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Every year, nearly 700 die from antibiotic resistance. people. Experts on the occasion of the World Antibiotic Awareness Week warn that by 2050 this number could rise to 10 million deaths per year. Concrete action is needed to keep the problem from growing.
Antibiotic resistance is a potential health catastrophe
According to the WHO, antibiotic resistance should be recognized as a global threat to health worldwide. UK Chief Medical Officer Dr Sally Davis said back in 2013 that “antibiotic resistance poses a health catastrophe of terrorism and climate change.”
According to a report commissioned by the UK government and the Wellcome Trust, nearly 700. people die each year from infections caused by antibiotic-resistant bacteria. This figure will rise to 2050 million in 10 unless appropriate preventive action is taken.
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One of the main reasons is abuse of antibiotics. Based on American data, the same report estimates that out of about 40 million people who received this type of antibacterial drug in the course of respiratory infections, 27 million people (67,5%) received them unnecessarily, and only 13 million (32,5%). percent) – actually in justified situations.
Also in Poland, the National Antibiotic Protection Program for 2016-2020 indicates that antibiotic resistance is a threat to health and life. The effectiveness of antibiotics, and thus the possibility of treating bacterial infections and diseases, depends primarily on their reasonable use.
The latest data from the European Drug Resistance Monitoring Network EARS-Net shows that in 2018 more than half of the reported Escherichia coli strains were resistant to at least one antibiotic. In Poland, an increase in Escherichia coli resistance to third generation cephalosporins (resistance rate: 2014%), fluoroquinolones (17,6%) and aminoglycosides (34,7%) has been observed since 15,1, as well as resistance to these three groups of drugs (10,5%).
The rapid growth of the so-called the population-weighted mean percentage of vancomycin resistance in Enterococcus faecium with 10,5%. in 2015 to 17,3 percent in 2018. In Poland in this period there was an increase from 17,7%. up to 35,8 percent vancomycin resistance in E. faecium.
We are still doing too little when it comes to antibiotic resistance
The EARS-Net report shows that the phenomenon of bacterial resistance to antibiotics remains one of the major public health challenges and poses a serious threat to patient safety in Europe. Thus, the measures taken so far in European countries are insufficient to effectively stop the growth of antibiotic resistance.
The most dangerous are the so-called alarm pathogens, multidrug-resistance (MDR), and extended resistance pathogens, i.e. extremely resistant (XDR – extensively drug resistance) and resistant to all available antibacterial drugs (PDR – pandrug-resistance).
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XDR-type alert pathogens that have become particularly dangerous include carbapenemase-producing gram-negative enteric bacteria, enzymes that exclude therapy with beta-lactam antibiotics, including carbapenems, which are considered ‘drugs of last resort’. The only remaining effective drug in the treatment of infections with such microorganisms is colistin, but as a result of abuse of this drug (especially in animal husbandry), resistance has emerged, eliminating this drug from the therapy.
The EARS-Net report found that the average level of antimicrobial use in primary care did not decline overall in 2009-2018. There were decreases in Austria, Belgium, Denmark, Finland, the Netherlands, Luxembourg, Germany, Norway, Portugal, Slovenia, Sweden and Italy, but increased in Bulgaria, Ireland, Latvia and Poland.
It was similar in inpatient medicine. Between 2009 and 2018, there was an increase in the consumption of carbapenems in hospitals in Bulgaria, Croatia, Denmark, Estonia, Malta and Hungary, and a decrease in Norway and Portugal.
Enteric sticks producing carbapenemases are often imported to Poland from countries such as India and Pakistan. A feature of these bacteria is the ease of transferring resistance to other microorganisms and being a carrier for a long time in the gastrointestinal tract.
Alarm bacteria also cause community-acquired infections. An example is Streptococcus pneumoniae, which causes respiratory infections, including pneumonia, which are often untreatable with the first-line antibiotic amoxicillin – and require hospitalization. Poland is among the countries with the highest percentage of antibiotic-resistant strains of these bacteria.
World Antibiotic Awareness Week is an initiative of the World Health Organization (WHO). This year it will last until November 24.
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