NOVEMBER – DECEMBER 2023
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Infections due to antibiotic-resistant bacteria double the risk of death, according to an exhaustive systematic review and meta-analysis of fifty studies in the region.
Almost 100 years after the accidental discovery of penicillin, antibiotic resistance is a pressing public health problem that affects health, the economy and human development. Drug-resistant infections caused 1,3 million deaths in 2019 and are projected to kill 10 million people annually by 2050, generating a cumulative economic loss of $100 trillion if adequate measures are not taken to control them. The director of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, has described the phenomenon as a global threat that “erodes modern medicine and puts millions of lives at risk.”
Although it is expected or known that infections due to microorganisms resistant to more than one antibiotic, or multidrug-resistant, increase adverse health outcomes in patients compared to those caused by sensitive organisms, this increased risk has never been quantified in terms of mortality. for Latin America and the Caribbean. To address this question, we carried out a systematic review and meta-analysis recently published in Centers for Disease Control and Prevention (CDC) which included 54 observational studies published between 2000 and 2020, mostly cohort (93%) and retrospective, on 13.611 adult and pediatric patients in the region hospitalized for serious infections. Most of the studies were carried out in Brazil (54%), followed by Argentina (15%), Colombia (11%) and Mexico (11%).
The multidrug-resistant microorganism most frequently isolated in the studies analyzed was Staphyloccus aureus methylcino-resistant (30%). Other bacteria involved included Pseudomonas aeruginosa resistant to carbapenemases and enterobacteria producing broad-spectrum beta-lactamases.
The estimated fatality data were eloquent about the magnitude of the threat: almost half of the participants hospitalized for multidrug-resistant infections died, and the risk of that fatal outcome compared to those with non-resistant infections increased 93% after taking into account the characteristics of the patient and the infection.
A trend towards greater lethality was also observed in those patients with multidrug-resistant infections who did not receive adequate empirical treatment compared to those who did, although the differences did not reach statistical significance (see infographic).
The painting is somber, but it is also a call to action and reinforces the need to implement strategy to curb this threat to public health. Not only must the development of new drugs be encouraged, but, above all, efforts must be focused on preventing the appearance and transmission of these organisms through the strategy One Health of the WHO, which includes everything from good management of the rational use of antibiotics in human patients to a strong restriction of their use in animal production.
See infographic of this work here.
Company:
Dr. Agustín Ciapponi, director of the Argentine Cochrane Center of the IECS, doctor in Public Health and principal investigator of CONICET.