"Superbugs" may cause 39 million deaths, new research: drug resistance in the next 25 years | antibiotics | superbugs

A paper published in the famous British medical journal The Lancet on the 16th warned that antibiotic resistance could cause more than 39 million deaths worldwide in the next 25 years, with the elderly facing the greatest threat. However, if measures such as reducing the abuse of antibiotics can be taken, the worst situation can be avoided.

Antibiotic resistance has often attracted attention over the years. On the one hand, antibiotics can be used to treat infectious diseases caused by bacteria, fungi, etc., and have a wide range of clinical applications. But on the other hand, the problem of antibiotic resistance follows, and pathogens that are "immune" to antibiotics are called "superbugs."

The Lancet published a research report on the 16th, analyzing the long-term trend of antibiotic resistance worldwide. The time span and geographical scope covered are rare in the industry and are representative.

The study is based on data from 520 million people of all ages in 204 countries and regions around the world, including medical records, death records, and antibiotic use. Based on these data, a team of researchers from multiple countries evaluated 22 pathogens, 84 combinations of pathogens and drugs, and 11 infectious syndromes, such as meningitis.

The study found that between 1990 and 2021, more than 1 million deaths worldwide each year were directly related to antibiotic resistance, and the average number of indirectly related deaths reached 4.71 million per year.

It is worth mentioning that this study revealed huge regional differences in the problem of antibiotic resistance. In contrast, low- and middle-income countries and regions are particularly at risk, and antibiotic resistance-related mortality rates are particularly high in sub-Saharan Africa and South Asia.

The study also revealed stark differences in the development of antibiotic resistance in different populations. Between 1990 and 2021, the number of deaths from antibiotic resistance in children under the age of five worldwide fell by 50%, while the number of deaths in people aged 70 and over increased by more than 80%.

Some believe that this is mainly because the world has strengthened infection prevention and control measures such as vaccination for infants and young children; the aging population and the fact that the elderly are more susceptible to infection have led to an increase in the risks faced by the elderly.

The researchers expect these trends to continue in the coming decades: By 2050, deaths from antibiotic resistance are expected to be halved among children under the age of five, while deaths among people aged 70 and over will more than double.

The researchers also predicted that based on current trends, if no action is taken, the number of deaths related to antibiotic resistance will gradually increase in the coming decades. Between 2025 and 2050, antibiotic resistance may be directly associated with more than 39 million deaths and indirectly associated with 169 million deaths.

"These findings highlight that antibiotic resistance has been a major threat to global health for decades, and that threat is growing," said Mohsen Nahawi, a researcher at the Institute for Health Metrics and Evaluation at the University of Washington. Antibiotics are considered one of the cornerstones of modern medicine, but the increasing resistance of various pathogens to antibiotics is worrying.

However, according to the study, there is still hope - if the world works together to improve care for those with serious infections, an estimated 92 million deaths could be avoided between 2025 and 2050.

"We urgently need new strategies," said Stan Walsett, a researcher at the Institute for Health Metrics and Evaluation. The risk of serious infections can be reduced by taking measures such as preventing infections, reducing the misuse of antibiotics and developing new drugs.

There is also a view that phage therapy may be used to deal with "superbugs". Phages are viruses that specifically use bacteria as hosts. They can invade bacteria and continuously replicate their own genes, eventually engulfing bacteria, and are therefore considered to be the natural enemy of bacteria. Previously, with the emergence of antibiotics, the interest in phage therapy gradually faded.

At the same time, some believe that although the new study provides a relatively comprehensive assessment of the long-term development trend of antibiotic resistance worldwide, it does not take into account the possible emergence of new "superbugs" in the future, which may lead to the related impact being underestimated.

In fact, antibiotic resistance is not a strange topic. In September 2016, the United Nations General Assembly held a high-level meeting on the issue, which attracted widespread attention. At that time, countries voted to adopt a political declaration - Resolution 71/3. However, since then, the momentum of countries to jointly address the problem of antibiotic resistance has weakened.

Today, antibiotic resistance is increasingly seen as a systemic risk similar to climate change, ecosystem changes, etc.

Last year, the World Health Organization listed antibiotic resistance as "one of the greatest global threats to public health and development."

The World Bank estimates that antibiotic resistance will have a negative impact on economic and social development, and could result in an additional $1 trillion in medical costs by 2050. By 2030, antibiotic resistance will result in an annual loss of $1 trillion to $3.4 trillion in GDP.

It is worth mentioning that when The Lancet published the research report on the 16th, the new UN General Assembly was scheduled to hold a new high-level meeting on the 26th to discuss the issue of antibiotic resistance. At that time, leaders of various countries will gather in New York and are expected to issue a new common voice on related topics.