One in six bacterial infections is now resistant to standard drugs, WHO warns

One in six bacterial infections worldwide is now resistant to standard treatments, according to anew report from the World Health Organization (WHO) that identified an alarming global rise in infections that no longer respond to antibiotics.

This phenomenon is known as antimicrobial resistance (AMR), and it occurs when bacteria and other pathogens – causing infections of the blood, gut, urinary tract, and sexually transmitted infections (STIs), among others – evolve to the point where standard antibiotics can no longer control them.

People accelerate this process by, for example, stopping antibiotic treatment before finishing the prescribed course, and when doctors incorrectly prescribe antibiotics to treat ailments the medicines do not help with.

The WHO findings, drawn from more than 23 million cases across 104 countries in 2023, show that resistance has risen in about 40 per cent of the pathogen-antibiotic combinations analysed since 2018.

According to the study, the problem is particularly severe in low- and middle-income countries, where AMR surveillance, microbiological diagnostic capacity, and access to effective alternative treatments may be limited.

For example, the WHO estimates that one in three bacterial infections in Southeast Asia and the Eastern Mediterranean are now resistant to antibiotics, compared with one in five in Africa.

Despite the disparities, no region is immune from the risks. According to a study published last year, the annual number of AMR-attributable deaths in high-income countries is expected to grow from 125,000 to 192,000 between 2021 and 2050.

"Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide," WHO chief Tedros Adhanom Ghebreyesus said.

Hospital infections leading the surge

The WHO report found that resistance to essential antibiotics is rising fastest among Gram-negative bacteria, the group responsible for many of the most severe hospital infections. Infections in the bloodstream can cause sepsis, organ failure, and death.

Some species, such as Klebsiella pneumoniae and E. coli, have shown resistance rates of over 70 per cent in parts of Africa, leaving few viable treatment options.

Salmonellaand Acinetobacter bacteria are also increasingly resistant to antibiotics such as carbapenems and fluoroquinolones.

Even the last remaining treatment for gonorrhoea – ceftriaxone – has begun to show signs of resistance in parts of the Eastern Mediterranean region, threatening to render one of the world’s most common STIs untreatable with existing medicines.

The report urges countries to cut reliance on powerful antibiotics on the WHO's “Watch” list, and ensure that 70 per cent of global antibiotic use comes from first-line “Access” drugs by 2030 – a target set by the UN last year.

"Our future also depends on strengthening systems to prevent, diagnose and treat infections and on innovating with next-generation antibiotics and rapid point-of-care molecular tests," Tedros said.