MORE than 39 million people across the world could die from antibiotic-resistant infections over the next 25 years, a global analysis has found.
Over one million people died each year between 1990 and 2021 as a result of antimicrobial resistance (AMR), researchers said – warning that this number could increase by 70 per cent by 2050.
Millions may die in the next 25 years due to growing resistance to antimicrobial drugs
Researchers say “now is the time to act” to protect people across the world from the threat posed by resistance to vital drugs.
AMR occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve to become resistant to the drugs that are used to treat them.
This means that the medicines become less effective or completely ineffective – making infections harder to treat and increasing the risk of disease spread, severe illness and even death, according to the World Health Organization (WHO).
WHO has described AMR as “one of the top global public health and development threats”.
A new study by the Global Research on Antimicrobial Resistance (GRAM) Project tracked global AMR trends over the years and predicted how these would change over time.
Researchers estimated that 1.91 million people could potentially die as a direct result of AMR in 2050, an increase of almost 70 per cent per year compared to 2022.
They predicted that resistance to drugs may also play a role in the deaths of 8.2 million per year people per year by 2050, up from 4.7 million in 2022 – that’s an almost 75 per cent increase.
The researchers warned that specific groups would be more at risk of AMR.
They observed that AMR deaths in children younger than five fell by 50 per cent between 1990 and 2021.
Meanwhile, deaths in people aged 70 and older shot up by more than 80 per cent.
This trend will likely continue in the next few decades, researchers reckoned.
They predicted that global AMR deaths among over-70s would double by 2050, while those in children under five would be halved in the same time period.
Study author Dr Mohsen Naghavi, from the University of Washington, said: “Antimicrobial medicines are one of the cornerstones of modern healthcare, and increasing resistance to them is a major cause for concern.
“These findings highlight that AMR has been a significant global health threat for decades and that this threat is growing.
“Understanding how trends in AMR deaths have changed over time, and how they are likely to shift in future, is vital to make informed decisions to help save lives.”
Dr Colin Brown, deputy director the UK Health Security Agency’s (UKHSA) AMR division, commented on the findings: “This report is another reminder that antibiotic resistance is a threat to all of us – not just in the future but now.
“If more infections continue to become resistant to treatment, lives will continue to be lost and we need universal action to turn this tide.”
Recent national surveillance data shows that the number of antibiotic resistant infections in England rose by 4 per cent between 2021 and 2022 – from 55,792 to 58,224.
Deaths due to severe antibiotic resistant infections also increased in that time period, from 2,110 to 2,202.
AGE-RELATED SHIFTS
The team’s findings reveal that more than one million lives were lost each year as a direct result of AMR between 1990 and 2021.
In 1990, 1.06 million people passed away directly due to AMR – with the deaths of 4.78 million people were linked to AMR.
As for 2021, AMR led directly to 1.14 million deaths and was associated with 4.71 million deaths.
Deaths directly from AMR increased most in five regions: western sub-Saharan Africa, Latin America, North America, Southeast Asia, and South Asia.
Over those three decades, researchers noted a major shift in AMR death trends when it came to the age of those affected.
AMR-related deaths in children under the age of five decreased by more than 50 per cent, coinciding with improvements to vaccine programmes for babies and young children, as well as other infection prevention and control measures.
What is AMR?
Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death.
It can make historically treatable illnesses harder to combat too.
According to an earlier report published by the GRAM project, everyone is at risk from AMR, but the data showed that young children are particularly affected.
In 2019, one in five deaths attributable to AMR occurred in children under the age of five.
It’s possible to become resistant to medications aside from antibiotics.
Antimicrobials can be grouped according to the microorganisms they target, so antifungals kill fungi, antibiotics attack bacteria, antivirals are used viruses, and antiparasitics treat parasites.
One of the major contributors to AMR is the overuse and misuse of antimicrobials, according to the AMR Narrative.
One of the ways this can happen is if doctors prescribe antibiotics based on symptoms a patient presents, rather than a confirmed diagnosis.
Common medical conditions where antibiotics are prescribed unnecessarily are flu, colds, and COVID-19 which are caused by viruses as opposed to bacteria.
How can I take antibiotics responsibly?
