“Looming threat” – Superbug deaths increase in over 70s by 80 per cent

A new study, published in The Lancet, has forecast that drug-resistant infections will be the direct cause of tens of millions of deaths by the middle of the century.

The Global Research on Antimicrobial Resistance Project (AMR) predicts that by 2050 there will be approximately 1.91 million global deaths attributable to AMR annually and a further 8.22 million annual deaths associated with AMR.

"Antimicrobial resistance occurs when microorganisms such as bacteria, viruses, fungi and parasites no longer respond effectively to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death," explained Professor Rajaraman Eri, an immunology and gut health expert at RMIT.

The conclusions in the study are based on data from 204 countries and territories. The researchers estimated the number of deaths that could be blamed on antimicrobial resistance from 1990 to 2021, and then forecast how many would occur from now up until 2050.

“Antimicrobial medicines are one of the cornerstones of modern healthcare, and increasing resistance to them is a major cause of for concern,” said the study’s chief author, Dr Mohsen Naghavi.

“These findings highlight that AMR has been a significant global health threat for decades and that this threat is growing.”

Most worryingly, perhaps, is the clear division of AMR impact based on age. Researchers have identified that older people have a significantly lower chance of surviving a drug-resistant infection.

In the three decades between 1990 and 2021, deaths caused by AMR more than halved for children under five, from a high of 488,000 deaths per year to 193,000, and these figures are still on a downward trend. However, for those aged 70 and over deaths have increased by a staggering 80 per cent.

“The rise of antimicrobial research poses a profound challenge to modern medicine, potentially reversing decades of medical progress," Dr Naghavi said.

AMR will be most damaging in south, southeast and east Asia, Oceania, and sub-Saharan Africa, the study’s authors predict.

Combating the issue will require the development of new forms of antibiotics, widespread vaccination, and various measures designed to lessen the risk of infection.

“Evaluating changing trends in AMR mortality across time and location is necessary to understand how this important global health threat is developing, and prepares us to make informed decisions regarding interventions,” the paper says.

“Our findings show the importance of infection prevention, as shown by the reduction of AMR deaths in those younger than five years.

“Simultaneously, our results underscore the concerning trend of AMR burden among those older than 70 years, alongside a rapidly ageing global community.

“The opposing trends in the burden of AMR deaths between younger and older individuals explains the moderate future increase in number of DALYs (deaths or disability-adjusted life years) versus number of deaths.

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“Given the high variability of AMR burden by location and age, it is important that interventions combine infection prevention, vaccination, minimisation of inappropriate antibiotic use in farming and humans, and research into new antibiotics.”

The widespread use of antibiotics to treat infection has presented a relentless catch-22; modern medical advancements have relied heavily on the use antibiotics, yet the more that doctors prescribe, the quicker microbes will develop resistance.

What's happening locally

CSIRO, the Australian national science agency, reports that AMR currently claims the lives of over 1600 Australians per year.

In a bid to combat AMR effects locally, the agency has collaborated with the Department of Agriculture, Fisheries and Forestry, and the Department of Health and Aged Care in the development of a new online resource: AMR Action and Insights, but it comes with a warning:

The site explains that "if we do not slow the rise of antimicrobial resistance, we will return to the dark ages of medicine where surgery becomes inherently risky, and currently treatable infections and injuries kill once again."

“AMR is one of the greatest threats facing humanity.”

Professor Branwen Morgan, lead of Minimising Antimicrobial Resistance at CSIRO, said the site will both inform the public but also hopefully drive much needed change.  

“Fragmented knowledge and misconceptions about AMR are major issues hindering effective action. The new website aims to bridge these gaps and foster a more unified understanding of AMR,” Professor Morgan said. 

"Information is often siloed within different sectors, leading many people to believe that AMR doesn't affect them or that they can’t do anything about it. They might think it's not relevant because they don't take antimicrobials, or they mistakenly believe there are new drugs in the pipeline that will solve the problem. 

"This project seeks to break down these silos by showcasing perspectives from all sectors. We have taken a one-health approach, which recognises the interconnection between people, animals, and the environment.

"We hope AMR Action and Insights will highlight how Australia can be a leading player in mitigating AMR and encourage decision-makers at all levels to consider AMR as a critical factor in their activities."

In light of the global study, the United Nations General Assembly has scheduled a high-level meeting on AMR, for only the second time in its 79 year history. World leaders will come together in New York on September 26 to "collectively address the looming threat AMR poses to global health, food security and achieving the 20230 Sustainable Development Goals."

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