Antibiotic-resistant bacteria kill 1.2 million a year — more than HIV/AIDS : Goats and Soda A new report in The Lancet finds that in 2019, antibiotic-resistant bacteria killed 1.2 million people — more than were killed by malaria or HIV/AIDS. The problem is mounting in lower-income nations.

Why humans are losing the race against superbugs

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As bad as it is, COVID-19 is far from the only illness that's worrying public health officials. Drug-resistant infections are now killing more than a million people a year around the world as antibiotic-resistant strains of bacteria continue to emerge. That's the conclusion of a report released just last week. The study finds that low- and middle-income countries are particularly hard hit by the rise in antibiotic resistance.

NPR's global health correspondent Jason Beaubien is with us to shed some light on this. Jason, thanks so much for joining us.

JASON BEAUBIEN, BYLINE: Oh, it's great to be with you.

MARTIN: So tell us about this study. What was it looking at, and what did it find?

BEAUBIEN: So this was one of the first attempts to get a solid handle on what's happening with antibiotic resistance globally. Researchers at the Institute for Health Metrics and Evaluation at the University of Washington - they gathered data from 204 countries on both what the degree of antibiotics resistance is that they're finding out there and what the impact of this rising resistance is on people's health. And what they found - it was pretty sobering.

CHRIS MURRAY: That resistance out there is actually now one of the leading causes of death in the world.

BEAUBIEN: That's Chris Murray. He's one of the lead authors of the study. And they found that these antibiotic-resistant bacterial infections, you know, sometimes called superbugs, are now directly responsible for 1.2 million deaths per year, which is more people than are killed each year by HIV or malaria.

MARTIN: When you talk about people dying from bacterial infections, can you just tell us what specific illnesses are you talking about?

BEAUBIEN: What's kind of amazing about this is that the problem is sort of happening all over the place. It's patients in intensive care units who get a staph infection. It's women with urinary tract infections. It's new, untreatable cases of pneumonia, blood infections, you know, even cuts and scrapes that get infected. In the past, a doctor could have just prescribed some antibiotics to get these things under control. Those are now becoming resistant to bacteria. You know, they're finding that the usual treatments - say, penicillin or doxycycline - it just has no effect, and then they try a second-line antibiotic. And what's concerning is now a significant number of bacterial infections - they can't be controlled even with those second-line antibiotics. In fact, there are some bacteria that are emerging that doctors say they simply have no treatment for at all.

MARTIN: And why is this? What is driving this rise in drug-resistant bacteria?

BEAUBIEN: Well, the short answer is that the bacteria are evolving, and we aren't. Not only are we overusing antibiotics - and not just in humans but also in livestock - but we've been overusing the same antibiotics for decades. The bacteria, on the other hand, they are steadily mutating. They're evolving so that new strains are emerging. And these new strains are able to evade what used to be incredibly powerful drugs. Some of the oldest antibiotics tend to be the cheapest, which Murray says is making this problem even worse in low- or middle-income countries.

MURRAY: In the past, I think we all thought that, in some sense, you had to be rich enough to use a lot of antibiotics inappropriately to have this problem. But that's not the case.

MARTIN: So can you explain that a bit more? I mean, is the point that these less wealthy countries aren't getting access to these new antibiotics, and that's making the problem of drug resistance worse because the legacy drugs are cheaper? Is that what I'm hearing?

BEAUBIEN: That's part of the problem. But to be clear, the problem is all around the globe. You're getting drug-resistant bugs that are turning up in hospitals in Boston as well as in Bangalore. But this new study found that death rates from antibiotic-resistant infections are even worse in lower-income and middle-income countries. I talked to Fiorella Krapp Lopez. She's an infectious disease physician in Lima, Peru.

FIORELLA KRAPP LOPEZ: We do have a very high frequency of resistance to different types of antibiotics, first-line and second-line, and the problem has been increasing in the last years.

BEAUBIEN: And she said she's quite concerned that antibiotic resistance got even worse during the COVID pandemic. You know, during the worst days of the pandemic, patients were showing up at hospitals that were in crisis, where staff were frantically just trying to keep people alive. You know, and at the same time, these wards were overcrowded, and infection control of these types of pathogens was slipping.

KRAPP LOPEZ: That was just the perfect storm to have a very high transmission of these pathogens.

BEAUBIEN: So the exact extent to which COVID added to this problem of antibiotic resistance, you know, it isn't completely clear yet, neither in Peru or globally. It's going to take time to monitor for resistance. And, you know, the labs to actually do this is quite limited in some places. But Krapp says she thinks COVID definitely made drug resistance worse.

MARTIN: That is NPR global health correspondent Jason Beaubien. Jason, thank you so much.

BEAUBIEN: You're welcome, Michel.


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