Researchers warn

Deaths from antibiotic resistance on the rise

Antibiotic resistance occurs when bacteria change over time and no longer respond to medication.

(Bild: nobeastsofierce - stock.adobe.co)

By 2050, more than 39 million people worldwide could die from infections with antibiotic-resistant germs, and such pathogens could at least play a role in a further 169 million deaths. A key reason for the increase in resistance is the excessive and inappropriate use of antibiotics in human and veterinary medicine.

"To prevent this from becoming a deadly reality, we urgently need new strategies to reduce the risk of serious infections through vaccines, new drugs, improved health care, better access to existing antibiotics and guidance on how to use them most effectively," warned study author Stein Emil Vollset from the Norwegian Institute of Public Health.

Because the population group of over-64-year-olds will grow the most in the coming years, resistance-related deaths could also increase overall by 2050 according to the model: from 1.14 million (2021) to 1.91 million (2050) per year. According to the model calculation, the number of deaths in which multi-resistant germs play a role could increase from 4.71 million to 8.22 million.

Antibiotic-resistant bacteria and bacteriophages run riot in this petri dish. These are viruses that only infect bacteria.

(Bild: AFP)

Crisis hits the USA and Canada hard
The antibiotics crisis is not only affecting countries with a low or medium average income. The USA and Canada were among the five regions of the world where resistance-related deaths rose the most between 1990 and 2021. The other regions are tropical Latin America, West Africa, South Asia and Southeast Asia.

By 2050, the highest rates of increase are expected in South Asia (including India), Latin America and the Caribbean. "This data should drive investment and targeted action to tackle the growing challenge of antimicrobial resistance in all regions," emphasized Samuel Kariuki from the Kenya Medical Research Institute, who was not involved in the study.

Every application can lead to the proliferation of resistant bacteria, as these then have a survival advantage. Mohsen Naghavi from the University of Washington, one of the first authors of the study, explains that being able to assess future developments is crucial for life-saving countermeasures.

The research team led by Christopher Murray from the University of Washington in Seattle used 520 million data sets to depict the development of antibiotic resistance in the period from 1990 to 2021 in a computer model. This was then used as the basis for a forecast for the coming years, which is presented in the specialist journal "The Lancet".

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High number of unreported cases feared
The extent of the problem with resistance is not so easy to determine: If, for example, complications due to multi-resistant germs occur during the treatment of cancer, the cause of a patient's death is nevertheless usually attributed to the cancer. The authors of the study used hospital discharge data, data on causes of death, resistance profiles of individual drugs, surveys on antibiotic use and numerous other sources to record the extent of resistance and develop the global model.

However, the researchers' model also showed a possible positive development: better treatment of serious infections and improved access to antibiotics could prevent 92 million deaths between 2025 and 2050.

From 1990 to 2021, more than one million people died worldwide every year due to antimicrobial resistance. The total number rose slightly, from 1.06 million in 1990 to 1.14 million in 2021. If population growth is taken into account, the death rate per 100,000 people fell from 19.8 (1990) to 14.5 (2021).

Resistance increases with age
However, the trend varies greatly by age group: while the number of resistance-related deaths among children under the age of five has been reduced by 50 percent, the number among people aged 70 or over has risen by 80 percent.

With regard to young children, the researchers write: "A large part of this reduction is due to a decrease in drug-resistant Streptococcus pneumoniae and pathogens that are usually spread by fecal-oral transmission". Vaccination campaigns and improved hygienic conditions have contributed to this. The researchers attribute the increase in cases in older people to the often lower effectiveness or intolerance of vaccines and medicines in older people as well as more underlying illnesses.