The World Health Organisation (WHO) has released surveillance data on antibiotic resistance (AMR) that reveals high levels of resistance to a number of serious bacterial infections in both high- and low-income countries.

The data was collected as part of the WHO’s Global Antimicrobial Surveillance System (GLASS), an initiative that was launched in October 2015 to foster standardised AMR surveillance globally.

The aim of GLASS is to collect data and report on AMR rates aggregated at national level. The validated data on AMR is then analysed and shared with countries and partners in order to inform decision-making, drive local, national and regional action, and provide the evidence for interventions and advocacy. All data produced by GLASS is available for free online and is updated regularly.

The recently released GLASS data reveals widespread occurrence of antibiotic resistance among 500,000 people with suspected bacterial infections across 22 countries.

The most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, followed by Salmonella spp.

Mycobacterium tuberculosis data is omitted because the WHO has been tracking it since 1994 and provides annual updates in the Global tuberculosis report.

Among patients with suspected bloodstream infection, the proportion that had bacteria resistant to at least one of the most commonly used antibiotics ranged tremendously between different countries – from zero to 82%.

Resistance to penicillin – the medicine used for decades worldwide to treat pneumonia – ranged from zero to 51% among reporting countries. And between 8% to 65% of E. coli associated with urinary tract infections presented resistance to ciprofloxacin, an antibiotic commonly used to treat this condition.

“The report confirms the serious situation of antibiotic resistance worldwide,” said Director of WHO’s AMR Secretariat, Dr Marc Sprenger.

“Some of the world’s most common – and potentially most dangerous – infections are proving to be drug-resistant. And most worrying of all, pathogens don’t respect national borders. That’s why WHO is encouraging all countries to set up good surveillance systems for detecting drug resistance that can provide data to this global system,” continued Dr Sprenger.

To date, 52 countries (25 high-income, 20 middle-income and 7 low-income countries) are enrolled in WHO’s GLASS. For the first report, 40 countries provided information about their national surveillance systems and 22 countries also provided data on levels of antibiotic resistance.

Any country, at any stage of the development of its national AMR surveillance system, can enrol in GLASS.

“The report is a vital first step towards improving our understanding of the extent of AMR. Surveillance is in its infancy, but it is vital to develop it if we are to anticipate and tackle one of the biggest threats to global public health,” said Coordinator of GLASS, Dr Carmem Pessoa-Silva.

Data presented in this first GLASS report vary widely in quality and completeness. Some countries face major challenges in building their national surveillance systems, including a lack of personnel, funds and infrastructure.

However, the WHO is supporting more countries to set up national AMR surveillance systems that can produce reliable, meaningful data. GLASS is helping to standardise the way that countries collect data and enable a more complete picture about AMR patterns and trends.

Drug resistance surveillance programmes in TB, HIV and malaria have been functioning for many years and have helped estimate disease burden, plan diagnostic and treatment services, monitor the effectiveness of control interventions, and design effective treatment regimens to address and prevent future resistance. GLASS is expected to perform a similar function for common bacterial pathogens.

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