A new study finds that more people died from drug-resistant bacterial infections in 2019 than died from HIV or malaria.

The study, published Wednesday in The Lancet, suggests that if all drug-resistant bacterial infections had not occurred that year, 4.95 million deaths could have been prevented in 2019, and if all drug-resistant bacterial infections were replaced by infections that could Appropriately treated, 1.27 million lives could have been saved.

Antimicrobial resistance, or AMR, occurs when bacteria, viruses, fungi, and parasites become resistant to the drugs normally used to treat the infections they cause.

“By any measure, antibiotic-resistant bacteria are a leading global health issue,” an international team of researchers wrote in the study, adding that resistance appears to be a leading cause of death, ahead of both HIV and malaria.

The researchers — including the Institute for Health Metrics and Evaluation at the University of Washington in Seattle — analyzed data from the current scientific literature on antimicrobial resistance. Their analyzes included 471 million individual records, and produced estimates for 204 countries and territories.

Based on their analyzes, the researchers estimated that 4.95 million deaths were associated with bacterial resistance to antimicrobials in 2019 globally. Data were limited based on the number of regions with information available on antimicrobial resistance.

The researchers estimated that, of 21 regions around the world, Australia had the lowest burden of antimicrobial resistance in bacteria in 2019, with 6.5 deaths per 100,000 people directly attributable to resistance and 28 deaths per 100,000 appearing to be related to resistance.

The study reports that western sub-Saharan Africa had the highest burden of bacterial antimicrobial resistance in 2019, with 27.3 deaths per 100,000 people directly attributable to resistance and 114.8 deaths per 100,000 associated with resistance.

5 things you need to know about antimicrobial resistance

Of the 23 pathogens studied, researchers found that six were responsible for 73.4% of deaths attributable to antimicrobial resistance of bacteria: E. coli, Staphylococcus aureus, K. pneumoniae, S pneumoniae, and Acinetobacter baumannii, and Pseudomonas aeruginosa. For deaths attributable to antimicrobial resistance, Escherichia coli was responsible for the most deaths in 2019, according to the researchers.

The researchers estimated that these six pathogens were responsible for 929,000 of the 1.27 million deaths directly attributable to antimicrobial resistance and 3.57 million of the 4.95 million resistance-related deaths globally.

Study co-author Chris Murray of the University of Washington’s Institute for Health Metrics and Evaluation said in a press release.

“Previous estimates projected 10 million annual deaths from antimicrobial resistance by 2050, but we now know for sure that we are already much closer to that number than we thought,” Murray said. “We need to leverage this data to correct course and drive innovation if we are to stay ahead in the race against antimicrobial resistance.”

With the Covid-19 pandemic, the antimicrobial resistance pandemic continues “in the shadows,” and there are “significant gains to be made” from preventing microbial infection in the first place, said Ramanan Laxminarayan, founder and director of the Center for Books in Disease Dynamics, Economics, and Politics in Washington, D.C. editorial It was published along with the study in The Lancet.

“Among the major bacterial pathogens addressed in this study, only pneumococcal pneumonia can be prevented through vaccination. Vaccines against viral pathogens including influenza, respiratory syncytial virus and rotavirus can be effective in reducing the need for treatment. , thus reducing inappropriate consumption of antibiotics,” Laxminarayan wrote in the editorial, which also called for more spending on tackling antimicrobial resistance.

“From being a hidden and unrecognized problem, a clearer picture of the burden of antimicrobial resistance is finally emerging,” Laxminarayan wrote. “Spending should be directed to prevent infection in the first place, to ensure that existing antibiotics are used appropriately and judiciously, and to bring new antibiotics to market.”

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