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Each year, an estimated 7.7 million deaths globally are caused by bacterial infections – one in eight of all global deaths, making bacterial infections the second largest cause of death globally.

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Sizwe sama Yende

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About 750 000 deaths annually that are linked to antibiotics resistance could be prevented in low-and middle-income countries by improving and expanding existing infection prevention methods.

According to an international study that the University of Cape Town’s (UCT) academics participated in, these methods include hand hygiene, regular cleaning and sterilisation of healthcare equipment, ensuring the availability of safe drinking water, effective sanitation and the use of paediatric vaccines.

Authors of a new Lancet Series on antimicrobial (AMR) resistance say if the world does not prioritise action on AMR now, there will be a steady increase in the global death toll.

“The current death toll is 4.95 million per year from infections linked to AMR – with young infants, elderly people, and people with chronic illnesses or requiring surgical procedures at the highest risk,” they say in a report.

Each year, an estimated 7.7 million deaths globally are caused by bacterial infections – one in eight of all global deaths, making bacterial infections the second largest cause of death globally.

“Out of these bacterial infection deaths, almost five million are associated with bacteria which have developed resistance to antibiotics,” the study found.

The authors call for support for sustainable access to antibiotics to be central to ambitious and actionable targets on tackling AMR introduced at the High-Level Meeting of the United Nations General Assembly in September 2024.

UCT said in a statement that its academics were among a group of international scientists calling for urgent global action on AMR and ensuring sustainable access to antibiotics.

The UCT academics said this could be achieved  through:

·      Intensifying efforts to promote vaccination, access to safe water and sanitation, and hospital infection control, thereby reducing infections and the use of antibiotics, which protects their long-term effectiveness;

·     Expanding access to existing and new antibiotics, which could save many lives lost to bacterial infections;

·     Increasing investment in new antibiotics, vaccines and diagnostics that are designed to be affordable and accessible to patients in need globally;

Novel modelling analysis undertaken for the series estimates that existing infection prevention methods could prevent 750 000 deaths associated with AMR infections annually.

The analysis estimates that improving infection prevention and control in healthcare facilities including better hand hygiene and more regular cleaning and sterilisation of equipment, could save up to 337 000 lives a year.

It also estimates that universal access to safe drinking water and effective sanitation in community settings could prevent approximately 247 800 deaths annually.

Thirdly, the analysis estimates that expanding the roll out of some paediatric vaccines, such as pneumococcal vaccines which help protect against pneumonia and meningitis, and introducing new ones, such as Respiratory Syncytial Virus (RSV) vaccines for pregnant mothers, could save 181 500 lives a year.

The series also looks at the evidence for preventing resistance emerging in bacteria, alongside preventing infections in the first place.

Antibiotic stewardship (reducing the use of antibiotics when the benefit to patients is limited) is thought to reduce the selection pressure on bacteria to develop resistance. However there is a lack of research in this area.

Co-author Associate Professor Esmita Charani from UCT says: “The current limited evidence on the impact of antibiotic stewardship on AMR from low- and middle-income countries does not mean it is not a key intervention that needs focus, but rather makes it difficult to anticipate the effects of antibiotic stewardship in those countries. We urgently need studies to investigate the impact to help inform future policies and interventions fit for different contexts.”

A recent study in The Lancet estimated that 7.7 million deaths were caused by non-Tuberculosis bacterial infections in 2019, of which almost five million were associated with bacterial AMR and 1.3 million directly caused by bacterial pathogens resistant to the antibiotics available to treat them.

The new series highlights how babies, children, the elderly and people with chronic illness are most vulnerable to AMR as they have a higher risk of contracting bacterial infections in general.

AMR is a huge threat to new born survival around the world and also to the elderly and the chronically ill.

“AMR undermines the safety of common medical procedures such as organ transplants, joint replacements, cancer chemotherapy, and treatment of non-communicable diseases such as cardiovascular disease, diabetes and chronic lung illnesses.”