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"It poses an increasingly serious threat to global public health and requires actions by all government departments and the entire society
.
Antimicrobial resistance exists all over the world
.
New resistance mechanisms have emerged and spread globally
.
In 2012, WHO reported a gradual increase in HIV drug resistance, when drug resistance had not yet reached a critical level
.
Since then, reports of increased resistance to first-line drugs have been received from various sources, and it is expected that more expensive drugs may be required in the near future
.
In 2013, there were approximately 480,000 new cases of MDR-TB
.
XDR-TB has been detected in 100 countries
.
Multidrug-resistant tuberculosis requires a longer course of treatment, and the treatment effect is not as good as that of non-drug-resistant tuberculosis
.
In parts of the Greater Mekong Subregion, resistance to the best available treatment for falciparum malaria (artemisinin-based combination therapy) has been found
.
The spread and emergence of multidrug resistance in other regions, including resistance to combination therapies, can jeopardize recent progress in the control of the disease
.
In all regions of the world, bacteria that cause common infections (such as urinary tract infections, pneumonia, bloodstream infections) have a high rate of antibiotic resistance
.
A high percentage of hospital-acquired infections are caused by highly resistant bacteria, such as methicillin-resistant Staphylococcus aureus or multidrug-resistant gram-negative bacteria
.
Ten countries have reported treatment failures caused by resistance to the last resort (third-generation cephalosporins) for the treatment of gonorrhea
.
Given that there are currently no vaccines or new drugs under development, gonorrhea may soon become an untreatable disease
.
Generally speaking, patients infected by drug-resistant bacteria face a worse clinical outcome and higher risk of death than patients infected with the same type of bacteria that are not resistant, and will consume more health care resources
.
What is antimicrobial resistance? Antimicrobial resistance refers to the resistance of microorganisms to antimicrobial drugs that can effectively treat the infections they cause
.
Drug-resistant microorganisms (including bacteria, fungi, viruses, and parasites) can withstand the attack of antimicrobial drugs such as antibiotics, antifungals, antivirals, and antimalarials
.
As a result, standard treatments have no effect, the infection persists, and the risk of infecting others is greater
.
The evolution of drug-resistant bacteria is a natural phenomenon, which occurs when microorganisms copy themselves by mistake or exchange drug-resistant characteristics between microorganisms
.
The use and misuse of antimicrobial drugs will accelerate the emergence of resistant bacteria
.
Poor infection control, inadequate sanitation and improper food handling will promote the further spread of antimicrobial resistance
.
What is the difference between antibiotic resistance and antimicrobial resistance? Antibiotic resistance refers specifically to the resistance of common bacteria that cause infection to antibiotics
.
Antimicrobial resistance is a broader term that includes resistance to drugs that treat infections caused by other microorganisms such as parasites (such as malaria), viruses (such as HIV), and fungi (such as Candida)
.
Why is antimicrobial resistance a global concern? New resistance mechanisms have emerged and spread globally, threatening our ability to treat common infectious diseases, leading to the death or disability of people who could continue to live normally
.
Without effective anti-infective treatment, many standard treatment methods will fail or become high-risk procedures
.
Antimicrobial resistance is fatal
.
Infections caused by drug-resistant microorganisms often do not respond to conventional therapies, resulting in long-term illness, increased health care expenditures, and greater risk of death
.
For example, the mortality rate of patients treated for severe infections of common bacteria in the hospital is about twice that of patients infected with the same species but not resistant to bacteria
.
For example, patients infected with methicillin-resistant Staphylococcus aureus (a common source of serious infections in communities and hospitals) are 64% more likely to die than patients infected with non-resistant Staphylococcus aureus
.
Antimicrobial drug resistance hinders the prevention and control of infectious diseases.
Antimicrobial resistance reduces the effectiveness of treatment.
As a result, patients are contagious for longer, and the risk of infecting drug-resistant microorganisms to others is greater
.
For example, the emergence of artemisinin-resistant Plasmodium falciparum in the Greater Mekong Subregion is an urgent public health concern and threatens global efforts to reduce the burden of malaria
.
