In 1928 Alexander Fleming discovered penicillin. The following decades witnessed a healthcare revolution in which routine infections were no longer a death sentence. Owing to their variety of uses, we have become increasingly accustomed to and reliant on antibiotics. At the same, however, bacteria have responded by developing resistance to the antibiotics we use to treat infections.
In 2014 the World Health Organisation (WHO) looked at resistance across 114 countries and found that AMR was already occurring, citing high levels of resistance across all regions of the world. The WHO now considers AMR to be “one of the greatest challenges to global public health today”. The UK Government has also stressed the importance of AMR, mentioning it in the 2015 National Risk Register of Civil Emergencies. They explained that “without effective antibiotics, even minor surgery and routine operations could become high-risk procedures, leading to increased duration of illness and ultimately premature mortality.”
Public awareness to AMR is growing. In 2014 the British public confirmed AMR was a key concern when it chose antibiotics to be the focus of our £10 million prize fund, the Longitude Prize. The prize supports those working towards developing diagnostic tests that will determine the need for antibiotics. More recently, we commissioned a poll by Populus which found that almost one third (30%) of those surveyed consider the risk that antibiotics become ineffective to be the greatest health threat to the UK.
Despite growing awareness, there is little accessible information on how the threat posed by AMR is evolving, and how it differs by country. There are a myriad of bacteria to consider, and each may acquire different levels of resistance to a range of antibiotics. As a result, it is extremely difficult for a non-specialist to gain an accurate picture of the threat posed by AMR.
Our interactive data visualisation aims to show how Europe is faring in the fight against resistance to antibiotics. It uses the latest available data (released this week) from the European Centre for Disease Prevention and Control (ECDC). The visualisation shows acquired resistance of five common bacteria (such as E. coli) to a range of antibiotics for each of the EU/EEA member states.
The most striking result is the large variation in resistance levels across Europe. For a given bacteria and antibiotic, resistance rates can range from 2% in one country to over 70% in another. Broadly, countries in the south and east of Europe tend to report higher resistance percentages than those in the north of Europe. The ECDC has said that “these differences are most likely related to differences in antimicrobial use, infection control and healthcare utilisation practices in the countries” (p1).
Among the five bacteria shown, resistance of Klebsiella pneumoniae is of particular concern. K. pneumoniae is a common cause of urinary tract, respiratory tract and bloodstream infections. It can spread rapidly between patients in healthcare settings and is a frequent cause of hospital outbreaks. The visualisation shows that resistance of K. pneumoniae to a range of antibiotic groups increased significantly between 2011 and 2014 for the EU/EEA.
While the data visualisation focuses on Europe, AMR is a global problem. WHO Director General Margaret Chan recently commented at the World Health Summit that “drug resistant pathogens are notorious globetrotters”. During WHO’s World Antibiotic Awareness Week, it is important we all do our part in combatting resistance to antibiotics. You can start by washing your hands.