Large number of deaths linked to superbugs could be avoided, experts say | MRSA and superbugs

Every year, 750,000 deaths linked to drug-resistant superbugs could be avoided through better access to clean water and sanitation, infection control and childhood vaccinations, research suggests.

Antimicrobial resistance, or AMR, poses a huge global challenge, with the evolution of drug-resistant superbugs driven by factors such as inappropriate and excessive use of antibiotics, opening the prospect of a future where medicine modern fails.

Experts warn that if the world does not prioritize action against AMR, the number of deaths will steadily rise, with infants, the elderly and those with chronic illnesses or requiring surgery most at risk. .

“It kills more people than HIV, malaria and tuberculosis combined,” said Professor Ramanan Laxminarayan of Princeton University, US, adding that tackling AMR was crucial to achieving the goals. newborn survival and healthy aging.

Experts also warned of a scenario in which once-trivial infections prove deadly and crucial procedures in modern medicine, from cesarean sections to cancer treatments and organ transplants, become too risky to be feasible .

According to 2019 data, an estimated 4.95 million deaths were associated with bacterial AMR, including 1.27 million deaths directly caused by such resistance.

However, experts have warned that low- and middle-income countries (LMICs) are disproportionately affected by AMR.

Models created by Laxminarayan and colleagues suggest that AMR-associated deaths in LMICs could be reduced by 18%, or the equivalent of about 750,000 per year, in three key steps.

The team suggests that around 247,800 deaths could be avoided through universal access to clean water and improved sanitation and hygiene, while 337,000 deaths could be avoided through better prevention and control of infections in health care settings.

Another 181,500 deaths could be avoided through childhood vaccination, they add. This is not only about preventing infections resistant to current drugs, but also about reducing inappropriate antibiotic consumption.

While the team notes that 95,400 deaths among those under 15 could be directly prevented each year through the use of vaccines against four key bacterial infections, vaccinations against viral infections are also important.

“People have symptoms…they can’t distinguish whether it’s viral or bacterial and, just to be safe, they take antibiotics. But by creating this safety, they are creating drug resistance,” Laxminarayan said, noting that influenza was the main driver of antibiotic consumption worldwide.

The study, published in the Lancet, is part of a series on AMR that includes proposed global targets called “10-20-30 by 2030” goals. These refer to a 10% reduction in AMR mortality compared to 2019, a 20% reduction in inappropriate antibiotic use in humans, and a 30% reduction in inappropriate use of antibiotics in animals.

Although ambitious, these goals, Laxminarayan said, were achievable. He noted that while deaths from AMR had increased since 2019, inappropriate use of antibiotics in animals had already decreased.

The researchers also highlight the need for better access and development of antibiotics, diagnostic tests and vaccines, and called for the creation of an independent group on access and antimicrobial resistance, similar to the Intergovernmental Panel on Climate Change (IPCC), to gather evidence on AMR and inform guidelines.

The team stresses that time is running out. “The window of opportunity to ensure our ability to treat bacterial pathogens is shrinking,” they write.

Laxminarayan added that RAM was not an intractable problem. “Why wouldn’t the world want to solve a big problem that can be solved? ” he said.

Professor Ben Cooper, from the University of Oxford, who was not involved in the research, said the estimate of 750,000 preventable deaths was based on careful and in-depth analysis. “This work highlights that we already have affordable tools that we know could make a significant contribution to the problem, but achieving these reductions will require tackling chronic global underinvestment in the fight against antimicrobial resistance. »

Dr Danna Gifford, an AMR expert at the University of Manchester, also said there would be challenges ahead, and sustained engagement and collaboration on an unprecedented global scale would be needed to achieve the proposed targets. .

But, she added, preventive measures are crucial. “It is clear that reducing the global burden of resistance requires preventing the occurrence of infections, rather than simply relying on new antimicrobials. »