AMR at a Glance

AMR is one of the leading public health threats of the 21st century which is exacerbated by the overuse and misuse of antibiotics worldwide.1,2,3 AMR continues to severely dent the global health and world economy and is now camouflaged by the SARS-CoV-2 pandemic.2 It has been associated with severe infections, complications, longer hospital stays, and increased mortality.1 It is responsible for causing 700,000 deaths annually.4 It is predicted that more than 10 million people will die per year due to AMR infections by 2050.5 Low- and middle-income countries (LMICs) remain at the epicentre of the AMR scourge and the O’Neill report has estimated that up to 90% of the 10 million projected deaths associated with AMR will occur in these countries.6 

 The ongoing SARS-CoV-2 pandemic has intensified the AMR crisis due to the increased use of antibiotics to treat COVID-19 patients. It is likely to have caused more COVID-19 deaths as secondary bacterial infections can worsen the prognosis of severe and critically ill patients.7 

Excessive, rampant, and irresponsible antibiotic usage has led to the emergence of MDR pathogens which are associated with increased mortality, morbidity, prolonged hospitalizations, and significant burden on the healthcare systems.8,9,10 MDR infections caused by Gram-negative bacteria are widely recognized as one of the greatest areas of unmet medical need due to the limited treatment options available and slow pace with respect to the development of new antimicrobial therapeutics.5,9 

In particular, WHO critical category of priority Gram-negative pathogens, namely carbapenem-resistant Acinetobacter baumanii (A. baumanii and Pseudomonas aeruginosa (P. aeruginosa) and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae are becoming a serious problem, especially in nosocomial infections.8,11 The clinical pipeline of antibiotics is insufficient to tackle the threat posed by AMR, especially with respect to the WHO critical category of priority pathogens.12

The WHO has called for global action on AMR which has encouraged several actions such as: (a) prevention and control actions in healthcare facilities; (b) antimicrobial stewardship programs; (c) reducing antibiotic usage in livestock production and the environment; and (d) quest for suitable alternatives to the currently used antibiotics especially for MDR pathogens having a global impact.13

Reference:

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  2. Baker RE, Mahmud AS, Miller IF, et al. Infectious disease in an era of global change. Nat Rev Microbial. 2022;20(4):193-205. doi:10.1038/s41579-021-00639-z.
  3. Mukherjee S. Emerging Infectious Diseases: Epidemiological Perspective. Indian J Dermatol. 2017;62(5):459-467. doi:10.4103/ijdijD_379_17.
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  6. Excler JL, Saville M, Berkley S, Kim JH. Vaccine development for emerging infectious diseases. Nat Med. 2021;27(4):591-600. doi:1038/s41591-021-01301-o.
  7. Grennan D, Varughese C, Moore NM. Medications for Treating Infection. JAMA. 2020;323(1):100. doi:10.1001/jama.2019.17387.
  8. What are anti-infectives? https://www.pfier.com/science/therapeutic-areas/anti-infectives/about-anti%2oso,anti%2Dinfectives%2C%2owe%20can%3A& text= Treat%20m i nor%20 i nfections%20an d%20most,d iseases%2C%20like%20pn eumon ia%20or%2otuberculosis. Last accessed 15th July 2022.
  9. Sparrow E, Friede M, Sheikh M, Torvaldsen S. Therapeutic antibodies for infectious diseases. Bull World Health Organ. 2017;95(3):235-237. doi:10.2471/BLT. 16.178061.
  10. Tripathi NK, Shrivastava A. Recent Developments in Bioprocessing of Recombinant Proteins: Expression Hosts and Process Development. Front Bioeng Biotechnol. 2019;7:420. Published 2019 Dec 20. doi:10.3389/fbioe.2019.00420.
  11. Kum raj G, Pathak S, Shah S, et al. Capacity Building for Vaccine Manufacturing Across Developing Countries: The Way Forward. Hum Vaccin lmmunother. 2022;18 (1):2020529. doi:10.1080/21645515.2021.2020529.
  12.  Alfaleh MA, Alsaab HO, Mahmoud AB, et al. Phage Display Derived Monoclonal Antibodies: From Bench to Bedside. Front lmmunol. 2020;11:1986. Published 2020 Aug 28. doi:10.3389/fimmu.2020.01986.
  13. Nagano K, Tsutsumi Y. Phage Display Technology as a Powerful Platform for Antibody Drug Discovery. Viruses. 2021;13(2):178. Published 2021 Jan 25. doi:10.3390/v13020178.