WHO updates bacterial priority pathogen list to combat antimicrobial resistance

The World Health Organization (WHO) today announced the updated Bacterial Priority Pathogen List (BPPL) 2024. In this list, 15 families of antibiotic-resistant bacteria are divided into severe, high, and moderate categories for prioritization. This list provides guidance on the development of new treatments needed 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 disease spread, illness, and death. AMR is primarily caused by the misuse and overuse of antibiotics. The updated BPPL incorporates new evidence and expert insights to guide new antibiotic research and development (R&D) and foster international collaboration to foster innovation.

This list is key to guiding investment and addressing the antibiotic pipeline and access crisis by mapping the global burden of drug-resistant bacteria and assessing the public health impact. Since the publication of the first Bacterial Priority Pathogen List in 2017, the threat of antimicrobial resistance has intensified and antimicrobial resistance is eroding. efficacy of Many antibiotics are used and many of the advances of modern medicine are at risk. ”

Dr. Yukiko Nakatani, WHO Deputy Director-General for Antimicrobial Resistance Temporary advertisement

high-priority pathogens such as Gram-negative bacteria that are resistant to antibiotics of last resort, and Mycobacterium tuberculosis It is resistant to the antibiotic rifampicin and poses a major threat globally due to its high burden, resistance to treatment, and ability to spread resistance to other bacteria. Gram-negative bacteria have a built-in ability to find new ways to resist treatment and can pass on genetic material that allows other bacteria to become drug resistant as well.

High priority pathogens such as: Salmonella and Staphylococcus ruberthe burden is particularly high in low- and middle-income countries; Pseudomonas aeruginosa and Staphylococcus aureuswhich poses significant challenges to medical practice.

Other high-priority pathogens, such as antibiotic-resistant bacteria gonorrhea and Enterococcus faeciumpresent unique public health challenges, including persistent infections and resistance to multiple antibiotics, and require targeted research and public health interventions.

Medium-priority pathogens include Group A Streptococcus and Group B Streptococcus (both new to the 2024 list). Streptococcus pneumoniaeand Haemophilus influenzae, resulting in a high disease burden. These pathogens require increased attention, especially in vulnerable populations, including children and the elderly, and especially in resource-limited settings.

“Antimicrobial resistance threatens our ability to effectively treat burdensome infectious diseases such as tuberculosis, leading to increased rates of severe disease and mortality,” says WHO's Universal Health Coverage, Infectious and Non-communicable Diseases. said Dr. Jerome Salomon, Under-Secretary-General for Communicable Diseases.

BPPL 2024 also supports quality and affordable measures for the prevention, diagnosis and appropriate treatment of infectious diseases, as outlined in WHO's people-centred approach and core package to combat AMR. highlights the need for a comprehensive public health approach to combating AMR, including universal access to AMR. AMR intervention. This is critical to mitigating the impact of his AMR on public health and the economy.

Changes between 2017 and 2024 listings

BPPL 2024 removes five pathogen-antibiotic combinations that were included in BPPL 2017 and adds four new combinations.The fact that third-generation cephalosporin-resistant bacteria exist intestinal bacteria It is listed as a separate item within a key priority category to highlight the burden and the need for targeted interventions, particularly in low- and middle-income countries.

Carbapenem resistance Pseudomonas aeruginosa (CRPA) The transition of infectious diseases from critical status to priority status in BPPL 2024 reflects recent reports of declining global resistance. Despite this shift, investment in research and development and other prevention and control strategies for CRPA remains important, given the high burden of CRPA in some regions.

WHO BPPL 2024 includes the following bacteria:

Important priorities:

• Acinetobacter baumanniicarbapenem resistance.
• Enterobacteriales, third-generation cephalosporin resistance.and
• Enterobacteriales, carbapenem resistance.
• Mycobacterium tuberculosisrifampicin resistance (included after independent analysis with parallel adjusted criteria and subsequent application of an adapted multi-criteria decision analysis matrix).

High priority:

• Salmonella Typhoid fever, fluoroquinolone resistance
• Staphylococcus ruber spp., fluoroquinolone resistant
• Enterococcus faeciumvancomycin resistance
• Pseudomonas aeruginosacarbapenem resistance
• non-typhoid fever Salmonellafluoroquinolone resistance
• gonorrheathird-generation cephalosporin-resistant and/or fluoroquinolone-resistant
• Staphylococcus aureusmethicillin resistance

Medium priority:

• Group A Streptococcus, macrolide resistance
• Streptococcus pneumoniaemacrolide resistance
• Haemophilus influenzaeampicillin resistance
• Group B streptococci, penicillin resistance

Changes since 2017 reflect the dynamic nature of AMR and require tailored interventions. Building on the value of BPPL as a global tool, the list can be tailored to national and regional contexts to account for regional differences in pathogen distribution and his AMR burden.For example, antibiotic resistance Mycoplasma genitalium Although not included in the list, there is growing concern in some parts of the world.