WHO: Widespread, high levels of antibiotic resistance across the globe
High levels of resistance were also found in bacteria that have been deemed “priority pathogens” by the WHO. In South Korea, nearly 75 percent of Acinetobacter isolates found in blood were resistant to the carbapenem antibiotics imipenem and meropenem. Carbapenem-resistant A baumannii has been classified by the WHO as a critical priority for research and development of new antibiotics.
Some countries also reported high levels of resistance in the bacterium that causes gonorrhea. In Malawi, nearly 100 percent of Neisseria gonorrheae genital isolates were non-susceptible to ceftriaxone and roughly 15 percent were non-susceptible to azithromycin. These drugs that constitute the only remaining treatment for gonorrhea. The WHO has warned that the emergence of pan-drug–resistant gonorrhea is on the horizon and has classified N gonorrheae as a high-priority pathogen.
The WHO notes, however, that the data—submitted from April 2017 through July 2017—vary widely in quality and completeness because of differences in surveillance capabilities. The countries combined submitted 507,746 isolates with antibiotic susceptibility testing results, but the number of isolates per country was as low as 72 and as high as 167,331. Only one country submitted data on all selected pathogens. Because of this variability, the report does not attempt to compare results between countries and regions.
The GLASS report does not include data on drug-resistant tuberculosis, which the WHO tracks separately.
Surveillance capabilities vary
The WHO calls the GLASS report “an important first step” and says it shows that more and more countries are building up their surveillance capabilities and will be able to provide more complete data in the future. The agency says almost all countries enrolled in GLASS have what it considers to be the three essential core components for national AMR surveillance: a national coordination center, a national reference laboratory, and sentinel surveillance sites where diagnostic results and epidemiologic data are collected.
But some countries face larger hurdles than others in establishing their AMR surveillance systems. Lack of funds, too-few personnel, and poor health system infrastructure are particular challenges for low- and middle-income countries and will have to be overcome.
“A global system such as GLASS can succeed only through continued data sharing as well as global collaboration, harmonisation, and coordination between all partners involved in the implementation of AMR surveillance,” the WHO writes in the report.
The WHO says GLASS is supporting countries in their efforts to build national laboratory capacity and is prioritizing technical assistance in low-income countries through a range of activities.
— Read more in Global Antimicrobial Resistance Surveillance System (GLASS) Report Early implementation 2016-2017 (World Health Organization, 2017)
