Antimicrobial resistance in the Americas: a tale of multiple realities

In this issue, the first regional profile of the AMR burden in the Americas, covering 35 countries in the region, reveals that, as of 2019, more than two in every five deaths that involved an infection in the Americas were associated with AMR. Infections represented the largest share of deaths in Haiti, where the highest age-standardised mortality rate associated with AMR (>90 per 100 000 person-years) was also observed, followed by Bolivia, Guatemala, Guyana, and Honduras. By contrast, in Canada, Colombia, Cuba, Jamaica, and the USA, less than 50 deaths per 100 000 person-years were reported. Heterogeneity throughout the Americas is reflected in infection burden, AMR-attributable deaths, and antibiotic resistance patterns as a direct consequence of differences in access to antibiotics and basic health-care services. AMR is not only responsible for invasive, hospital-acquired infections in at-risk populations (ie, severely ill, very young, and very old patients), but it can also threaten every-day procedures such as caesarean sections and urgent appendectomies, by exposing patients to a higher risk of resistant infections, especially in less resourceful settings.