Battling antimicrobial resistance: new guidance and insights

Antimicrobial resistance (AMR) is a major public health threat, projected to cause 1.91 million deaths annually by 2050, with more than 65% in people over 70. Hospital-associated sepsis shows high incidence (13.8–175.0 per 100,000 adults/year) and mortality (>50%). Neonates, particularly in intensive care units, account for ~60% of hospital-associated sepsis cases. LMICs carry a disproportionate burden.

WHO Priority Pathogens List (BPPL):

• First published in 2017; updated in 2024.

• Top-tier retained: Carbapenem-resistant Klebsiella pneumoniae, 3rd-generation cephalosporin-resistant Escherichia coli, carbapenem-resistant Acinetobacter baumannii.

• Newly added: Rifampicin-resistant Mycobacterium tuberculosis.

• Heightened focus: Fluoroquinolone-resistant Salmonella Typhi, Shigella spp., Neisseria gonorrhoeae.

• Deprioritised: Penicillin-non-susceptible Streptococcus pneumoniae, vancomycin-resistant Staphylococcus aureus.

• Notable shift: stronger attention to community-associated drug-resistant pathogens, especially in LMICs.

Therapeutics & prevention:

• Since 2017, 13 new antimicrobials approved; four included in WHO Essential Medicines List, but resistance already reported.

• R&D priorities include vaccines (e.g., K. pneumoniae), shorter antibiotic regimens, and prevention bundles for patients with devices.

• Infection prevention remains crucial: hand hygiene, soap and water in communities, and adherence among healthcare workers can dramatically reduce infection rates (e.g., maternal mortality halved with proper handwashing).

Conclusion:
AMR bacteria remain a critical global health threat. While novel drugs and vaccines are emerging, optimisation of preventive strategies—particularly hand hygiene—offers the most effective and immediate way to reduce transmission and impact of AMR infections.