As a WHO Collaborating Centre the Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, PHE works closely with WHO to share expertise internationally.
This comprehensive review covers data from 114 member states on levels of antimicrobial resistance in many types of bacteria and also in viruses, fungi and parasites.
The survey looked at bacteria of international concern and levels of resistance to the antibiotics used to treat them; resistance to antivirals used to treat HIV and flu and anti-malarial drugs.
The report notes very high levels of resistance in all WHO regions in those that cause both community and healthcare-associated infections. This includes ‘E.coli’ which can cause urinary tract and bloodstream infections, methicillin resistant staphylococcus aureus (MRSA) and multi-resistant tuberculosis (TB) among others.
Although some WHO regions record very high levels of antibiotic resistance in many different bacteria this is not the pattern seen in the UK. Resistance to carbapenems, the antibiotics of ‘last resort’ for multi resistant ‘klebsiella’ has increased over the years but the number of isolates (2,789 since 2003) are still relatively low in the UK. Levels of resistance to these very important antibiotics is extremely worrying but is kept under close scrutiny.
Professor Neil Woodford, Head of the Antimicrobial Resistance and Healthcare Associated Infections Reference Unit at PHE, said:
The development of resistance to any drug is an issue as it means that care and treatment of the patient is more difficult.
Resistance to antibiotics is widespread in some parts of the world and this is a big concern. It arises from the use and misuse of antibiotics and can be spread through international travel. Because we cannot undo the resistance that has already developed we must preserve the antibiotics that we have that still work and prevent spread of resistant strains.
Tuberculosis was another bacteria of note in the WHO report. The UK has an active surveillance of TB to make sure that people are promptly diagnosed and treated to reduce spread of the disease. Although there is resistance to first-line drug treatments this is seen in less than 8% of cases. Multi-drug resistance is seen 1.6% of cases.
Treatment for gonorrhoea is an area of concern as the bacteria shows high levels of resistance across a range of antibiotics. This is coupled with sustained transmission and repeat infections making it a major issue for public health.
Dr Paul Cosford, Director for Health Protection and Medical Director at PHE, said:
Whilst the UK does not have the levels of antibiotic resistance seen in some parts of the world we do see patients with infections resistant to antibiotics. This is a trend that is increasing and we take this very seriously.
Combatting the development and spread of antibiotic resistance requires a multi-faceted approach and PHE is working very closely with its stakeholders to address this. Our work is contributing to the new cross-government national strategy that aims to tackle one of the biggest healthcare issues of our time.
Notes to Editors
In England ‘klebsiella’ resistant to the important carbapenem antibiotics is less than 2% of cases of bloodstream infections. In 2 out of 6 WHO regions resistance of over 50% is recorded.
Levels of MRSA in hospitals have reduced substantially over the past years.
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