Antibiotic-Resistant Superbugs Will Kill 40 Million People by 2050, and We Created Them

Deaths from drug-resistant infections could increase by nearly 2050% by 70, reports CNNIn total, more than 2025 million deaths could occur worldwide between 2050 and 39. They, according to a study published Sept. 16 in The Lancet, will be directly related to bacterial antimicrobial resistance (AMR).

Photo: Bacterial © Albert Tietz | Dreamstime.com

The World Health Organization (WHO) has called AMR “one of the world’s major public health threats,” caused by the misuse and overuse of antibiotics and antimicrobials in humans, animals, and plants. This helps pathogens (bacteria and fungi) develop resistance to them.

"We expect the situation to get worse," said Dr. Chris Murray, director of the Institute for Health Evaluation at the University of Washington. "We need to pay due attention to new antibiotics and their use."

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Old people are in danger

The researchers estimated the number of deaths and illnesses associated with antimicrobial resistance for 22 pathogens, 84 pathogen-drug combinations and 11 infections in 204 countries and territories from 1990 to 2021.

They found that from 1990 to 2021, AMR deaths declined by more than 50% among children under 5 years old, but increased by more than 80% among adults over 70. These trends are expected to continue.

As Murray put it, it was surprising to see these patterns: “We had two opposing trends. One was a decline in AMR deaths in people under 15, largely due to vaccination and water and sanitation programs. And then the other was a steady increase in deaths in people over 50.”

The researchers found that the most dangerous combination was methicillin-resistant Staphylococcus aureus, or MRSA, and the antibiotic methicillin, which was used to treat the bacterial infection. The number of deaths linked to antibiotic-resistant Staphylococcus aureus has nearly doubled, from 57 in 200 to 1990 in 130.

Using statistical modeling, the researchers obtained estimates of AMR-related mortality and morbidity by 2050 in three scenarios:

1. If the current climate continues.
2. If new, powerful antibiotics are developed to combat resistant pathogens.
3. If the world improves the quality of medical care for infections and access to antibiotics.

Projections show that deaths from antimicrobial-resistant bacteria and fungi will increase by 2050 unless steps are taken to improve access to quality health care, powerful antibiotics and other resources to treat these infections.

Quality medicine is very important

Researchers estimate that the number of deaths linked to antimicrobial resistance could reach 2050 million by 8,2.

The regions of the world most affected by AMR and its associated deaths are South Asia, Latin America, the Caribbean, and sub-Saharan Africa. Many of these regions, Murray noted, lack access to quality health care.

“Unfortunately, there are still many places where people who need antibiotics are not getting them. But it’s not just about antibiotics. It’s about the package of care, including oxygen,” Murray said. “In resource-poor settings, even basic resources like oxygen are often not available. Let alone if you’re very sick and need intensive care. But there are countries where there’s not free and equal access to quality medicine. Whereas it’s not just antibiotics that are important for recovery, it’s the full range of supportive care.”

In a scenario where the world has better health care, 92 million deaths could be prevented between 2025 and 2050, the researchers predict. And when the world has new, more powerful drugs, about 11 million deaths could be avoided.

Hope for viruses

The innovative approach to this study provides a "comprehensive assessment" of antimicrobial resistance and its potential threat to the world, Samuel Kariuki of the Kenya Medical Research Institute wrote in a commentary accompanying the new study in The Lancet.

But he cautioned that the forecast models do not take into account the emergence of new superbugs. Overall, Kariuki wrote, “these data should spur action” to address antimicrobial resistance in all regions of the world.

Dr. Stephanie Strathdee, associate dean for global health sciences and professor at the University of California San Diego School of Medicine, saw firsthand the dangers of antimicrobial-resistant bacteria when her husband nearly died from an infection.

While on a Nile cruise on Thanksgiving Day in 2015, Strathdee’s husband, Tom Patterson, suddenly developed severe stomach cramps. When a clinic in Egypt failed to help him, Patterson was sent to Germany, where doctors discovered a grapefruit-sized abdominal abscess filled with Acinetobacter baumannii, a virulent bacterium resistant to nearly all antibiotics.

The annual number of people dying from Gram-negative bacteria like A. baumannii that are resistant to carbapenems (a class of antibiotics recently used to treat severe bacterial infections) rose by 89 from 200 to 1990, more than any class of antibiotics during that period, according to a new study.

“My husband was 69 when he became ill,” Strathdee said. “He was right at the age of concern described in the study. Older people will be more likely to suffer from bacterial infections in the future as the population ages and infections are compounded by underlying conditions, such as my husband’s diabetes.”

Strathdee's husband recovered after treatment with phages, viruses that selectively kill bacteria and could be used as a new approach to treating antimicrobial-resistant bacterial infections.

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“The most important alternative to antibiotics is phage therapy, or bacteriophage therapy, and it saved my husband’s life,” Strathdee said. “Phages are very effective in combination with antibiotics to reduce the number of antibiotics. They can even be used in livestock and agriculture.”

The new research gives Strathdee hope that the world can reduce the potential burden of antimicrobial resistance. This will require improving access to antibiotics and new antimicrobials, vaccines, clean water and other aspects of good health care around the world, she said. At the same time, antibiotic use in livestock, food production and the environment must be reduced. Overuse can create new bacteria that are resistant to them.

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