WHO's New Surveillance System Finds High Levels of Antibiotic Resistance Worldwide

Antibiotic resistance is one of the world’s most pressing public health problems, according to the Centers for Disease Control and Prevention (CDC). Now, the World Health Organization (WHO)’s first report of surveillance data on antibiotic resistance underscores the seriousness of the problem.

What are the biggest takeaways from the report?

High- and low-income countries alike have elevated levels of resistance to several serious bacterial infections, according to the official press release.

“The report confirms the serious situation of antibiotic resistance worldwide,” Dr. Marc Sprenger, director of WHO’s Antimicrobial Resistance Secretariat, commented in the release. The results also reinforce the need to develop strong surveillance systems to combat the problem.

One such system is the Global Antimicrobial Surveillance System (GLASS), which showed that antibiotic resistance was widespread among 500,000 individuals with suspected bacterial infections across 22 different countries.

Furthermore, Escherichia coli (E. coli), Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, all topped the list as some of the most commonly reported resistant bacteria, with Salmonella spp. following close behind.

According to the report, the proportion of patients with suspected bloodstream infections with bacteria resistant to at least 1 of the most commonly used antibiotics ranged from 0% to 82% across countries. Resistance to penicillin in, particular, ranged from 0% to 51% across countries. Furthermore, resistance to ciprofloxacin, an antibiotic commonly used to treat E. coli associated with urinary tract infections, ranged from 8% to 65%.

“Some of the world’s most common—and potentially most dangerous—infections are proving drug-resistant,” Dr. Sprenger stated. “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.”

Since March 2016, a total of 52 countries—25 high-income, 20 middle-income, and 7 low-income—have enrolled in the surveillance system. “The rapid increase in country enrollment and active participation in a global system to monitor antimicrobial resistance reflects a collective understanding and engagement to support the global effort to control AMR,” a WHO media contact shared with Contagion^®.

In the WHO’s first GLASS report, 40 countries presented information about their national surveillance systems, with 22 countries also providing data pertaining to antibiotic resistance levels. The countries were Bahrain, Bosnia and Herzegovina, Canada, Egypt, Finland, Germany, Japan, Lebanon, Madagascar, Norway, and others.

As each country is faced with different challenges to building national surveillance systems, such as a lack of personnel, funds, and infrastructure, among others, WHO is working with some of the countries to set up surveillance systems to provide complete, high-quality data.

Some examples of how countries are already benefitting from GLASS including the following:

• Kenya enhanced the development of its national antimicrobial resistance system
• Tunisia has begun to collect data pertaining to antimicrobial resistance on a national level
• The Republic of Korea revised their surveillance system to align with GLASS, and, as a result, have been able to provide complete, high-quality data
• Afghanistan and Cambodia have enrolled in GLASS and are working on strengthening surveillance on antimicrobial resistance

The WHO media representative acknowledged that the data collected in this report “vary considerably,” and, as such, the organization is not attempting to compare AMR status at a regional or country level.

“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,” Dr. Carmem Pessoa-Silva stressed in the press release.

As more countries enroll in the GLASS system and they provide AMR information, the system may be able to provide “a more complete picture about the AMR situation globally.”