Resistance of bacteria to treatment grows by more than 15%, according to WHO

Common bacteria have become more resistant to treatments in recent years, according to a new report published by the WHO (World Health Organization). In most of the microorganisms monitored, the trend towards ADR (antimicrobial resistance) was stable between 2017 and 2020. But in others, growth exceeded 15%, raising concerns about global infection control.

The report indicates, for example, that more than 60% of the isolated strains of the bacteria that cause gonorrhea are resistant to ciprofloxacin, one of the antibiotics used to treat the disease, which in 2019 totaled 87 million cases around the globe.

In Brazil, a protocol launched by the government in 2015 already contraindicated the use of this antibiotic (until then the standard treatment) against gonorrhea in the states of São Paulo, Rio de Janeiro and Minas Gerais. The most recent guideline, released this year, recommends treatment with ceftriaxone and azithromycin.

Furthermore, more than 20% of the bacterial strains Escherichia colithe most common cause of urinary tract infections, are resistant to both first-line care options, such as ampicillin or cotrimoxazole, and second-line treatments with fluoroquinolones.

The survey also points to resistance above 50% in bacteria Klebsiella pneumoniae and Acinetobacter spp, a frequent cause of sepsis (generalized infection) in hospitals. In these cases, antibiotics known as carbapenems are used, but the new survey shows that in more than 8% of bloodstream infections caused by Klebsiella pneumoniae there is also resistance to this last resort, increasing the possibility of death from an untreatable infection.

“Antimicrobial resistance undermines modern medicine and puts millions of lives at risk,” said Tedros Adhanom Ghebreyesus, director-general of WHO, in a statement released by the organization.

The Global Report on Antimicrobial Resistance and Antimicrobial Use Surveillance System (Glass), released last Friday (9), was produced with data reported in 2020 by 87 countries, including Brazil. For the WHO, the Covid-19 pandemic prevented more nations from contributing to the update and it is still necessary to research whether the discharge in hospitalizations and the increased use of antibiotics during the global emergency had an impact on the increase in ADRs.

The data may also have been affected by variation in testing across higher and lower income countries. For example, the global median level of RAM for the bacterium Staphylococcus aureus, associated with infections in the hospital environment when exposed to methicillin was 35%. But when only countries with high test coverage were considered, that level dropped to 6.8%.

For the entity, the difference can be partially attributed to the fact that in many low- and middle-income countries there are only a few reference hospitals that report data for the study, and these hospitals often serve the sickest patients, who may have received treatment. prior antibiotic.

To overcome the problem, the WHO announced that it will act on two fronts: in the short term, it will conduct periodic surveys in selected locations and, in the long term, strengthen systematic surveillance. With this, she hopes to provide robust data for the formulation and monitoring of public policies and, also, to increase the number of laboratories with quality assurance that report representative data.

“To truly understand the extent of the global threat and mount an effective public health response to AMR, we must scale up microbiological testing and provide quality-assured data in all countries, not just the richest,” said Adhanom.

Threat

ADR occurs when bacteria, fungi, viruses, or parasites undergo changes when exposed to antimicrobials, including antibiotics, antifungals, and antivirals.

Resistance occurs naturally over time, but overuse of antimicrobials is accelerating the process, and as a result, some drugs are losing their effectiveness.

For WHO, AMR represents a concern because it threatens the ability to treat common infectious diseases. In addition, more complex and expensive treatments are needed and, without effective antimicrobials to prevent and treat infections, procedures such as organ transplants, chemotherapy, cesarean sections or hip replacements are more risky.