Over 40 million people might die from superbugs by 2050: Study

The study that highlights the severity of the current superbugs epidemic predicts that by 2050, the number of deaths globally from illnesses that are resistant to the drugs used to treat them might rise by about 70%.

According to a research that was published on Monday in the journal The Lancet, there may be a cumulative total of over 39 million fatalities worldwide between 2025 and 2050 that are directly related to antibiotic resistance, or AMR.

Antimicrobial resistance occurs when bacteria, fungi, and other pathogens learn to resist the drugs meant to eradicate them. AMR is “one of the top global public health and development threats,” according to the World Health Organization. It is caused by the overuse and abuse of antibiotics in people, animals, and plants, which can lead to bacteria becoming resistant to them.

The head of the University of Washington’s Institute for Health Metrics and Evaluation and main author of the new study, Dr. Chris Murray, stated that “we expect it to get worse” in terms of the prevalence of AMR and its impacts.

“To address what is really quite a large problem, we need to give new antibiotics and antibiotic stewardship the appropriate attention,” he stated.

The researchers estimated the number of deaths and illnesses linked to antimicrobial resistance versus those caused by it for 22 pathogens, 84 pathogen-drug combinations, and 11 infections across 204 countries and territories between 1990 and 2021. They were from the Global Research on Antimicrobial Resistance Project, the Institute for Health Metrics and Evaluation, and other institutions. A mortality linked to antimicrobial resistance (AMR) may have had a secondary cause that the antimicrobial resistance amplified, whereas a death due to AMR was caused directly by the antimicrobial resistance.

Impact of Superbugs on Global Health: Projections and Regional Concerns

Approximately 520 million distinct records comprised the dataset used to generate those estimations.

The study’s findings show that between 1990 and 2021, mortality from antimicrobial resistance (AMR) decreased by over 50% in children under the age of five but increased by over 80% in people 70 years of age and above. These patterns are expected to persist.

Murray claimed that the patterns that appeared were unexpected.

“We had these two opposite trends going on: a decline in AMR deaths under age 15, mostly due to vaccination, water and sanitation programs, some treatment programs, and the success of those,” Murray said. “And at the same time, there’s this steady increase in the number of deaths over age 50,” he said, as the world ages; older adults can be more susceptible to severe infection.

Methicillin-resistant Staphylococcus aureus, or MRSA, was the pathogen-drug combination that had the most rise in generating the most burden across all age categories, according to the report. The number of fatalities attributed to this combination—the bacterium S. aureus and the drug methicillin—nearly quadrupled from 57,200 in 1990 to 130,000 in 2021.

Through statistical modeling, the researchers also generated projections for the number of deaths and illnesses linked to antimicrobial resistance (AMR) by 2050 under three different scenarios: the continuation of the current climate, the development of new, powerful antibiotics to target resistant pathogens, and the improvement of infection care and antibiotic accessibility globally.

According to projections, if action is not taken to promote access to high-quality healthcare, potent antibiotics, and other resources to prevent and treat illnesses, the number of fatalities from antimicrobial resistance is expected to rise by 2050.

The researchers projected that 8.2 million fatalities worldwide might be linked to antibiotic resistance by 2050, and 1.9 million deaths worldwide could be directly caused by antibiotic resistance.

The data indicates that South Asia, Latin America and the Caribbean, and sub-Saharan Africa are the regions of the globe most affected by AMR and fatalities that can be attributed to it; many of these places, according to Murray, do not have fair access to high-quality healthcare.

“There are still, unfortunately, a lot of places in low-resource settings where people who need antibiotics are just not getting them, and so that’s a big part of it. But it’s not just the antibiotics. It’s when you’re sick, either as a kid or an adult, and you get sent to hospital, and you get a package of care, essentially, that includes things like oxygen,” Murray said.

“In low-resource settings, even basics like oxygen are often not available. And then, if you are very sick and you need an intensive care unit, well, there’s big parts of the low-resource world – most of them, actually – where you wouldn’t get access to that sort of care,” he said. “So there’s a spectrum of supportive care, plus the antibiotics, that really make a difference.”

Nevertheless, the researchers predict that 92 million deaths might be prevented globally between 2025 and 2050 if health care standards are improved. Furthermore, around 11 million fatalities may be prevented if the globe were to get new, more po\werful medications.

“There may be hope in the near future.”

This study’s “innovative and collaborative” methodology offers a “comprehensive assessment” of antibiotic resistance and its possible global burden. The Kenya Medical Research Institute’s Samuel Kariuki provided a commentary to go along with the recently published report in The Lancet.

However, he cautioned that the forecast models “may lead to underestimation if new pathogens arise” since they do not account for the introduction of new superbugs.

All things considered, according to Kariuki, “this facts should motivate investments and focused action” toward resolving the escalating problem of antibiotic resistance in all parts of the world.

Dr. Steffanie Strathdee, assistant dean of global health sciences and distinguished professor at the University of California San Diego School of Medicine, who was not involved in the study, stated that the new publication represents decades of research on the worldwide impact of antimicrobial resistance.

Strathdee’s husband almost passed away from a superbug illness, allowing her to witness directly the consequences that antibiotic resistance may have on health.

“I’m somebody who’s lived with antimicrobial resistance affecting my family for the last eight years. My husband nearly died from a superbug infection. It’s actually one of the infections that’s highlighted in this paper,” said Strathdee, who serves as co-director of the Center for Innovative Phage Applications and Therapeutics at UC San Diego.

In 2015, Strathdee Patterson’s husband Tom Patterson experienced unexpectedly terrible stomach aches while on a Thanksgiving cruise on the Nile. A grapefruit-sized abdominal abscess filled with Acinetobacter baumannii, a vicious bacteria resistant to almost all antibiotics, was found by physicians in Germany after Patterson was transferred from an Egyptian clinic that was unable to alleviate his deteriorating symptoms.

As per the latest study, the number of deaths from carbapenem-resistant gram-negative bacteria, such as A. baumannii, which are used as last-resort antibiotics to treat severe bacterial infections, increased by 89,200 annually between 1990 and 2021, surpassing the deaths from any other antibiotic class during that time.

“That’s one of the urgent priority pathogens, which is one of these gram-negative bacteria,” Strathdee said. “And my husband, when he fell ill from this, he was 69. So he’s exactly at the age that this paper is highlighting, that older people are going to be affected by this more in the future, because our population is aging and people have comorbidities, like diabetes, like my husband has.”

Following treatment with phages—virals that specifically target and eradicate bacteria—Strathdee’s spouse made a full recovery. Phage therapy is a therapeutic option for bacterial illnesses resistant to antibiotics.

“The most important alternative to antibiotics is phage therapy, or bacteriophage therapy, and that’s what saved my husband’s life,” Strathdee said. “Phage can be used very effectively with antibiotics, to reduce the amount of antibiotics that are needed, and they can even be used potentially in livestock and in farming.”

Strathdee is optimistic that the globe can lessen the possible burden of antibiotic resistance as a result of the current study. She stated that in order to achieve this, it would be necessary to decrease the use of antibiotics in livestock, food production, and the environment, which can lead to the development of resistance, while simultaneously increasing access to vaccinations, clean water, newer antimicrobial drugs, and other components of high-quality healthcare globally.

“Perhaps there is hope coming,” stated Strathdee. “We could significantly lower the number of deaths in the future if we were to scale up these interventions.”

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