This medical illustration shows drug-resistant Mycobacterium tuberculosis.
The World Health Organization (WHO) today released its updated 2024 Bacterial Key Pathogen List, which includes 15 drug-resistant bacteria, classified as critical, high and medium priority in order of importance. The catalogue provides guidance for the development of new and necessary treatments to stop the spread of antimicrobial resistance.
Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites no longer respond to drugs. This can make people sicker and increase the risk of disease transmission, morbidity and death. Antimicrobial resistance is largely caused by errors and overuse of antimicrobials. The updated catalogue incorporates new evidence and expert insights to guide research and development of new antibiotics and promote international harmonization in favour of innovation.
Yukiko Nakatani, WHO Assistant Director-General ad interim on antimicrobial resistance, said: "This catalogue is key to guiding investment and responding to the crisis of antibiotic development and access by clarifying the global burden of drug-resistant bacteria and assessing their impact on public health. Since the publication of the first list of priority bacterial pathogens in 2017, the threat of antimicrobial resistance has intensified, eroding the efficacy of many antibiotics and putting many of the achievements of modern medicine at risk. ”
Focus on 15 drug-resistant bacteria
The 2024 Bacterial Key Pathogen Catalogue removes the five pathogen-antibiotic combinations included in the 2017 catalogue and adds four new ones. Enterococci, a third-generation cephalosporin-resistant, is listed as a stand-alone item among the key priority pathogens because of the high disease burden caused by this bacterium and the need for targeted interventions, particularly in low- and middle-income countries.
Other key priority pathogens, such as gram-negative bacteria that are resistant to last-resort antibiotics and Mycobacterium tuberculosis (Mycobacterium tuberculosis), which are resistant to the antibiotic rifampicin, are the most significant global threats due to the associated disease burden and the ability of pathogens to resist treatment and spread resistance to other bacteria. Gram-negative bacteria have an inherent ability to find new ways to resist treatment and can pass on genetic material that makes other bacteria resistant as well.
High-priority priority pathogens include Salmonella and Shigella, which are particularly burdened in low- and middle-income countries, and Pseudomonas aeruginosa and Staphylococcus aureus, which pose a major challenge to healthcare settings.
Other high-priority priority pathogens include drug-resistant Neisseria gonorrhoeae and Enterococcus faecium. They pose unique public health challenges, including persistent infection and resistance to multiple antibiotics, and require targeted research and public health interventions.
Medium-priority priority pathogens include group A and B streptococci (both new to the list in 2024), Streptococcus pneumoniae and Haemophilus influenzae. These pathogens contribute to a high burden of disease. These pathogens require more attention, especially in vulnerable populations, including children and older populations, especially in resource-limited settings.
The 2024 List of Priority Bacterial Pathogens also highlights the need for a comprehensive public health approach to combat antimicrobial resistance, including universal access to high-quality and affordable infection prevention, diagnosis, and appropriate treatment. This is essential to mitigate the public health and economic impact of antimicrobial resistance.
