New Delhi: Over 1.2 million people died in 2019 as a direct result of antimicrobial resistance, far outnumbering the number of deaths caused by HIV/AIDS or malaria, said a study published Wednesday in The Lancet journal.
This is the most comprehensive estimate to date of the global impact of antimicrobial resistance, according to researchers from the University of Washington in the US.
Antimicrobial resistance has been a growing cause of concern across the world as widespread use of over-the-counter antimicrobials has caused several disease-causing pathogens — including bacteria, viruses, fungi and parasites — to evolve to be resistant to the drugs.
For the study, researchers analysed data from 204 countries and territories, and found that antimicrobial resistance is now a leading cause of death worldwide — higher than HIV/AIDS or malaria.
It was directly responsible for an estimated 1.27 million deaths worldwide, and associated with an estimated 4.95 million deaths, in 2019. HIV/AIDS and malaria were estimated to have caused 860,000 and 640,000 deaths, respectively, in 2019, the study said.
Millions of deaths now occur due to common infections that were previously treatable, such as lower respiratory and bloodstream infections, because the microbes that cause them have become resistant to the available drugs, the study added.
It highlighted an urgent need to scale up action to combat antimicrobial resistance, and outlined immediate actions for policymakers that will help save lives and protect health systems. These include optimising the use of existing antimicrobials, taking greater action to monitor and control infections, and providing more funding to develop new antimicrobials and treatments.
“These new data reveal the true scale of antimicrobial resistance worldwide, and are a clear signal that we must act now to combat the threat. Previous estimates had predicted 10 million annual deaths from antimicrobial resistance by 2050, but we now know for certain that we are already far closer to that figure than we thought,” Chris Murray, director, Institute for Health Metrics and Evaluation, University of Washington, said in a statement.
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Need to collect data
The study estimated deaths linked to 23 pathogens and 88 pathogen-drug combinations (referring to drugs and the response of pathogens to them). It used 471 million individual records obtained from systematic literature reviews, hospital systems, surveillance systems, and other data sources to produce these estimates.
Drug-resistance in lower respiratory infections, such as pneumonia, caused more than 400,000 deaths. Drug resistance in bloodstream infections — which can lead to sepsis — caused around 370,000 deaths and was associated with nearly 1.5 million deaths.
Young children were found to be at particularly high risk, with around one in five deaths attributable to antimicrobial resistance occurring in children aged under five years.
Deaths caused directly by antimicrobial resistance were estimated to be highest in Sub-Saharan Africa and South Asia, at 24 deaths per 100,000 population and 22 deaths per 100,000 population, respectively.
Of the 23 pathogens studied, drug resistance in six — E. coli, S. aureus, K. pneumoniae, S. pneumoniae, A. baumannii, and P. aeruginosa — led directly to 929,000 deaths and was associated with 3.57 million.
One pathogen-drug combination — methicillin-resistant S. aureus, or MRSA — directly caused more than 100,000 deaths in 2019, while six others each caused between 50,000 and 100,000 deaths.
“With resistance varying so substantially by country and region, improving the collection of data worldwide is essential to help us better track levels of resistance and equip clinicians and policymakers with the information they need to address the most pressing challenges posed by antimicrobial resistance,” Christiane Dolecek, scientific lead of the study based in Oxford University, said in a statement.
“We identified serious data gaps in many low-income countries, emphasising a particular need to increase laboratory capacity and data collection in these locations,” Dolecek added.
(Edited by Amit Upadhyaya)
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