The World Health Organization has set off the Alarm Through a Study that has Revealed an Increase in Cases of Pathogens with Resistance to Antibiotics.
LatinAmerican Post | Julián Andrés Pastrana Cuéllar
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Leer en español: OMS alerta sobre incremento de la resistencia a los antibióticos en infecciones mortales
A recent report from the World Health Organization (WHO) yields a worrying conclusion: levels of resistance to antibiotics above 50% have been detected in bacteria that cause highly lethal sepsis in hospitals. Similarly, an increase in resistance to treatments has been discovered in bacteria responsible for common infections throughout the globe.
According to the US Centers for Disease Control and Prevention (CDC), resistance to these drugs and treatments is one of the biggest challenges facing health systems worldwide. In certain cases, antibiotics stop working to eliminate fungus and microbes, which is why these agents continue to multiply in the patient's body, making it necessary for the patient to undergo longer hospitalization periods and expensive and toxic treatments.
One of the causes for which resistance to antibiotics is generated is the formulation of antibiotics, by medical offices and emergency centers, in cases where it is not necessary. The CDC estimates that up to 47 million antibiotics are prescribed in the United States to fight infections such as colds and flu that do not require these treatments.
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Fatal sepsis with high resistance to antibiotics
The WHO based its study on a report from the Global Antimicrobial Resistance and Use Surveillance System (GLASS). This, in turn, analyzed “the rates of resistance to antimicrobials (or antibioresistance) in relation to the coverage of analytical tests in each country, as well as the trends in this regard since 2017 and data on the human consumption of antimicrobials in 27 countries”. It should be added that, in a period of six years, 127 countries have been involved in the study, that is, a representation of 72% of the world population.
Disturbing conclusions emerge from this report, such as, for example, a prevalence of high levels of resistance in bacteria such as Klebsiella pneumoniae or Acinetobacter spp, responsible for delicate cases of septicemia in hospital settings. It must be remembered that septicemias are extremely serious clinical pictures that occur when the body reacts to an infection causing damage to its own tissues. Sepsis can evolve into septic shock, which is when blood pressure drops significantly, which can trigger severe organic problems and even death.
Treatment of these life-threatening infections demands the use of antibiotics of last resort, known as carbapenems. However, the GLASS and WHO study has been able to determine that 8% of sepsis caused by Klebsiella pneumoniae have developed resistance to carbapenems.
Common infections are also resistant to treatments
Other findings from this study also cause alarm in that common bacterial infections have also been found to be increasingly resistant to treatment. To cite an example, ciprofloxacin, an oral antibacterial regularly used to treat gonorrhea, has been ineffective in eradicating more than 60% of the isolated strains of Neisseria gonorrhea, the causative agent of this sexually transmitted disease. For its part, 20% of the isolated strains of E. coli -a pathogen involved in the majority of cases of urinary tract infections- have developed resistance not only to first-line treatments such as ampicillin and cotrimoxazole, but also to those of second line (fluoroquinolones).
Other alarming conclusions
From 2017 to date, the cases of gonorrhea and septicemia caused by strains resistant to Escherichia coli and Salmonella Spp have increased by at least 15%. In this regard, Dr. Tedros Adhanom Ghebreyesus, Director General of the WHO, states that "antimicrobial resistance erodes modern medicine and puts millions of lives at risk." And he adds that "in order to really grasp the magnitude of the global threat and organize an effective public health response against antimicrobial resistance, we must multiply microbiological analyzes and generate data of guaranteed quality in all countries, and not only in the richest ones."
The WHO analyzes also infer a greater possibility that developing countries, and therefore with lower analytical test coverage, report much higher rates of resistance to antibacterials, a situation that may be due to the fact that in these nations there are only a few referral hospitals that provide information to GLASS. “These hospitals usually care for the sickest patients who may have received prior antibiotic treatment,” says the WHO.
This scenario of low coverage of analytical tests and almost zero laboratory capacity in low- and middle-income countries continues to be an obstacle to the interpretation of antimicrobial resistance rates. The solution to this problem is that these countries intensify their surveillance capacity and also provide high-quality information in this regard.