Scientific Articles – GARDP

The changing landscape of antimicrobial resistance and use in South Africa: The need for access to new antibiotics: A position paper

Hasina Khatun — Mon, 21 Oct 2024 11:14:20 +0000

Described as the silent pandemic, antimicrobial resistance (AMR) was identified in 2017 as one of the World Health Organization (WHO)’s top 10 global healthcare threats.[1] It is estimated that AMR was associated with 4.95 million deaths in 2019, with a disproportionate burden in low- and middle-income countries (LMICs), especially in Africa, where AMR is estimated to be associated with 1.05 million deaths.[2,3] The highest burden is in respiratory followed by bloodstream infections.[3] Neonatal deaths associated with AMR exceeded older age groups in most African countries.[3] Six pathogens are associated with almost 1 million deaths: Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii and Pseudomonas aeruginosa. K. pneumoniae is a more prevalent organism in LMICs compared with high-income countries (HICs), where E.coli contributes more significantly to AMR and associated deaths.[2] The rate at which AMR develops has been linked to overuse of antibiotics; however, there are several other contributory factors, especially in LMICs, including environmental contamination, healthcare transmission and suboptimal diagnostics.[4,5] While consumption of antibiotics in HICs is higher than in LMICs, there has been minimal increase over the last 5 years. This contrasts with LMICs, where consumption of antibiotics continues to rise.[2]

Authors

H Finlayson,Cert ID (Paeds), MBA ; V Chibabhai, MB BCh, FCPath Micro ; P Jeena, FCP (Paeds), PhD ; S Kolman, BPharm, MSc (Med) ; W Lowman, MMed (Micro), FC Path Micro ; T C Manzini, Cert ID, MMed (Int Med) ; T Nana, MB BCh, FCPath Micro ; J Nuttall, MB ChB, FCPaed ; A Parker, Cert ID, PhD ; P Skosana, MPharm, PhD ; V Ueckermann, PhD (Infect Dis), MMed (Int Med) ; A Wise, Cert MFM (SA), MSc

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Multicentre external validation of the Neonatal Healthcare-associated infectiOn Prediction (NeoHoP) score: a retrospective case–control study

Hasina Khatun — Tue, 01 Oct 2024 08:06:51 +0000

Neonatal mortality due to severe bacterial infections is a pressing global issue, especially in low- middle- income countries (LMICs) with constrained healthcare resources. This study aims to validate the Neonatal Healthcare- associated infectiOn Prediction (NeoHoP) score, designed for LMICs, across diverse neonatal populations

Authors

Lizel G Lloyd, Angela Dramowski, Adrie Bekker, Daynia Elizabeth Ballot, Cecilia Ferreyra, Birgitta Gleeson, Trusha Nana, Michael Sharland, Sithembiso Christopher Velaphi, Jeannette Wadula, Andrew Whitelaw, Mirjam Maria van Weissenbruch

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Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050

Hasina Khatun — Mon, 16 Sep 2024 10:30:35 +0000

Background: Antimicrobial resistance (AMR) poses an important global health challenge in the 21st century. A previous study has quantified the global and regional burden of AMR for 2019, followed with additional publications that provided more detailed estimates for several WHO regions by country. To date, there have been no studies that produce comprehensive estimates of AMR burden across locations that encompass historical trends and future forecasts.

Introduction: In 2014, the Review on Antimicrobial Resistance (AMR) projected that 10 million deaths caused by AMR could occur by 2050. This estimate, while the subject of scientific criticism, helped position AMR as one of the most pressing threats to health of the 21st century. In the years since, WHO committed to the 2015 AMR global action plan, AMR was the focus of a high-level UN general assembly in 2016, and an AMR-specific indicator was included as a Sustainable Development Goal: to reduce the percentage of bloodstream infection due to selected antimicrobial-resistant organisms (indicator 3.d.2). Despite the attention AMR has received at the global level, the implementation and funding of national action plans has been uneven, leading to uncertain progress in attenuating the burden of AMR.

GBD 2021 Antimicrobial Resistance Collaborators: Mohsen Naghavi, Stein Emil Vollset, Kevin S Ikuta, Lucien R Swetschinski, Authia P Gray, Eve E Wool, Gisela Robles Aguilar, Tomislav Mestrovic, Georgia Smith, Chieh Han et al.

GBD 2021 Antimicrobial Resistance Collaborators

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Coverage gaps in empiric antibiotic regimens used to treat serious bacterial infections in neonates and children in Southeast Asia and the Pacific

Hasina Khatun — Wed, 01 Nov 2023 08:56:14 +0000

High levels of antimicrobial resistance (AMR) are propagating deaths due to neonatal and paediatric infections globally. This is of particular concern in Southeast Asia and the Pacific, where healthcare resources are constrained and access to newer agents to treat multidrug-resistant pathogens is limited.

Authors

Phoebe C.M. Williams, Mark Jones, Thomas L. Snelling, Robert Duguid, Nerida Moore, Benjamin Dickson, Yue Wu, Jessica Saunders, Priyali Wijeratne, Anousone Douangnouvong, Elizabeth A. Ashley, Paul Turner

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Neonatal sepsis and antimicrobial resistance in Africa

Hasina Khatun — Tue, 29 Aug 2023 09:59:25 +0000

Mortality rates in children younger than 5 years have reduced by half globally since 1990, but neonatal mortality rates remain high and far from the Sustainable Development Goal target of less than 12 deaths per 1000 livebirths by 2030. Sepsis is a leading cause of death in the first 28 days of life, particularly in sub-Saharan Africa. Bacterial sepsis is dominated by Gram-negative pathogens with substantial antimicrobial resistance, contributing to this region having the highest death rates attributable to antimicrobial resistance globally. WHO’s antibiotic treatment guidelines have not kept pace with the exponential rise of antimicrobial resistance in sub- Saharan Africa, potentially exacerbating neonatal sepsis deaths. We, as representatives of the African Neonatal Association, call for urgent action and innovation (panel).

Authors

Pui-Ying Iroh Tam, Adrie Bekker, Olufunke Bosede Bolaji, Gwendoline Chimhini, Angela Dramowski, Felicity Fitzgerald, Alemayehu Mekonnen Gezmu, John Baptist Nkuranga, Uduak Okomo, Alexander Stevenson, Jonathan P Strysko, the African Neonatal Association Sepsis Working Group

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Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis

Hasina Khatun — Thu, 20 Jan 2022 10:48:11 +0000

DOI:https://doi.org/10.1016/S0140-6736(21)02724-0

About: This study provides the first comprehensive assessment of the global burden of AMR, as well as an evaluation of the availability of data. AMR is a leading cause of death around the world, with the highest burdens in low-resource settings. Understanding the burden of AMR and the leading pathogen–drug combinations contributing to it is crucial to making informed and location-specific policy decisions, particularly about infection prevention and control programmes, access to essential antibiotics, and research and development of new vaccines and antibiotics. There are serious data gaps in many low-income settings, emphasising the need to expand microbiology laboratory capacity and data collection systems to improve our understanding of this important human health threat.

Authors: Christopher JL Murray Kevin Shunji Ikuta Fablina Sharara Lucien Swetschinski et al.

Commentary by Ramanan Laxminarayan, founder and director of the Centre for Disease Dynamics, Economics & Policy (CDDEP) and GARDP Board Chair

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