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Extremely and pandrug-resistant bacteria extra-deaths: myth or reality?
Cédric Abat1, Pierre-Edouard Fournier2, Marie-Thérèse Jimeno2
1IRD, MEPHI, AP-HM, IHU-Méditerranée-Infection, Aix-Marseille University, Marseille, France.
Summary
Multidrug-resistant (MDR) bacterial infections cause fewer deaths than predicted. A Marseille surveillance system found only one death from extremely drug-resistant (XDR) or pandrug-resistant (PDR) bacteria, contrasting with alarming global forecasts.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Global health organizations have issued alarming predictions regarding deaths from multidrug-resistant (MDR) bacterial infections.
- Estimates suggest hundreds of thousands of deaths annually in Europe and France attributed to MDR bacteria.
- The United Nations forecasts 10 million annual deaths by 2050 due to antimicrobial resistance.
Observation:
- A retrospective analysis of antibiotic resistance data from Marseille, France (November 2009-March 2015) was conducted.
- The study focused on deaths attributable to extremely drug-resistant (XDR) and pandrug-resistant (PDR) bacterial strains across 11 species/genera.
- A parallel PubMed literature search identified studies on human deaths caused by PDR bacteria published before July 2016.
Findings:
- Out of 35,723 infected patients, only 85 had XDR/PDR strains.
- A single death was attributed to an XDR bacterial infection in a patient with severe comorbidities and septic shock.
- The literature review found only four articles reporting human deaths due to PDR bacteria.
Implications:
- There is a significant discrepancy between widely reported mortality predictions for XDR/PDR bacterial infections and actual observed data.
- The findings suggest that current alarmist predictions may overestimate the immediate mortality impact of XDR/PDR bacteria.
- Further research is needed to reconcile these discrepancies and refine future public health strategies for antimicrobial resistance.
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