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

Read article Submitted by: Dr Shaima Al Madhani and Dr. Laila Al Yazidi, Sultan Qaboos University Hospital, University Medical City, Muscat, OmanBackground: Antimicrobial resistance (AMR) is a major global health issue in the 21st century. This study assessed global AMR-related deaths and DALYs from 1990 to 2021 across 204 countries using 520 million records. It also projected the AMR burden to 2050 under baseline, Gram-negative resistance, and enhanced care scenarios.Main Findings: In 2021, an estimated 4.71 million deaths were associated with bacterial antimicrobial resistance (AMR), with 1.14 million directly attributable. AMR mortality trends varied significantly by age: there was a 50% reduction in deaths among children under 5 years, while mortality increased by 80% in adults over 70. The decline in pediatric AMR mortality was observed across all global regions, contrasting with rising deaths in individuals aged 5 and older. Globally, MRSA-related deaths rose from 261,000 in 1990 to 550,000 in 2021, and carbapenem-resistant Gram-negative bacterial deaths increased from 619,000 to over 1 million. By 2050, AMR may cause up to 1.91 million attributable deaths annually, with the greatest burden projected in South Asia, Latin America, and the Caribbean. Enhancing infection care and access to antibiotics could save up to 92 million lives by 2050. A focused investment in Gram-negative drug development may further prevent over 11 million AMR-related deathsTake home message: Effective infection control has significantly reduced AMR-related deaths in children under 5. This highlights the urgent need to strengthen infection prevention strategies to further lower pediatric AMR mortality by the year 2050.

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Quiz Questions

1.
1. Which age group showed a greater than 50% reduction in AMR mortality from 1990 to 2021?
- A.
  A) Adults over 65
- B.
  B) Teenagers
- C.
  C) Children under 5 years
- D.
  D) Middle-aged adults
- E.
  E) Neonates
2.
2. Which town or city close to Australia has a current outbreak of multi-drug resistant TB?
- A.
  A) Dili, Timor-Leste
- B.
  B) Daru, Papua New Guinea
- C.
  C) Honiara, Solomon Islands
- D.
  D) Kupang, Indonesia
3.
3. Which of the following patient groups were NOT included in the endTB trial examining 9-month oral regimes for RR-TB?
- A.
  A) HIV positive
- B.
  B) Bilateral pulmonary disease
- C.
  C) Cavitary disease
- D.
  D) Miliary TB

Quiz Outcomes

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Results