An extensive research study has disclosed that in 2019, 569,000 deaths in the World Health Organization’s Region of the Americas were attributable to bacterial antimicrobial resistance (AMR). This disturbing statistic accounts for 11.5% of global deaths associated with AMR. The predominant causes included bacterial infections of the respiratory system and bloodstream. Nations lacking a publicly disclosed National Action Plan (NAP) for combating AMR exhibited elevated mortality rates. Experts equate the severity of this health crisis to that of HIV/AIDS and malaria.
A considerable 43% of infection-related fatalities in the region had a connection to AMR.
A recent scholarly article published in The Lancet Regional Health – Americas has shown that 569,000 deaths across all 35 countries of the WHO Region of the Americas were linked to bacterial AMR. This study offers the most exhaustive data set thus far on the AMR burden in the Americas, covering 35 countries, 23 bacterial pathogens, and 88 pathogen-drug pairings.
The research estimates that over two in five deaths involving infections in the Americas in 2019 had a link to AMR, accounting for 11.5% of global AMR-related fatalities. Deaths associated with AMR are those where drug-resistant infections contributed to mortality, although other underlying conditions could also be factors. Of these, 141,000 deaths were specifically due to AMR, making up 11.1% of global deaths solely attributable to AMR.
Deaths specifically attributable to AMR are those where individuals succumbed because their resistant infections were untreatable; in such cases, AMR is considered the direct cause of death.
The four most deadly AMR-related infectious syndromes in the region were bacterial respiratory infections (293,000 deaths), bloodstream infections (266,000 deaths), intra-abdominal infections (181,000 deaths), and urinary tract infections (80,000 deaths). These accounted for 89% of bacterial infection-induced deaths.
The pathogens responsible for the highest number of AMR-associated deaths were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, collectively causing 452,000 deaths.
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Mortality Rates Across Countries
Countries such as Haiti, Bolivia, Guatemala, Guyana, and Honduras recorded the highest AMR-related mortality rates. On the other end of the spectrum, countries like Canada, the United States, Colombia, Cuba, Panama, Costa Rica, Chile, Venezuela, Uruguay, and Jamaica had the lowest. The mortality rate patterns were relatively consistent across nations when considering deaths directly attributable to AMR.
Age-Related Mortality Rates
AMR-related mortality rates demonstrated a similar trend across age groups in different countries. Rates were highest among newborns and then dipped for children under five, increasing steadily thereafter until around the age of 65, when a significant spike was observed.
Significance of National Action Plans
Nine of the countries with the highest AMR-related mortality rates either had no National Action Plan for AMR or had not made theirs public. Chile, Colombia, Costa Rica, and the United States were among the countries with published and financed AMR NAPs, and they also had some of the lowest AMR-related mortality rates.
Lucien Swetschinski of the Institute for Health Metrics and Evaluation (IHME) warns that without timely intervention, this global health emergency could spiral out of control and attain proportions akin to HIV/AIDS or malaria.
AMR-linked infections were the third primary cause of death in several countries including Bolivia, Brazil, Chile, Haiti, the Dominican Republic, Uruguay, and Peru.
Dr. Gisela Robles Aguilar of the University of Oxford emphasized the need for a robust surveillance network and policy action to mitigate the AMR crisis.
Preventative Measures
For countries like Haiti, Bolivia, and Peru, where high rates of infectious deaths are observed, infection control measures could drastically reduce the AMR burden. Strict AMR stewardship and surveillance are essential for countries like Chile, Mexico, and Peru.
Additional Information and Initiatives
Post the release of global bacterial AMR burden estimates in January 2022, IHME introduced an interactive visualization tool to create awareness about the burgeoning public health challenge. Further scholarly papers are in the pipeline.
Policy briefs for all 204 countries studied are available online, compiled by the Global Research on Antimicrobial Resistance (GRAM) Project, a collaboration between IHME and Oxford, with support from the UK Fleming Fund, the Wellcome Trust, and the Bill and Melinda Gates Foundation.
The findings will be presented at the World AMR Congress in Philadelphia on September 7-8, under the panel session titled “An Emerging Threat: AMR Burden at the Country Level.”
