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WHO updates the list of drug-resistant bacteria that threaten human health the most
The World Health Organization (WHO) today published its the updated Bacterial Priority Pathogen List (BPPL) 2024, with 15 families of antibiotic-resistant bacteria grouped into critical, high, and medium categories for prioritization. The list provides guidance for the development of new and needed treatments to stop the spread of antimicrobial resistance (AMR).
AMR occurs when bacteria, viruses, fungi and parasites no longer respond to drugs, making people sicker and increasing the risk of spreading disease, illness and death. AMR is largely caused by misuse and overuse of antimicrobials. The updated BPPL includes new evidence and expert insights to guide research and development (R&D) for new antibiotics and promote international coordination to foster innovation.
“By mapping the global burden of drug-resistant bacteria and assessing their impact on public health, this inventory is critical to guide investment and confront the antibiotic oil and access crisis,” said Dr Yukiko Nakatani, WHO's Assistant Director-General for Antimicrobial Resistance. ad interim. “Since the first List of Bacterial Priority Pathogens was published in 2017, the threat of antimicrobial resistance has intensified, reducing the effectiveness of many antibiotics and putting many of the achievements of modern medicine at risk.”
Critical priority pathogens, such as gram-negative bacteria resistant to last-line antibiotics, i Mycobacterium tuberculosis resistant to the antibiotic rifampicin, represent a major global threat due to their high burden and ability to resist treatment and spread resistance to other bacteria. Gram-negative bacteria have a built-in ability to find new ways to resist treatment and can transfer genetic material that allows other bacteria to also become drug-resistant.
High priority pathogens such as Salmonella and shigellaare a particularly heavy burden in low- and middle-income countries, along with Pseudomonas aeruginosa and Staphylococcus aureuswhich represent significant challenges in healthcare institutions.
Other high-priority pathogens, such as those resistant to antibiotics Neisseria gonorrhoeae and Enterococcus faeciumpresent unique public health challenges, including persistent infections and resistance to multiple antibiotics, which require targeted research and public health interventions.
Medium priority pathogens include group A and B streptococci (both new to the 2024 list), Streptococcus pneumoniaeand Haemophilus influenzae, which represent a large disease burden. These pathogens require increased attention, especially in vulnerable populations including pediatric and elderly populations, especially in resource-limited settings.
“Antimicrobial resistance threatens our ability to effectively treat high-burden infections, such as tuberculosis, leading to severe disease and increased mortality rates,” said Dr Jérôme Salomon, WHO Assistant Director-General for Universal Health Care, Communicable and Noncommunicable Diseases .
BPPL 2024 also emphasizes the need for a comprehensive public health approach to address AMR, including universal access to quality and affordable measures for the prevention, diagnosis and appropriate treatment of infections, as outlined by the WHO A people-centred approach to addressing AMR and a core package of interventions against AMR. This is critical to mitigating the impact of AMR on public health and the economy.
Changes between the 2017 and 2024 lists
BPPL 2024 led to the removal of five pathogen-antibiotic combinations that were included in BPPL 2017 and the addition of four new combinations. The fact that it is resistant to third-generation cephalosporins Enterobacteriales listed as an independent item within the critical priority category highlights their burden and the need for targeted interventions, especially in low- and middle-income countries.
Resistant to carbapenems Pseudomonas aeruginosa (CRPA) infection moving from critical to high priority in BPPL 2024 reflects recent reports of declining global resistance. Despite this transition, investment in research and development and other prevention and control strategies for CRPA remains important, given its significant burden in some regions.
WHO BPPL 2024 includes the following bacteria:
Critical priority:
- Acinetobacter baumanniicarbapenem resistant;
- Enterobacterales, third generation resistant to cephalosporins; and
- Enterobacterales, resistant to carbapenem;
- Mycobacterium tuberculosisresistant to rifampicin (included after independent analysis with parallel tailored criteria and subsequent application of a customized multi-criteria decision analysis matrix).
High priority:
- Salmonella Typhi, resistant to fluoroquinolones
- shigella spp., resistant to fluoroquinolones
- Enterococcus faeciumresistant to vancomycin
- Pseudomonas aeruginosaresistant to carbapenems
- Non-typhoidal Salmonellaresistant to fluoroquinolones
- Neisseria gonorrhoeaethird generation resistant to cephalosporins and/or fluoroquinolones
- Staphylococcus aureusresistant to methicillin
Medium priority:
- Group A streptococci, resistant to macrolides
- Streptococcus pneumoniaeresistant to macrolides
- Haemophilus influenzaeresistant to ampicillin
- Group B streptococci, resistant to penicillin
Changes since 2017 reflect the dynamic nature of AMR, which requires tailored interventions. Building on the value of the BPPL as a global tool, tailoring the list to country and regional context can account for regional variation in pathogen distribution and AMR burden. For example, resistant to antibiotics Mycoplasma genitalium which is not included in the list, is a growing concern in some parts of the world.
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Sources 2/ https://www.who.int/news/item/17-05-2024-who-updates-list-of-drug-resistant-bacteria-most-threatening-to-human-health The mention sources can contact us to remove/changing this article |
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