The largest ever study that examines the threat from superbugs revealed that antibiotic-resistant infections caused 1.2 million deaths in 2019 alone.
Superbugs would be a greater global threat than AIDS and malaria which each killed 640,000 people in the same year. Covid is estimated to have killed 3.5million people between 2021 and 2022.
On top of direct deaths, researchers estimate superbugs were also a potential factor in another 5million deaths globally in 2019.
Researchers from University of Washington and University of Oxford Not a good idea. The death toll could increase over the years if nothing is done.
Superbugs can be bacteria that has developed resistance to antibiotics over time due to incorrect prescribing or misuse of drugs. The emergence of superbugs could lead to dangerous and deadly conditions in medical care and make it more difficult for patients to survive.
This figure of 1.2million deaths is significantly higher than the World Health Organization’s previous largest estimate, which indicated that the problem was responsible for 700,000. In England alone, 5,000 deaths every year are estimated to be cause caused by resistant infections.
Although superbugs are predicted to kill 10 million people each year worldwide by 2050 according to official estimates, the most recent study’s researchers claim that the death rate is rising faster than anticipated.
People can be infected by bacteria in a number of ways, from a person coughing, contaminated food or drink, to an open wound, infecting organs such as the lungs, or even the bloodstream. They can be fatal, causing issues like inflammation, or sepsis, as the immune system tries to fight off the bacteria.
Previously, medics could help a patient fight off the bacteria by prescribing antibiotics — but some species have developed resistance to the medications, making them far more dangerous.
They used 471million records to arrive at their figures. This data included both previous research on superbugs and surveillance systems by hospitals and authorities that track resistant antibiotic-resistant diseases. These data were used by researchers to make an estimate of the death rate if the superbugs could have been treated with antibiotics.
In the latest research, this graph displays the global direct and indirect deaths due to antibiotic-resistant bacteria. While South Asia and Africa had the highest number of deaths per 100 000 people respectively, Western European countries such as the UK still saw a significant increase in fatalities.
Below is a graph showing the number of superbug-related fatalities by type in 2019. LRIs, or lower respiratory tract infections such as pneumonia, were the most deadly. This led to approximately 400,000 deaths. It also contributed nearly 1.5million. BSIs (bloodstream infection) was the second most deadly killer. They were directly responsible for almost 175,000 deaths. This was followed by intraabdominal infections, urinary tract infections (UTIs), tuberculosis, skin infections, central nervous system infections, typhoid fever, paratyphoid fever, and invasive non-typhoidal Salmonella infections (TF–PF–iNTS), diarrhoea, cardiac infections, and bone infections
An illustration of Bacterium Pseudomonas aeruginosa, one of the 23 antibiotic resistant superbugs examined in the study, and one of the six biggest global killers
Chris Murray, a University of Washington expert in global health and co-author of the study, stated that these figures are a “clear signal we need to act now”.
He said, “Previous estimates predicted that 10 million deaths annually from antimicrobial resistant disease by 2050. But we know now that we’re already much closer than that number.”
“We must use this data to drive innovation and course-corrective action if we are to win the fight against antimicrobial resistant.”
Murray called for a better use and funding of current antibiotics, to reduce the risk of developing superbugs.
The findings were published in The Lancet.
The highest death rates from superbugs in areas like Africa or South Asia with less well-developed health infrastructure were found.
High-income countries like the UK had higher death rates, however.
Researchers also found that of the 23 pathogens studied, just six, including an antibiotic resistant strain of the stomach bug E.coli, were directly responsible for 900,000 deaths, and contributed to 3.5million more.
It was the resistance to two types of antibiotics — fluoroquinolones and beta-lactam — considered the ‘first line of defence’ against severe infections that accounted for 70 per cent of the global death toll.
Beta lactam antibiotics, also known as penicillin or penicillin, are the first antibiotics that were developed to treat modern medicine. It was identified in 1928 by Sir Alexander Fleming (Scotland).
Infections from antibiotic-resistant bacterial lower respiratory tract infections — which can lead to pneumonia, a swelling of the lung tissues — was the biggest killer in the study.
The death of this virus was directly estimated at 400,000 in 2019, and it is associated with over 1.5 million deaths.
The second most deadly killer was superbugs that infected the bloodstream. They caused around 370,000 deaths, and were associated with less than 1.5 million.
This was followed by intra-abdominal infections, which can lead to appendicitis — where the appendix swells and needs to be removed surgically.
This condition was associated with 800,000.
The number of deaths directly caused by superbugs was highest in sub-Saharan Africa in 2019, which includes all African regions except North Africa. There were 24 such deaths for every 100,000.
The South Asia region, including countries like India and Pakistan, saw 22 deaths per 100,000 people.
High income countries, such as the UK, had 13 deaths for every 100,000 inhabitants.
Associated deaths, where superbugs played a role in a death, were estimated to be 99 per 100,000 in Sub-Saharan Africa and 77 per 100,000 in South Asia.
The cases involved deaths due to drug-resistant bacteria. However, it is not clear if antibiotics could have saved the victim if they were susceptible to them.
The graph below shows 23 antimicrobial resistant pathogens that were included in this study, and how many deaths they caused in 2019. Just six of these were directly responsible for 900,000 deaths and contributed to 3.5million more
Regional differences were found in the superbugs responsible for most of the deaths in the study.
In Sub-Saharan Africa, 36 per cent of all fatalities caused by antibiotic resistant bacteria were caused by two species, Klebsiella pneumoniae and Streptococcus pneumoniae.
In comparison, around half of superbug deaths in countries like the UK were caused by either Staphylococcus aureus, a type of bacteria which causes skin infections, or E. coli — famous for causing stomach bugs.
The authors admit that one of the weaknesses of their study is the assumption they had to use to calculate superbug deaths in certain parts of the world because there was not enough data.
Study co-author, Professor Christiane Dolecek an expert in tropical diseases from Oxford University, said this was a data gap that needed to be addressed if the global community wanted to curb the spread of antimicrobial resistance.
She stated that resistance can vary so significantly by region and country. It is important to improve the global collection of data to better track resistance levels and provide clinicians and policymakers the necessary information to tackle the greatest challenges of antimicrobial resistance.
“We found serious data gaps across many low-income nations, and highlighted the need for increased laboratory capacities as well as data collection.
Commenting on the research, Dr Ramanan Laxminarayan, an epidemiologist from the Center for Disease Dynamics, Economics and Policy, said the study’s finding should drive global leaders to invest more in research to combat superbugs.
He stated that spending should be directed towards preventing infection in the first instance, making sure antibiotics are properly and wisely used, as well as bringing new anti-infectives to the market.
‘Health officials and leaders on all levels of government, including at the national, international and local level, need to be aware of the critical importance of dealing with AMR and the challenges of low access to effective, affordable antibiotics.
The overuse of antibiotics, mainly for minor ailments like ear infections or their misuse by those incorrectly using them for viral illnesses such as the flu, is believed to be a contributing factor to antimicrobial resistance.
The overuse of antibiotics can result in resistance. Patients may become more susceptible to the drugs after severe infections, major surgeries or other serious conditions.
Researchers calculated the global superbug burden using 471million individual records gathered from records in hospitals and studies around the world.