Although multidrug-resistant tuberculosis is a growing concern, the problem is largely under-reported and has also affected efforts to control the disease
.
Antimicrobial resistance increases the cost of healthcare .
After infections become resistant to first-line drugs, more expensive therapies are required
.
The longer the illness and treatment (often hospitalization), the higher the cost of medical care and the heavier the economic burden on the family and society
.
Antimicrobial resistance threatens the health and health benefits of society Antimicrobial resistance puts the achievements of modern medicine at risk
.
Without effective antimicrobial drugs to prevent and treat infections, the success of organ transplantation, cancer chemotherapy, and major surgery will be threatened
.
Current situation bacterial resistance The WHO Global Monitoring Report on Antimicrobial Resistance in 2014 pointed out that antibiotic resistance is no longer a prediction of the future, but a reality that is happening all over the world, and it is threatening the ability of humans to treat common infections in hospitals and communities
.
If coordinated action is not taken urgently, the world may enter the post-antibiotic era-common infections and minor injuries that have been treatable for decades will become fatal again
.
Many countries have confirmed that there have been treatment failures caused by resistance to the last resort (third-generation cephalosporins) for the treatment of gonorrhea
.
Untreated gonorrhea has led to an increase in the incidence of diseases and complications such as infertility, adverse pregnancy outcomes, and newborn blindness, and may also reverse the achievements in controlling this sexually transmitted infection
.
Fluoroquinolones are one of the most widely used oral drugs for the treatment of urinary tract infections caused by Escherichia coli, and resistance to these drugs is very common
.
Staphylococcus aureus is a common cause of serious infections acquired in health care facilities and communities, and resistance to first-line drugs to treat the infections caused by it is also very common
.
Carbapenem antibiotics are the last resort to treat life-threatening infections caused by common intestinal bacteria, and resistance to these drugs has spread to all regions of the world
.
Important tools for dealing with antibiotic resistance (such as the basic system for tracking and monitoring the problem) still have major deficiencies
.
Many countries do not even exist such tools
.
Drug-resistant tuberculosis In 2013, there were an estimated 480,000 new cases of multidrug-resistant tuberculosis worldwide
.
From a global perspective, 3.
5% of new tuberculosis cases and 20.
5% of previously treated cases are MDR-TB, but the frequency of MDR-TB appears to vary greatly across countries
.
XDR-TB has been found in 100 countries in all regions of the world (multidrug-resistant tuberculosis that is also resistant to all fluoroquinolones and all second-line injection drugs)
.
Proportion of MDR-TB among new tuberculosis cases
Proportion of MDR-TB among previously treated TB cases
Malaria resistance The emergence of artemisinin-resistant (including artemisinin-based combination therapies) Plasmodium falciparum in the Greater Mekong Subregion is an urgent public health concern and threatens global efforts to reduce the burden of malaria
.
To guide and adjust treatment policies, routine monitoring of treatment effects is essential
.
Surveillance also helps to detect changes in the susceptibility of Plasmodium falciparum to antimalarial drugs early
.
HIV drug resistance HIV drug resistance will appear when the virus replicates in the infected person's body while the HIV-infected person is taking antiretroviral drugs
.
Even if the antiretroviral treatment program is well managed, there will still be a certain degree of HIV resistance
.
Available data show that the continued increase in antiretroviral therapy is associated with an increase in HIV resistance
.
In 2013, 12.
9 million people living with HIV worldwide received antiretroviral treatment, of which 11.
7 million lived in low- and middle-income countries
.
HIV drug resistance is likely to reach a higher level, rendering the current first-line and second-line antiretroviral treatment methods used to treat AIDS ineffective, causing harm to human life and threatening national and global investment in antiretroviral therapy Effect
.
In 2010, in countries where antiretroviral treatment was increased, the global average level of HIV resistance among untreated adults was 5%
.
Since 2010, there have been reports showing that pre-treatment drug resistance is increasing, up to 22% in some areas
.
Continuous monitoring of HIV drug resistance is of great significance to global and national choices for first-line and second-line antiretroviral therapy and to maximize the overall treatment effect of the population
.
