The World Health Organisation's (WHO) surveillance data on antibiotic resistance has revealed high level of resistance to a number of serious bacterial infections in both high- and low-income countries.
WHO’s new Global Antimicrobial Surveillance System (GLASS), which was made available to the Ghana News Agency by Christian Lindmeier of the WHO, reveals widespread occurrence of antibiotic resistance among 500 000 people with suspected bacterial infections across 22 countries.
According to the report the most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, followed by Salmonella species.
It noted that the system did not include data on resistance of Mycobacterium tuberculosis, which causes tuberculosis (TB), as WHO had been tracking it since 1994 and providing annual updates in the Global tuberculosis report.
It said among patients with suspected bloodstream infection, the proportion that had bacteria resistant to at least one of the most commonly used antibiotics ranged tremendously between different countries – from zero to 82 per cent.
It said resistance to penicillin – the medicine used for decades worldwide to treat pneumonia – ranged from zero to 51 per cent among reporting countries and between eight per cent to 65 per cent of E. coli associated with urinary tract infections presented resistance to ciprofloxacin, an antibiotic commonly used to treat this condition.
“The report confirms the serious situation of antibiotic resistance worldwide,” says Dr Marc Sprenger, the Director of WHO’s Antimicrobial Resistance Secretariat.
“Some of the world’s most common – and potentially most dangerous – infections are proving drug-resistant,” Dr Sprenger added.
“And most worrying of all, pathogens don’t respect national borders. That’s why WHO is encouraging all countries to set up good surveillance systems for detecting drug resistance that can provide data to this global system.”
The report revealed that to date, 52 countries (25 high-income, 20 middle-income and seven low-income countries) were enrolled in WHO’s Global Antimicrobial Surveillance System.
It said for the first report, 40 countries provided information about their national surveillance systems and 22 countries also provided data on levels of antibiotic resistance.
“The report is a vital first step towards improving our understanding of the extent of antimicrobial resistance. Surveillance is in its infancy, but it is vital to develop it if we are to anticipate and tackle one of the biggest threats to global public health,” said Dr Carmem Pessoa-Silva, who coordinates the new surveillance system at the WHO.
The report said data presented in this first GLASS report vary widely in quality and completeness.
It said some countries face major challenges in building their national surveillance systems, including a lack of personnel, funds and infrastructure.
The report said however, WHO was supporting more countries to set up national antimicrobial resistance surveillance systems that could produce reliable, meaningful data.
It said GLASS was helping to standardise the way that countries collect data and enable a more complete picture about antimicrobial resistance patterns and trends.
It noted that solid drug resistance surveillance programmes in TB, HIV and malaria had been functioning for many years and had helped estimate disease burden, plan diagnostic and treatment services, monitor the effectiveness of control interventions, and design effective treatment regimens to address and prevent future resistance.
The GLASS was expected to perform a similar function for common bacterial pathogens.
It said the rollout of GLASS was already making a difference in many countries.
The report cited that Kenya had enhanced the development of its national antimicrobial resistance system; Tunisia started to aggregate data on antimicrobial resistance at national level; the Republic of Korea completely revised its national surveillance system to align with the GLASS methodology, providing data of very high quality and completeness; and countries such as Afghanistan or Cambodia that face major structural challenges have enrolled in the system and were using the GLASS framework as an opportunity for strengthening their AMR surveillance capacities.
In general, national participation in GLASS is seen as a sign of growing political commitment to support global efforts to control antimicrobial resistance.