Health organizations need ‘new methodologies’ to assess impact of drug-resistant diseases: WHO

The resistance to some drugs of diseases — including some types of sepsis, pneumonia and gonorrhoea — is hurting the global economy and leading to higher health-care costs, but there is a “general lack” of surveillance on antibacterial resistance that could give better information on the economic impact, suggests a report released Thursday by the World Health Organization.

The 257-page report, titled Antimicrobial Resistance: Global Surveillance Report, “focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea,” Geneva-based WHO stated in a press release.

“Systematic reviews of the scientific evidence show that (antibiotic resistance) has a negative impact on outcomes for patients and health-care expenditures,” wrote Dr. Keiji Fukuda, WHO’s assistant director-general for health security, in the forward to the report. The document includes several tables listing published resistance rates of common bacterial pathogens – such as the resistance of Escherichia coli to third-generation cephalosporinsa and to fluoroquinolonesa – in different regions, and breaks those regions down by country.

Other pathogens listed include Klebsiella pneumoniae, Streptococcus pneumoniae, Nontyphoidal Salmonella, Shigella and Neisseria gonorrhoeae.

“Treatment failure to the last resort of treatment for gonorrhoea-third generation cephalosporins has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom,” WHO warned.

WHO collected data from scientific literature, networks for ABR resistance and national official sources, including health ministries, national reference laboratories and public health institutes.

“The evidence obtained shows that (antibacterial resistance) has a significant adverse impact on clinical outcomes and leads to higher costs due to consumption of health-care resources,” WHO stated in the report. “However, the overall health and economic burden resulting from acquired ABR cannot be fully assessed with the presently available data; new methodologies are needed to more precisely assess the total impact of resistance, to better inform health policies and to prioritize the deployment of resources.”

WHO concludes there is a “lack of coordinated global ABR surveillance — with a defined goal and agreed epidemiological and microbiological methods and standards — to provide a comprehensive situation analysis.”

There is also a “general lack of population-based ABR surveillance to provide information on the overall morbidity and mortality, and the economic burden and societal impact of ABR,” WHO added.

Antimicrobial resistance “has been a growing threat to the effective treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi,” WHO noted, adding the annual cost to the health care system in the United States has been estimated at US$21 billion to $34 million, as well as an additional eight million days’ worth of hospital stays.

“Because AMR has effects far beyond the health sector, it was projected, nearly 10 years ago to cause a fall in real gross domestic product (GDP) of 0.4% to 1.6%, which translates into many billions of today’s dollars globally.”

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