Deaths from drug-resistant bacteria predicted to increase 70% by 2050

A systematic analysis shows that from 1990 to 2021, antibiotic-resistant infections directly caused more than one million deaths per year worldwide, and that number is predicted to increase by approximately 70% over the next 25 years.

In 2021, the number of deaths attributable to bacterial antimicrobial resistance (AMR) reached 1.14 million worldwide, slightly surpassing the 1.06 million deaths attributable to AMR in 1990, reported Christopher Murray, MD, PhD, of the University of Washington in Seattle, and his colleagues at the University of Washington. Lancet.

Bacterial AMR is also associated with an estimated 4.71 million deaths in 2021, roughly the same as in 1990.

Murray and his colleagues projected that an estimated 1.91 million AMR-attributable deaths and 8.22 million AMR-related deaths could occur annually worldwide by 2050. Between 2025 and 2050, the cumulative number of deaths attributable to AMR could reach 39.1 million.

But improved access to healthcare and antibiotics could save an estimated 92 million lives between 2025 and 2050, the researchers argued.

“These findings highlight that AMR has been a significant global health threat for decades and that this threat is growing,” said co-author Mohsen Naghavi, MD, MPH, of the University of Washington. press release.

In more positive news, deaths attributable to AMR in children under 5 years of age fell by 60.4% and AMR-related deaths fell by 63.3% between 1990 and 2021. During this period, deaths due to sepsis in children under 5 years of age also fell by more than 60%.

However, among people aged 70 years and older, from 1990 to 2021, deaths directly attributable to AMR increased by 89.5%, and AMR-related deaths increased by 81.3%.

“The reduction in deaths from sepsis and AMR in young children over the past 30 years is an incredible achievement,” study co-author Kevin Ikuta, MD, MPH, of the University of California, Los Angeles, said in a press release.

“However, these findings indicate that although infections among young children are decreasing, they are becoming more difficult to treat when they do occur. Furthermore, as the population ages, the threat posed by AMR to older people will only increase,” Ikuta noted.

in Accompanying editorialDr. Samuel Kariuki of the Kenya Medical Institute in Nairobi said the decline in child mortality was “coinciding with expanded vaccination efforts and improved access to water, sanitation and hygiene.” [water, sanitation, and hygiene]and infection prevention and control strategies that have proven highly effective in reducing the AMR burden.”

Kariuki wrote that improved access to WASH infrastructure and practices, and use of childhood vaccines, could prevent around 430,000 AMR-related deaths, “both through the direct prevention of resistant infections and through reduced antibiotic consumption.”

Murray and his colleagues projected that South Asia, Latin America and the Caribbean will be the regions with the highest AMR mortality rates across all age groups in 2050. The increase in deaths attributable to AMR will be greatest among people aged 70 and over (65.9%).

But improved access to antibiotics and improved quality of care could have the greatest benefits in parts of South Asia, sub-Saharan Africa, Southeast Asia, East Asia and Oceania, the researchers said.

The researchers also documented an increase in AMR-attributable deaths from 12 pathogens between 1990 and 2021. In 2021, six pathogens were associated with at least 100,000 AMR-attributable deaths per year. Staphylococcus aureus, Acinetobacter baumannii, E. coli, Klebsiella pneumoniae, Streptococcus pneumoniaeand Pseudomonas aeruginosa.

Deaths from methicillin-resistant bacteria Staphylococcus aureus Globally, the largest increase is in antimicrobial resistance (AMR), with deaths attributable to AMR expected to double from 57,200 in 1990 to 130,000 in 2021.

Among gram-negative bacteria, which are the most resistant to antibiotics, resistance to carbapenems has increased more than any other antibiotic, increasing from 127,000 in 1990 to 216,000 in 2021. “The development of new antibiotics for current antibiotic-resistant gram-negative bacteria could avert the 11.1 million predicted deaths from drug resistance by 2050,” Kariuki noted.

Streptococcus pneumoniae The most significant declines have been seen in both AMR-related deaths and deaths attributable to AMR, with deaths attributable to AMR falling from 258,000 in 1990 to 155,000 in 2021.

The number of deaths attributable to AMR also varied by region. Five regions – Western sub-Saharan Africa, tropical Latin America, high-income North America, Southeast Asia, and South Asia – saw an increase of more than 10,000 deaths attributable to AMR over the 31-year period. However, among children under 5 years of age, all regions except Oceania saw a decrease in AMR-attributable and related deaths. Among children aged 5 years and older, all regions except Western and Central Europe saw an increase in AMR mortality.

The global study relied on statistical modelling techniques using 520 million individual records from a variety of sources, including hospital data, death records, antibiotic use surveys, drug sales data, insurance claims data and published scientific studies. Murray and colleagues looked at 22 pathogens, 84 pathogen-drug combinations and 11 infectious syndromes from 204 countries and territories.

The authors acknowledge that their analysis has several limitations. A lack of data in many low- to middle-income countries was a major drawback. Analytical errors and selection bias may also have occurred when combining data from a wide variety of sources. Projected scenarios of AMR burden also rely on the quality and availability of historical data and do not take into account the emergence of new resistant strains.