Influenza resistance In the past ten years, antiviral drugs have become an important tool for the treatment of pandemic and pandemic influenza
.
Many countries have formulated national guidance documents on their use and stockpiled medicines for pandemic prevention
.
The evolving characteristics of influenza determine the emergence of resistance to antiviral drugs
.
By 2012, almost all influenza A viruses circulating in humans were resistant to the drugs commonly used to prevent influenza (amantadine and rimantadine)
.
However, the frequency of resistance to neuraminidase inhibitor oseltamivir is still very low (1-2%)
.
Continuous monitoring of anti-virus susceptibility through the WHO Global Surveillance and Response System
.
What factors have accelerated the emergence and spread of antimicrobial resistance? The development of antimicrobial resistance is a natural phenomenon
.
However, certain human behaviors have accelerated the emergence and spread of antimicrobial resistance
.
Improper use of antimicrobial drugs, including improper use in animal husbandry, promotes the emergence and selection of drug-resistant microorganisms, and weak infection prevention and control measures promote the further emergence and spread of antimicrobial resistance
.
Need for coordinated action Antimicrobial resistance is a complex problem caused by multiple interrelated factors, so a single, isolated intervention has little effect
.
All parties need to coordinate their actions in order to minimize the emergence and spread of antimicrobial resistance
.
To deal with drug resistance, people should: wash hands, avoid close contact with patients to prevent bacterial infections and viral infections such as influenza or rotavirus, use condoms to prevent sexually transmitted infections; get vaccinated and keep vaccination timely Status; use antimicrobial drugs only when prescribed by a qualified health professional; complete the entire course of treatment even if you feel better (antiviral drugs may require life-long treatment); Do not share antimicrobial drugs with others, and do not use remaining prescription drugs
.
To deal with the problem of drug resistance, health workers and pharmacists should: strengthen infection prevention and control in hospitals and clinics; prescribe and provide antibiotics only when they are really needed; prescribe and provide the correct antimicrobial drugs to treat diseases
.
To address the issue of drug resistance, policy makers should:
improve the monitoring of the degree and cause of drug resistance; strengthen infection control and prevention; manage and promote the correct use of drugs ; expand the scope of information available on the impact of antimicrobial resistance , To inform the public and health professionals how to play a role; to reward the innovation and development of new treatment methods and tools
.
To address the issue of drug resistance, policymakers, scientists, and the business community should: promote innovation and the development of new vaccines, diagnostics, infection treatments, and other tools
.
The theme of WHO’s response to World Health Day 2011 is "Antimicrobial resistance: If you don’t take action today, there will be no medicine available tomorrow.
" WHO also launched a six-point policy package to assist member states in using antimicrobial resistance.
Tools for the fight against drug resistance
.
In 2014, WHO published the first global report on antimicrobial resistance surveillance, with data from 114 countries
.
WHO is guiding the antimicrobial resistance response work through the following measures: convene stakeholders to reach an agreement and make a coordinated response; strengthen the country's leading role and plan development in response to antimicrobial resistance; Formulate policy guidance and provide technical support to member states; actively encourage innovation and research and development
.
WHO works closely with the World Organization for Animal Health and the Food and Agriculture Organization of the United Nations to promote best practices to avoid the emergence and spread of antimicrobial resistance, including optimizing the use of antibiotics in humans and animals
.
The WHO has drafted a draft global action plan to address antimicrobial resistance and submitted it to the 68th World Health Assembly in May 2015
.
.
To guide and adjust treatment policies, routine monitoring of treatment effects is essential
.
Surveillance also helps to detect changes in the susceptibility of Plasmodium falciparum to antimalarial drugs early
.
HIV drug resistance HIV drug resistance will appear when the virus replicates in the infected person's body while the HIV-infected person is taking antiretroviral drugs
.
Even if the antiretroviral treatment program is well managed, there will still be a certain degree of HIV resistance
.
Available data show that the continued increase in antiretroviral therapy is associated with an increase in HIV resistance
.
In 2013, 12.
9 million people living with HIV worldwide received antiretroviral treatment, of which 11.
