Results from a European study predict steep increases in both blood stream infections and antimicrobial resistance (AMR) by 2050, especially among men and older adults.
There was also substantial variation in rates of AMR between different countries, with some countries like Poland facing up to 15-fold rises in resistant infections compared with others.
“Our study shows that the future burden of drug-resistant infections won’t be uniform—there will be substantial differences between countries, as well as across age groups and between sexes,” said Gwenan Knight, PhD, a professor at the London School of Hygiene and Tropical Medicine who led the work, which is published in PLOS Medicine.
“We see the steepest increases in incidence projected in older age groups, particularly the over 65s, meaning that simply preventing further rises in resistant bloodstream infections would already be a major public health achievement.”
Knight and colleagues collected data from 12,807,473 tests for bloodstream infections carried out across Europe in 29 countries between 2010 and 2019. They used this information to predict infection rates for eight bacteria from 2022-2050 taking into account sex and age. The bacteria they chose were those included in the European Antimicrobial Resistance Surveillance Network.
The results suggested blood stream infections would increase more in men than in women for six of the eight bacteria included in the analysis and that rates of infections would increase significantly in those aged 74 years or above. However, in younger age groups infection rates are expected to remain unchanged or go down.
Notably, the researchers highlight the danger of not including age and sex in predictions of future AMR and infection rates, as it can dramatically skew the results. They suggest it could result in significant underestimates of future AMR infection rates.
“Age and sex are still rarely considered in antimicrobial resistance projections, yet they make a real difference to who is most affected,” said Knight. “Combining these factors with demographic and infection trends really highlighted how challenging it will be to reverse the steady rise in bloodstream infections across Europe.”
Countries like Greece and Poland were predicted to have significantly higher increases in resistant blood stream infections as early as 2030, whereas places like Sweden and the Netherlands were predicted to have relatively stable or modestly increasing resistant infection rates.
These predictions are suggested to be due to differences in baseline resistance levels, infection prevention, and control measures, and antibiotic consumption rates in these countries, as well as socioeconomic factors, healthcare infrastructure, and access to new antibiotics or diagnostics.
The researchers suggest reducing blood stream infections by 10% by 2030 may be over ambitious, but emphasizes the urgent need for sustained infection prevention and control measures, especially aimed at older populations, to mitigate the future burden of AMR.
