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Reports worldwide highlight the rise in antimicrobial resistance (AMR), underscoring the need to step up surveillance and pathogen testing, more prudent use of prescription antibiotics, and simple hygiene to reduce this threat to world health and economies.
The data on AMR is sobering, according to the Organisation for Economic Co-operation and Development (OECD). In absence of immediate action, AMR could claim more than 2 million lives in Europe, North America, and Australia by 2050, OECD summarized in a recent report. “Resistance to backup antibiotics (second and third line) will be 70% higher in 2030 compared to 2005 in OECD countries,” the authors predicted.
Highest absolute death rates are projected for the United States, Italy, and France, “with almost 30,000 AMR deaths a year forecast in the U.S. alone by 2050,” according to OECD. Americans are apparently aware of this health threat. A recent public opinion survey commissioned by Research!America in collaboration with the Infectious Disease Society of America found that 81% of Americans are worried that AMR will make it challenging or even impossible to fight infection.
In European Union countries, OECD anticipates that resistance to third-line antibiotic treatments will double by 2050. Separately, the European Centre for Disease Prevention and Control (ECDC) found evidence of unnecessary antimicrobial use in hospitals and in long-term care facilities. “ECDC estimates that on any given day one in 15 patients in European hospitals, and one in 26 residents in long-term care facilities, have at least one healthcare-associated infection. Many of them were caused by multidrug-resistant bacteria,” the organization said in a statement.
The dangers related to AMR aren’t just limited to hospitals. Addressing this topic in the December issue of Clinical Laboratory News, Jen Miller wrote that “mild conditions easily treated by antibiotics are showing resistance too, and without treatment, could lead to life-threatening illnesses.”
Antibiotic consumption worldwide has no set pattern. A report from the World Health Organization (WHO) revealed that some countries overuse these drugs while others struggle to fight off infectious diseases due to limited access to antibiotics. WHO looked at 2015 data in 65 countries and areas and found wide variations in consumption. Mongolia averaged the highest dose levels, at 64 doses per 1,000 individuals per day, whereas Burundi averaged only 4 doses per 1,000 per day.
“Findings from this report confirm the need to take action to ensure that antibiotics are used appropriately, such as enforcing prescription-only policies and implementing antimicrobial stewardship programs,” WHO concluded. The organization called on governments to strengthen the supply chain and procurement process of antibiotics to ensure that all countries have access to needed medications. WHO also urged investments on national surveillance of antibiotic use, pointing to certain areas of the world that lack such data systems.
“Reporting and sharing data on antimicrobial consumption both nationally and internationally is an essential element of surveillance and provides important information in the global fight against antimicrobial resistance,” the report’s authors wrote. Some countries have already begun to evaluate their supply chain and procurement procedures as a means to strengthen their pharmaceutical systems.
In the Research!America report, 81% of Democrats, 76% of Republicans and 70% of Independents thought federal funds should support research and public health initiatives to address AMR. “Americans are calling for ‘all hands on deck’ to confront AMR—the government, the private sector, health professionals, hospitals and individuals,” said Mary Woolley, Research!America president and CEO in a statement.
OECD suggests that affordable solutions are within reach. Low-cost measures such as hand washing and more judiciousness in prescribing antibiotics could prevent 47,000 deaths in OECD countries due to superbug infections. The cost of these investments is about $2 per person per capita per year—a price tag even lower income countries could afford, according to the authors of the OECD report. “The public health package could pay for itself within just one year,” saving $4.8 billion per year in OECD countries, they suggested.
Shortening the time it takes to diagnose bacterial infections and rule out the need for antibiotics is another way to combat AMR, Miller wrote in December’s CLN. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry is a promising molecular technology that quickly and accurately reveals what an organism is. The limitation of MALDI-TOF is it can’t identify which antibiotics would work against a particular organism.
“Clinicians can also look at data generated by other labs to identify what has traditionally worked against that specific infection and guide drug deployment,” Miller wrote.