By IDSE News Staff
The World Health Organization recently updated its Bacterial Priority Pathogens List (BPPL) 2024, featuring 15 families of antibiotic-resistant bacteria prioritized into critical, high and medium categories. The list provides guidance for the development of new treatments to stop the spread of antimicrobial resistance (AMR).
WHO/Nazik Armenakyan
Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection moving from critical to high priority in the BPPL 2024 mirrors recent reports of decreases in global resistance. Despite this transition, investment in research and development as well as other prevention and control strategies for CRPA remain important, given its significant burden in some regions.
The WHO BPPL 2024 includes:
Critical priority:
- carbapenem-resistant Acinetobacter baumannii
- third-generation CREs
- CREs
- rifampin-resistant Mycobacterium tuberculosis
High priority:
- fluoroquinolone-resistant Salmonella typhi
- fluoroquinolone-resistant Shigella species
- vancomycin-resistant Enterococcus faecium
- CRPA
- fluoroquinolone-resistant non-typhoidal Salmonella
- third-generation cephalosporin- and/or fluoroquinolone-resistant Neisseria gonorrhoeae
- methicillin-resistant Staphylococcus aureus
Medium priority:
- macrolide-resistant Group A Streptococcus (GAS)
- macrolide-resistant Streptococcus pneumoniae
- ampicillin-resistant Haemophilus influenzae
- penicillin-resistant Group B Streptococcus (GBS)
AMR is driven in large part by the misuse and overuse of antimicrobials. The updated BPPL incorporates new evidence and expert insights to guide research and development for new antibiotics and promote international coordination to foster innovation.
“By mapping the global burden of drug-resistant bacteria and assessing their impact on public health, this list is key to guiding investment and grappling with the antibiotics pipeline and access crisis,” said Yukiko Nakatani, MD, PhD, WHO’s assistant director-general for Antimicrobial Resistance ad interim. “Since the first Bacterial Priority Pathogens List was released in 2017, the threat of antimicrobial resistance has intensified, eroding the efficacy of numerous antibiotics and putting many of the gains of modern medicine at risk.”
The critical-priority pathogens, such as gram-negative bacteria resistant to last-resort antibiotics and M. tuberculosis resistant to the antibiotic rifampin, present major global threats due to their high burden and ability to resist treatment and spread resistance to other bacteria. Gram-negative bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows for other drug-resistant bacteria.
High-priority pathogens, such as Salmonella and Shigella, are of particularly high burden in low- and middle-income countries, along with P. aeruginosa and S. aureus, which pose significant challenges in healthcare settings.
Other high-priority pathogens, such as antibiotic-resistant N. gonorrhoeae and E. faecium, present unique public health challenges, including persistent infections and resistance to multiple antibiotics, necessitating targeted research and public health interventions.
Medium-priority pathogens include GAS and GBS (both new to the 2024 list), S. pneumoniae and H. influenzae, which present a high disease burden. These pathogens require increased attention, especially in vulnerable populations including pediatric and elderly populations, particularly in resource-limited settings.
“Antimicrobial resistance jeopardizes our ability to effectively treat high burden infections, such as tuberculosis, leading to severe illness and increased mortality rates,” said Jérôme Salomon, MD, PHD, MPH, WHO's assistant director-general for Universal Health Coverage, Communicable and Noncommunicable Diseases.
The BPPL 2024 also emphasizes the need for a comprehensive public health approach to addressing AMR, including universal access to quality and affordable measures for prevention, diagnosis and appropriate treatment of infections, as outlined in the WHO’s People-centred Approach to Addressing Antimicrobial Resistance in Human Health and core package of AMR interventions. This is crucial for mitigating AMR’s impact on public health and the economy.
