Antibiotic Resistance a Serious Threat to Global Public Health

Troy Brown, RN

April 30, 2014

Antibiotic resistance is occurring all over the world in bacteria responsible for common but serious infections, including sepsis, diarrhea, pneumonia, urinary tract infections, and gonorrhea, according to a new report from the World Health Organization (WHO).

Experts from the WHO held a press conference in Geneva, Switzerland, today to present data from the organization's first global report on antimicrobial resistance and antibiotic resistance in 114 countries. The report is the most comprehensive report of drug resistance to date and includes information on drug resistance in other infections including HIV, malaria, tuberculosis, and influenza.

Antimicrobials have been one of the foundations of modern healthcare, Keiji Fukuda, MD, assistant director-general for Health Security, WHO, explained. Antimicrobial resistance occurs when bacteria change so that antibiotics and antimicrobials are no longer effective against them.

"This report documents that resistance is a global trend," Dr. Fukuda said. "This is not a regional phenomena, this is not a phenomena occurring in just poor countries or developing countries, or in rich countries or developed countries. This is something which is occurring in all countries in the world."

Dr. Fukuda emphasized that antimicrobial resistance is no longer a problem of the future, but one that is occurring today.

"All of us...when we are most vulnerable and in need of these medicines, there is a chance that they are simply not going to be available, and we are not going to have access to effective medical care in a number of instances," Dr. Fukuda added. Vulnerable patients include those receiving chemotherapy, premature babies, malnourished children, and surgical patients.

Common diseases can be very serious when antimicrobials are ineffective. Diarrhea is a common disease that is usually self-limited, but when it is resistant to antimicrobials, it can become very serious and even fatal, Carmem Pessoa, MD, PhD, team leader, antimicrobial resistance, WHO, said.

Critical Findings

  • All regions of the world are experiencing resistance to carbapenem antibiotics for treatment of Klebsiella pneumoniae, a major cause of hospital-acquired infections including pneumonia, bloodstream infections, and infections in newborns and intensive care unit patients. Carbapenem antibiotics are last-resort treatment for K pneumoniae and are ineffective in more than half of those treated for K pneumoniae infections in some countries.

  • Resistance to fluoroquinolones, one of the most commonly used antibiotics for the treatment of Escherichia coli–caused urinary tract infections, is very widespread. Fluoroquinolones are now ineffective in more than half of patients in some countries.

  • Third-generation cephalosporins, the last-resort treatment for gonorrhea, have been found to be ineffective in Austria, Australia, Canada, France, Japan, Norway, South Africa, Slovenia, Sweden, and the United Kingdom. At least 1 million people are infected with gonorrhea around the world every day.

  • Antibiotic resistance causes patients to be ill longer and increases the risk for death. It is estimated that patients with methicillin-resistant Staphylococcus aureus are 64% more likely to die than those with a nonresistant form of the infection. Healthcare costs are increased in patients with antimicrobial-resistant infections because of longer hospital stays and the need for more intensive care.

Key Measures Lacking

Key measures, including basic tracking and monitoring systems, are either inadequate or nonexistent in many countries. Although some countries are addressing the problem, much still needs to be done. The need for antibiotics can be reduced by infection control measures, including improved hygiene, access to clean water, infection control in healthcare facilities, and vaccination.

Healthcare professionals need new diagnostics, antibiotics, and other tools to head off emerging resistance.

Global Effort Needed

"This is a somewhat grim picture...but it's not a hopeless picture," Dr. Fukuda said. Countries that address this issue will be able to bring it under control.

The WHO is leading a global effort to address drug resistance, which includes the development of tools and standards and better collaboration globally to track drug resistance, measure its health and economic effects, and develop targeted solutions.

Individuals should use antibiotics only when prescribed by a healthcare provider, use the entire prescription even if they feel better, and avoid sharing antibiotics with others or using leftover prescriptions.

Healthcare workers and pharmacists should enhance infection prevention and control, prescribe and dispense antibiotics only when they are truly needed, and prescribe and dispense the appropriate antibiotic or antibiotics to treat the illness.

Policymakers should strengthen resistance tracking and laboratory capacity and regulate and promote appropriate use of medications. Policymakers and industry should foster innovation and research and the development of new tools and should encourage cooperation and information sharing among all stakeholders.

"Global Report on Surveillance of Antimicrobial Resistance: 2014." WHO. Summary

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