WHO updates list of most dangerous drug-resistant pathogens

For the first time in seven years, the World Health Organization has updated its list of the most dangerous, antimicrobial resistant pathogens. The revised list includes 24 pathogens from 15 different families of antibiotic-resistant bacteria.

The revision was prompted by the growth of the problem. There were approximately 4.95 million deaths caused by antibiotic resistance across low- and middle-income countries in 2019 alone, according to the May 17 report

"Despite current work, the global antibiotic pipeline is marked by limited innovation and limited global access to both new and existing treatments," the executive summary states. While the report is intended to be a guide, the WHO researchers also note that "...its application requires adaptation and contextualization to account for regional differences in the distribution and ecology of bacterial pathogens, as well as variation in the vulnerable groups and the burden of [antimicrobial resistance]."

New this year, is the inclusion of Gram-negative bacteria that are resistant to last-resort antibiotics, which the WHO calls special attention to.

"In this update, Gram-negative bacteria that are resistant to last-resort antibiotics… are listed as of critical priority because of their ability to transfer resistance genes, the severity of the infections and disease they cause and/or their significant global burden," the report states.

In its 2024 update, the WHO removed five pathogens that were listed in 2017, including: penicillin non-susceptible Streptococcus pneumoniae, vancomycin-resistant Staphylococcus aureus, fluoroquinolone-resistant Campylobacter, clarithromycin-resistant Helicobacter pylori, and third-generation cephalosporin-resistant Providencia.

There were three new additions to the list: macrolide-resistant Group A Streptococci, penicillin-resistant Group B Streptococci, and rifampicin-resistant Mycobacterium tuberculosis.

The 15 families of antibiotic-resistant priority pathogens to watch in 2024 are organized into three categories: Critical, high, and medium threats.

Critical Priority Pathogens

  • Acinetobacter baumannii — which is carbapenem-resistant

  • Enterobacterales — which is third-generation cephalosporin-resistant

  • Enterobacterales — which is carbapenem-resistant

  • Mycobacterium tuberculosis  — which is rifampicin-resistant

High Priority Pathogens:

  • Salmonella Typhi — which is fluoroquinolone-resistant

  • Shigella spp. — which is fluoroquinolone-resistant

  • Enterococcus faecium — which is vancomycin-resistant

  • Pseudomonas aeruginosa — which is carbapenem-resistant

  • Non-typhoidal Salmonella — which is fluoroquinolone-resistant

  • Neisseria gonorrhoeae — which is third-generation cephalosporin, and/or fluoroquinolone-resistant

  • Staphylococcus aureus — which is methicillin-resistant

Medium Priority Pathogens

  • Group A Streptococci — which is macrolide-resistant

  • Streptococcus pneumoniae — which is macrolide-resistant

  • Haemophilus influenzae — which is ampicillin-resistant

  • Group B Streptococci — which is penicillin-resistant

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