The World Health Organization (WHO) published its first ever list of antibiotic-resistant “priority pathogens,” identifying 12 bacterial threats and grouping them by priority: high, critical and medium.
Knowledge will guide research and development (R&D) of new antibiotics, as part of WHO’s efforts to address growing global resistance to antimicrobial medicines. The also create more conversation around antimicrobial resistance and infection control.
“Antibiotic resistance is growing, and we are fast running out of treatment options,” says Dr Marie-Paule Kieny, WHO’s assistant director-general for Health Systems and Innovation. “If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”
The list highlights bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well.
Critical pathogens were flagged. They include multidrug resistant bacteria and pose a particular threat in hospitals, nursing homes and among patients whose care requires devices such as ventilators and blood catheters. They can cause severe and often deadly infections, such as bloodstream infections and pneumonia. Such bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multi-drug resistant bacteria.
High and medium priority categories contain other increasingly drug-resistant bacteria that cause more common diseases, such as gonorrhoea and food poisoning caused by salmonella.
WHO priority pathogens list for R&D of new antibiotics:
Priority 1: Critical
- Acinetobacter baumannii, carbapenem-resistant
- Pseudomonas aeruginosa, carbapenem-resistant
- Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Priority 2: High
- Enterococcus faecium, vancomycin-resistant
- Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
- Helicobacter pylori, clarithromycin-resistant
- Campylobacter spp., fluoroquinolone-resistant
- Salmonellae, fluoroquinolone-resistant
- Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
Priority 3: Medium
- Streptococcus pneumoniae, penicillin-non-susceptible
- Haemophilus influenzae, ampicillin-resistant
- Shigella spp., fluoroquinolone-resistant
The list was developed by international experts in collaboration with the Division of Infectious Diseases at the University of Tübingen, Germany. Some criteria for selecting pathogens on the list were: how deadly the infections they cause are; whether their treatment requires long hospital stays; how frequently they are resistant to existing antibiotics when people in communities catch them; how easily they spread between animals, from animals to humans, and from person to person; whether they can be prevented (e.g. through good hygiene and vaccination); how many treatment options remain; and whether new antibiotics to treat them are already in the R&D pipeline.