[Antimicrobial resistance: it is a global crisis, "a slow tsunami"].

Abstract

Antimicrobial resistance (AMR) is the phenomenon whereby a microorganism (bacteria, fungi, viruses, and parasites) is resistant to an antimicrobial, previously effective for the treatment of infections generated by it. Although the emergence of AMR is a natural phenomenon, the lack of implementation of infection prevention and control hygiene measures and the excessive and inappropriate use of antimicrobials are among the causes linked to an accelerated appearance and spread of microorganisms resistant to their action, with a consequent loss of efficacy of the treatments and serious risks for public health. Antimicrobial resistant organisms are found in people, food, animals, plants and the environment and can spread among different ecosystems in a global way without respecting geographical borders. Antimicrobial resistance is therefore a global public health problem that requires a global solution. Without proper control and action, AMR will result in enormous human and economic costs. Currently, according to the most recent data available, it is estimated that the AMR is responsible for around 700 thousand deaths worldwide per year (including 230 thousand deaths from multidrug-resistant tuberculosis) and of the 33 thousand deaths that occur in Europe about 11 thousand concern our country, especially for infections contracted in hospital. In the next 35 years, in the absence of measures, it is assumed that worldwide there will be about 300 million people who died prematurely (10 million deaths per year until 2050) with a loss of 100 thousand billion dollars of economic production; in high-income countries it is estimated that between 2015 and 2050 about 2.4 million people could die in the absence of sustained contrast measures over time. The World Health Organization has stated that AMR represents one of the top ten threats to public health worldwide, as it compromises our ability to treat even minor infections, seriously jeopardizes surgical procedures and other advanced medical interventions such as chemotherapy and transplants and more generally endangers the Sustainable Development Goals (SDGs) related to human health and indirectly also the progress of the SDGs aimed at reducing poverty and inequality. We all have a role to play in the fight against AMR, a coordinated effort to address this threat to our health, to our economies is essential: lives around the world depend on this commitment.