Empowering appropriate antimicrobial use with rapid diagnostics.

WHO today published its first ever list of bacteria that pose the greatest threat to human health

On February 27th WHO published its first ever list of antibiotic-resistant "priority pathogens" – a catalogue of 12 families of bacteria that pose the greatest threat to human health.

"This list is a new tool to ensure R&D responds to urgent public health needs," says Dr Marie-Paule Kieny, WHO's Assistant Director-General for Health Systems and Innovation. "Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time."

The WHO list is divided into three categories: critical, high and medium priority.

The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include AcinetobacterPseudomonas and various Enterobacteriaceae (including KlebsiellaE. coliSerratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia.

These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multi-drug resistant bacteria.

The second and third tiers in the list – the high and medium priority categories – contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhoea and food poisoning caused by salmonella.

While more R&D for new antibiotics is vital, alone, it cannot solve the problem and is a long term solution to the threat of antimicrobial resistance. To preserve the antibiotics we currently have we must ensure they are prudently used. The use of rapid diagnostics to guide treatment decisions is one of the key strategies to preserve our current stock of antibiotics.

WHO priority pathogens list for R&D of new antibiotics

Priority 1: CRITICAL

1. Acinetobacter baumannii, carbapenem-resistant
2. Pseudomonas aeruginosa, carbapenem-resistant
3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing

Priority 2: HIGH

1. Enterococcus faecium, vancomycin-resistant
2. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
3. Helicobacter pylori, clarithromycin-resistant
4. Campylobacter spp., fluoroquinolone-resistant
5. Salmonellae, fluoroquinolone-resistant
6. Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant

Priority 3: MEDIUM

1. Streptococcus pneumoniae, penicillin-non-susceptible
2. Haemophilus influenzae, ampicillin-resistant
3. Shigella spp., fluoroquinolone-resistant

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