A recent study says that “bacteria have developed resistance against the medicines we invented to kill them, and these pathogens are instead killing people at rates that are higher than HIV/AIDS or malaria.”
Antimicrobial Resistance a Growing Concern in the 35 Countries of the Americas
In all 35 countries across the WHO Region of the Americas, antimicrobial resistance (AMR) is proving to be a serious threat, according to a newly published research paper in The Lancet Regional Health – Americas. The analysis provides the most extensive information to date for the region, covering 35 countries, 23 bacterial agents, and 88 pathogen-drug interactions.
In 2019, over 43% of infection-related fatalities in the Americas were connected to AMR, amounting to 569,000 deaths. This represents 11.5% of worldwide deaths linked to AMR. Such deaths refer to instances where drug-resistant infections contributed to fatalities, but other underlying health conditions may also have been factors.
Of these deaths, 141,000 were directly attributed to AMR, accounting for 11.1% of the total global deaths from AMR. In these instances, the individuals died specifically because their resistant infections were untreatable, and AMR was deemed the cause of death.
The most deadly AMR-related infections in the region were bacterial respiratory infections (293,000 deaths), bloodstream infections (266,000 deaths), intra-abdominal infections (181,000 deaths), and urinary tract infections (80,000 deaths). These four categories made up 89% of bacterial infection fatalities.
Six specific pathogens, including Staphylococcus aureus and Escherichia coli, were responsible for 452,000 AMR-associated deaths.
The countries showing the highest AMR-related mortality rates were Haiti, Bolivia, Guatemala, Guyana, and Honduras, while those with the lowest included Canada, the US, Colombia, Cuba, and several others. Age-related patterns for both associated and attributable AMR death rates were consistent across nations, with high death rates among newborns, a decrease among children under 5, and then a gradual increase, peaking after age 65.
Newborns in Dominica, the Dominican Republic, Guyana, Haiti, Jamaica, Suriname, and Venezuela had the highest death rates. Conversely, Antigua and Barbuda, Argentina, Canada, Chile, and Costa Rica showed the lowest rates among newborns.
Interestingly, the nine countries experiencing the highest AMR mortality rates either lacked a National Action Plan (NAP) on AMR or had not made theirs public. Countries like Chile, Colombia, Costa Rica, and the US had published and funded their AMR NAP and displayed some of the lowest AMR mortality rates.
Lucien Swetschinski, co-author and researcher at the Institute for Health Metrics and Evaluation (IHME), warned, “Bacteria have developed resistance against the medicines we invented to kill them, and these pathogens are instead killing people at rates that are higher than HIV/AIDS or malaria.
“If policymakers, clinicians, scientists, and even the general public don’t implement new measures now, this global health crisis will worsen and could become uncontrollable.”
In several countries, AMR-associated infections ranked as the third primary cause of death, following cardiovascular diseases and tumors.
Dr. Gisela Robles Aguilar, a co-author, and researcher at the University of Oxford, emphasized that the research’s detailed insights would aid policymakers in creating new strategies, enhancing sanitation, and devising fresh treatments to halt AMR. She also stressed the need for a robust global, regional, and local surveillance network to keep experts up-to-date on effective strategies.
The study suggested targeted approaches for countries with high infection death rates, such as Haiti, Bolivia, and Peru, where infection prevention could have the greatest impact on reducing the AMR burden.
Conversely, in nations like Chile, Mexico, and Peru, where resistant deaths are prevalent among infectious deaths, stringent AMR stewardship and monitoring are deemed essential.
The findings of the study on the burden of antimicrobial resistance (AMR) at the country level will be showcased by the researchers at a panel discussion titled “An Emerging Threat: AMR Burden at the Country Level,” which is scheduled to take place at the World AMR Congress in Philadelphia on September 7-8.
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