Millions are dying due to antibiotic-resistant infections, which pose a significant threat to global health, scientists warn.

• Almost 5 million deaths in 2019 were linked to drug-resistant bacterial infections, according to a massive global study.
• In the same year, scientists discovered that 1.27 million deaths were directly caused by antibiotic-resistant bacterial infections.
• A research paper in The Lancet examined 471 million health records from 204 nations and territories.

In 2019, approximately 1.3 million people died due to drug-resistant bacteria, which is more than the combined death tolls of HIV and malaria, as estimated by scientists.

In 2017, antibiotic-resistant bacterial infections were estimated to have contributed to approximately 4.95 million deaths.

The study, funded by the U.K. government and the Bill & Melinda Gates Foundation, was published in the peer-reviewed medical journal The Lancet on Wednesday.

Antibiotic resistance is a major threat to global health, food security, and development, according to the World Health Organization. While the phenomenon occurs naturally, the misuse of antibiotics in humans and animals is speeding up the process.

The overuse and misuse of antibiotics, such as treating viral infections with them, has contributed to some bacteria becoming resistant to them.

The resistance to antibiotics is endangering our ability to treat common illnesses, resulting in higher medical costs, longer hospital stays, and increased mortality. According to the U.S. Centers for Disease Control and Prevention, over 2.8 million antibiotic-resistant infections occur in the United States annually, with more than 35,000 people dying as a result.

The effectiveness of antibiotics in treating illnesses such as pneumonia, tuberculosis, and gonorrhea is decreasing, making them increasingly difficult to treat.

First global estimates

The study by the authors of the research paper presented the first global estimates of the burden of bacterial antimicrobial resistance (AMR), which they described as "one of the leading public health threats of the 21st century."

The research examined 471 million individual records from 204 countries and territories, and analyzed data from various sources. Its estimates were based on the number of deaths resulting from and linked to bacterial AMR for 23 pathogens and 88 pathogen-drug combinations.

In 2019, the most burdensome infectious syndrome related to bacterial AMR was lower respiratory infections like pneumonia, which resulted in 400,000 deaths. Bloodstream infections and intra-abdominal infections were the next most prevalent drug-resistant diseases that led to deaths, accounting for almost 80% of deaths attributable to AMR.

E.coli and MRSA

During the study period, MRSA, a type of bacteria resistant to methicillin, directly caused over 100,000 deaths. E. coli, another drug-resistant bacteria, also contributed to the deaths.

The WHO has identified the six pathogens causing the most deaths from AMR as priority pathogens, according to researchers.

In 2019, drug-resistant bacteria were responsible for 16.4 deaths in every 100,000 people globally, according to a study. However, in western sub-Saharan Africa, where AMR had the highest proportion of deaths worldwide, this rate rose to 27.3 per 100,000 deaths.

In 2019, deaths associated with bacterial AMR but not directly caused by it accounted for 64 out of every 100,000 deaths, according to researchers.

The scientists stated in their paper that drug resistance in leading pathogens is a major global health threat that requires more attention, funding, capacity building, research and development, and pathogen-specific priority setting from the broader global health community.

Antibiotic investment ‘essential’

The paper's authors recommended strict intervention measures, many of which involved antibiotic use, to combat the threat posed by drug-resistant bacteria. The suggestions included reducing human exposure to antibiotics in meat, minimizing unnecessary antibiotic use, such as treating viral infections, and preventing the need for antibiotics through vaccination programs and vaccine development.

Investment in the development of new antibiotics is crucial, according to researchers.

"Public health issues have received more substantial investments compared to the small amounts allocated to them in the past few decades," they stated.

The authors of the study recognized that their research had limitations, such as the scarcity of data from low- and middle-income countries, which could result in an underestimation of the burden of AMR in specific regions.

The report's authors emphasized that developing laboratory infrastructure is crucial in tackling the global issue of AMR, through better patient management and enhanced data quality in local and global surveillance.

Reducing the burden of bacterial AMR is an urgent priority, and expanding AMR research through enhanced infrastructure is necessary to evaluate the indirect effects of AMR in the future.