Don’t take antibiotics unnecessarily – you should never take antibiotic when you have an illness caused by a virus, as you’re putting yourself at risk of getting antibiotic resistance
Don’t double dose if you forget to take your antibiotics
Don’t stop taking antibiotics if it looks like the infection is getting better
Don’t keep an unfinished course of antibiotics to take later or pass round to friends and family
Regular hand-washing is one of the most basic but crucial ways to reduce the spread of resistant bacteria
Source: AMR Narrative
Despite the decline in the overall number of deaths, researchers noted that that the proportion of infectious deaths caused directly by AMR increased by 13.6 per cent among children under five years between 1990 and 2021.
Study author Dr Kevin Ikuta, of the University of California Los Angeles (UCLA), explained: “The fall in deaths from sepsis and AMR among young children over the past three decades is an incredible achievement.
“However, these findings show that while infections have become less common in young children, they have become harder to treat when they occur.”
At the same time, AMR deaths among adults 70 years or older increased by more than 80 per cent.
Researchers said this is due to rapidly ageing populations and older people’s greater vulnerability to infections.
“The threat to older people from AMR will only increase as populations age,” Dr Ikuta warned.
“Now is the time to act to protect people around the world from the threat posed by AMR,” he urged.
COMMON CULPRITS
The GRAM Project report showed that bugs are becoming increasingly resistant to vital antimicrobials medicines.
Deaths due to methicillin-resistant S. aureus (MRSA) increased the most globally, leading directly to 130,000 deaths in 2021 – more than doubling from 57,200 in 1990.
MRSA refers to an infection caused by a type of staph bacteria that’s become resistant to many of the antibiotics used to treat ordinary staph infections.
Among Gram-negative bacteria – some of the most resistant to antimicrobial drugs – resistance to carbapenems (antibiotics used to treat severe bacterial infections) increased more than any other type of antibiotic, from 127,000 in 1990 to 216,000 in 2021.
ACT NOW
The authors estimated that AMR deaths will increase steadily in the coming decades based on current trends.
They predicted that 1.91 million people would die each year directly due to AMR by 2050 – a 67.5 per cent increase on the 1.14 million deaths in 2021.
Researchers added that AMR may also play an indirect role in 8.22 million deaths by that time.
In total, they estimated AMR will lead directly to more than 39 million deaths between 2025 and 2050, and be associated with a broader 169 million deaths.
The team predicted that deaths from AMR will be highest in South Asia – including countries like India, Pakistan, and Bangladesh – forecasting that 11.8 million people may die directly due to AMR between 2025 and 2050.
While they said that deaths in people over 70 would rise globally, researchers noted regional differences in their predictions.
The team said deaths adults in North Africa and the Middle East would bear the brunt of it, predicting that deaths among over-70s would surge by 234 per cent by 2050 in these regions.
Meanwhile, deaths among people 70 years and older in high-income countries will rise by 72 per cent in that same time period, researchers estimated.
We can all help by only taking antibiotics if you have been told to do so by a healthcare professional. Do not save some for later or share them with friends and family. Treat antibiotics with respect and they will be there to help us all in the future
Dr Colin Brown
But improving infection care and access to antibiotics could prevent 92 million deaths between 2025 and 2050, the team noted.
Dr Stein Emil Vollset, of the Norwegian Institute of Public Health, said: “There has been real progress in tackling AMR, particularly among young children, but our findings indicate more must be done to protect people from this growing global health threat.
“By 2050, resistant infections could be involved in some 8 million deaths each year, either as the direct cause of death or as a contributing factor.
“To prevent this from becoming a deadly reality, we urgently need new strategies to decrease the risk of severe infections through vaccines, new drugs, improved healthcare, better access to existing antibiotics, and guidance on how to use them most effectively.”
Professor Samuel Kariuki, of the Kenya Medical Research Institute, who was not involved in the study, said: “These data should drive investments and targeted action towards addressing the growing challenge of AMR in all regions.”
Dr Brown provided some insight into UKHSA’s work in tackling antimicrobial resistance: “We’re working with partners to ensure the efficacy of antimicrobials now and for future generations using our expertise and capabilities.
“We have cutting-edge surveillance and modelling, ongoing research to inform prescribing practices, and are continually testing different therapeutic and diagnostic approaches to treat multidrug resistant organisms.
“We are also working to optimise the use of existing antimicrobials and discover new ways to stop infections occurring in the first place.
“We can all help by only taking antibiotics if you have been told to do so by a healthcare professional. Do not save some for later or share them with friends and family.
“Treat antibiotics with respect and they will be there to help us all in the future.”