Reference: The research is published in The Lancet Regional Health – Americas with the DOI 10.1016/j.lana.2023.100561.
Frequently Asked Questions (FAQs) about Antimicrobial Resistance (AMR) in the Americas
What is the main finding of the study on antimicrobial resistance (AMR) in the Americas?
The primary finding is that in 2019, 569,000 deaths in the WHO Region of the Americas were linked to bacterial antimicrobial resistance (AMR). This accounts for 11.5% of global deaths associated with AMR.
What were the leading causes of AMR-related deaths in the region?
The leading causes of AMR-related deaths in the region were bacterial respiratory and bloodstream infections. These were followed by intra-abdominal infections and urinary tract infections.
Which countries had the highest and lowest mortality rates associated with AMR?
The countries with the highest AMR-associated mortality rates were Haiti, Bolivia, Guatemala, Guyana, and Honduras. Conversely, countries with the lowest rates were Canada, the US, Colombia, Cuba, Panama, Costa Rica, Chile, Venezuela, Uruguay, and Jamaica.
What is the significance of a National Action Plan (NAP) in relation to AMR?
A National Action Plan outlines how governments can work to achieve objectives in combating antimicrobial resistance. The study found that countries without a published and financed National Action Plan had higher AMR-associated mortality rates.
How does the study compare the threat of AMR to other global health crises?
Experts have compared the threat posed by AMR to that of HIV/AIDS and malaria, highlighting the urgency to address this health crisis.
What age groups are most affected by AMR-related mortality?
High rates of death among newborns were observed, followed by near-zero rates in children under 5. Mortality then gradually increased until about age 65, where rates surged significantly.
What are the implications for policymakers?
The study calls for immediate action from policymakers, clinicians, scientists, and the general public to implement new measures for combating AMR. Without intervention, the global health crisis could worsen and become uncontrollable.
Are there preventative measures suggested for countries with high AMR death rates?
For countries like Haiti, Bolivia, and Peru with high rates of infectious deaths, infection prevention and control could result in the greatest reduction in AMR burden. Strict AMR stewardship and surveillance are also recommended.
Who conducted the study and where was it published?
The study was a collaborative effort between the Institute for Health Metrics and Evaluation (IHME) and the University of Oxford. It was published in The Lancet Regional Health – Americas.
What initiatives have been launched to raise awareness about AMR?
The Global Research on Antimicrobial Resistance (GRAM) Project has been supported by the UK Fleming Fund, the Wellcome Trust, and the Bill and Melinda Gates Foundation to raise awareness. IHME also produced policy briefs for policymakers.
More about Antimicrobial Resistance (AMR) in the Americas
- The Lancet Regional Health – Americas Journal
- Institute for Health Metrics and Evaluation (IHME)
- WHO Report on Antimicrobial Resistance
- UK Fleming Fund
- The Wellcome Trust
- Bill and Melinda Gates Foundation
- Global Research on Antimicrobial Resistance (GRAM) Project
- National Action Plan on AMR
7 comments
Well, if this doesn’t make governments take notice and actually fund their national action plans, don’t know what will. Lives are literally at stake here.
This is a health crisis flying under the radar. The focus is often on immediate problems, but AMR is like a ticking time bomb. The more we ignore it, the worse its gonna get.
the numbers on newborn death rates are just heartbreaking. Its not like they even have a chance. We really need to take action on AMR, like yesterday.
Wow, this is seriously alarming. 569k deaths in just the Americas alone? This should be a wakeup call for everyone. Antibiotic resistance isn’t a future problem, its happening right now.
I’m not surprised at all. We’ve been overusing antibiotics for years, and now we’re paying the price. But the scary part is comparing it to HIV/AIDS and malaria. We need to do somethin fast!
Can’t believe the numbers are so high, especially in countries without a National Action Plan. Do we really need a plan to tell us how important this is? Just shocking.
The list of pathogens causing the most deaths is a nightmare. Staph, E. Coli, Klebsiella? These are common bacteria, and if they’re becoming resistant, we’re in big trouble.