GLASS is already making a difference in many countries. For example, Kenya has enhanced the development of its national antimicrobial resistance system; Tunisia has started to aggregate data on antimicrobial resistance at the national level; the Republic of Korea has completely revised its national surveillance system to align itself with the GLASS methodology, providing data of the highest quality and completeness; and countries such as Afghanistan or Cambodia facing major structural challenges have joined the system and are using the GLASS framework as an opportunity to strengthen their AMR surveillance capabilities. In general, national participation in GLASS is seen as a sign of increasing political commitment to support global efforts to control antimicrobial resistance.