Excess mortality due to pandrug resistant bacteria: a survey of the literature

Abstract

The discovery and use of antibiotics in the clinical practice can be considered as one of the greatest successes in the history of medicine, but with the global spread of antibiotic resistant pathogens, the results of this success story are being compromised. Many reports and professional recommendations have been published on the significance of bacterial resistance, but it is important to note that all mortality data reported in these reports are based on estimated values based on mathematical models.A literature search was conducted using PubMed database to look for relevant publication. During the course of this study, publications reporting on deaths directly attributable to pandrug-resistant (PDR) bacterial infections and published before 10th December, 2018 were included, using appropriate keywords. English and Hungarian publications were analyzed.In the course of literature search, 2386 publications matched the search criteria from PubMed. A total of four communications have been identified that report a total of 14 PDR-associated deaths. In five cases, patients had cystic fibrosis and most fatal cases were associated with PDR Klebsiella pneumoniae.Although there are limitations to this study, the results suggest that the number of deaths caused by pandrug-resistant pathogens is inconsistent with the estimated extra-mortality (23000-25000 per year) published in international reports. The problem of antibiotic resistance is extremely complex, in addition to the development of new antibiotics, the solutions include the prudent use of these drugs and strict infection control measures.