This informal CPD article ’Antimicrobial Resistance-A Global Threat and Concern’ was provided by CBEHx, a world-online learning platform driven by the passion to accelerate learning in advanced scientific and technical disciplines and assist in professional skill development.
Within just a century of their discovery, antimicrobials are steadily losing their effectiveness, irrespective of whether they are antibiotics or antivirals.1 The transition from infection to recovery relying on antimicrobials is no longer as smooth as a couple of decades ago. An illness curable and preventable not long ago might be fatal since life-saving antimicrobials are no longer effective.1,2 Thanks to antimicrobial resistance, a phenomenon rendering antimicrobials ineffective against deadly pathogens, thus posing major healthcare, agricultural, and veterinary challenges.3
Understanding Antimicrobial Resistance
Before we delve into the global burden of antimicrobial resistance, let us understand what it means and how it develops. Antimicrobial resistance occurs when microbes evolve in a way that renders the antimicrobial once effective, now ineffective. The mechanism of antimicrobial resistance may involve limiting the uptake of a drug, altering the drug target, rendering the drug inactive, or through efflux of the drug in its active form.
The evolution may be natural, enabling microbes to coexist with other organisms.4 It may also arise due to the frequent or indiscriminate use of antimicrobial drugs in healthcare settings. In such cases, microbes may be forced to undergo mutational changes to adapt and survive in the presence of agents designed to kill them.4 Irrespective of how they evolve, the changes acquired are passed onto their progeny. Thus, these resistant microbes can persist or even grow in the presence of antimicrobial agents that are, in fact, designed to inhibit or eliminate them. When microbes develop resistance against most antimicrobials, they are termed superbugs.5
Growth of Antimicrobial Resistance
The invisible threat of antimicrobial resistance is growing and so is the concern among major health organizations globally. According to the WHO, it can happen to anyone, anywhere.6 The global burden posed includes limited therapeutic and preventive options, high transmissibility, extended hospital stays, prolonged treatment costs, loss of income, loss of human lives, and grief.3 The ‘WHO Bacterial Priority Pathogens List’ published in 2024 lists some of the families of antibiotic-resistant bacterial families. These include Mycobacterium tuberculosis, Salmonella, Shigella, Neisseria gonorrhoeae, Pseudomonas aeruginosa, and Staphylococcus aureus.7
In a recent study published in the Lancet, researchers have estimated the global burden of antimicrobial resistance from 2019 to 2021, with forecasts up to 2050.8 Based on their estimates, 4.71 million deaths were associated with antimicrobial resistance while 1.14 million deaths were attributable to it. Although since the 1990s, deaths due to antimicrobial resistance have substantially reduced (more than 50%) in children below 5 years of age, the corresponding statistics among adults over 70 years of age have increased by more than 80%.8 Based on their current forecasts, in 2050, 1.91 million deaths would be attributable to antimicrobial resistance while 8.22 million deaths would be associated with it globally, with regions such as Latin America, South Asia, and the Caribbean likely to witness the highest rate of all-age antimicrobial resistance mortality.8