7 million lived in low- and middle-income countries
.
HIV drug resistance is likely to reach a higher level, rendering the current first-line and second-line antiretroviral treatment methods used to treat AIDS ineffective, causing harm to human life and threatening national and global investment in antiretroviral therapy Effect
.
In 2010, in countries where antiretroviral treatment was increased, the global average level of HIV resistance among untreated adults was 5%
.
Since 2010, there have been reports showing that pre-treatment drug resistance is increasing, up to 22% in some areas
.
Continuous monitoring of HIV drug resistance is of great significance to global and national choices for first-line and second-line antiretroviral therapy and to maximize the overall treatment effect of the population
.
Influenza resistance In the past ten years, antiviral drugs have become an important tool for the treatment of pandemic and pandemic influenza
.
Many countries have formulated national guidance documents on their use and stockpiled medicines for pandemic prevention
.
The evolving characteristics of influenza determine the emergence of resistance to antiviral drugs
.
By 2012, almost all influenza A viruses circulating in humans were resistant to the drugs commonly used to prevent influenza (amantadine and rimantadine)
.
However, the frequency of resistance to neuraminidase inhibitor oseltamivir is still very low (1-2%)
.
Continuous monitoring of anti-virus susceptibility through the WHO Global Surveillance and Response System
.
What factors have accelerated the emergence and spread of antimicrobial resistance? The development of antimicrobial resistance is a natural phenomenon
.
However, certain human behaviors have accelerated the emergence and spread of antimicrobial resistance
.
Improper use of antimicrobial drugs, including improper use in animal husbandry, promotes the emergence and selection of drug-resistant microorganisms, and weak infection prevention and control measures promote the further emergence and spread of antimicrobial resistance
.
Need for coordinated action Antimicrobial resistance is a complex problem caused by multiple interrelated factors, so a single, isolated intervention has little effect
.
All parties need to coordinate their actions in order to minimize the emergence and spread of antimicrobial resistance
.
To deal with drug resistance, people should: wash hands, avoid close contact with patients to prevent bacterial infections and viral infections such as influenza or rotavirus, use condoms to prevent sexually transmitted infections; get vaccinated and keep vaccination timely Status; use antimicrobial drugs only when prescribed by a qualified health professional; complete the entire course of treatment even if you feel better (antiviral drugs may require life-long treatment); Do not share antimicrobial drugs with others, and do not use remaining prescription drugs
.
To deal with the problem of drug resistance, health workers and pharmacists should: strengthen infection prevention and control in hospitals and clinics; prescribe and provide antibiotics only when they are really needed; prescribe and provide the correct antimicrobial drugs to treat diseases
.
To address the issue of drug resistance, policy makers should:
improve the monitoring of the degree and cause of drug resistance; strengthen infection control and prevention; manage and promote the correct use of drugs ; expand the scope of information available on the impact of antimicrobial resistance , To inform the public and health professionals how to play a role; to reward the innovation and development of new treatment methods and tools
.
To address the issue of drug resistance, policymakers, scientists, and the business community should: promote innovation and the development of new vaccines, diagnostics, infection treatments, and other tools
.
The theme of WHO’s response to World Health Day 2011 is "Antimicrobial resistance: If you don’t take action today, there will be no medicine available tomorrow.
" WHO also launched a six-point policy package to assist member states in using antimicrobial resistance.
Tools for the fight against drug resistance
.
In 2014, WHO published the first global report on antimicrobial resistance surveillance, with data from 114 countries
.
WHO is guiding the antimicrobial resistance response work through the following measures: convene stakeholders to reach an agreement and make a coordinated response; strengthen the country's leading role and plan development in response to antimicrobial resistance; Formulate policy guidance and provide technical support to member states; actively encourage innovation and research and development
.
WHO works closely with the World Organization for Animal Health and the Food and Agriculture Organization of the United Nations to promote best practices to avoid the emergence and spread of antimicrobial resistance, including optimizing the use of antibiotics in humans and animals
.
The WHO has drafted a draft global action plan to address antimicrobial resistance and submitted it to the 68th World Health Assembly in May 2015
.
