About 7.5L deaths a year in low-and middle-income countries could be prevented by infection control: Study

New Delhi: About 7.5 lakh deaths associated with antimicrobial resistance (AMR) could be prevented every year in low-and middle-income countries (LMICs) by improving measures that prevent infections, according to an analysis, part of a four-paper series published in The Lancet journal.

These measures included hand hygiene, regular cleaning and sterilisation of equipment in healthcare facilities, along with providing access to safe drinking water, effective sanitation and paediatric vaccines, researchers said.

The international team of researchers estimated that each year, one in every eight deaths globally is caused by bacterial infections - about 77 lakh deaths in total, of which 50 lakh are associated with bacteria that have become resistant to antibiotics.

The authors called for support in providing sustainable access to antibiotics to be central to ambitious and actionable targets for tackling AMR.

"Access to effective antibiotics is essential to patients worldwide. A failure to provide these antibiotics puts us at risk for not meeting the UN sustainable development goals on child survival and health ageing," said series co-author, Iruka Okeke of the University of Ibadan, Nigeria.

Okeke said that effective antibiotics prolong lives, reduce disabilities, limit healthcare costs and enable other life-saving medical actions such as surgery.

"However, antimicrobial resistance is on the rise - accelerated by inappropriate use of antibiotics during the COVID-19 pandemic - threatening the backbone of modern medicine and already leading to deaths and disease which would have once been prevented," said Okeke.

Existing infection prevention methods can prevent AMR-associated deaths, according to modelling analysis undertaken for putting together the series of papers.

Up to 3.37 lakh deaths a year could be saved by improving infection prevention and control in healthcare facilities including better hand hygiene and regular cleaning and sterilisation of equipment, the authors found.

Around 2.5 lakh deaths could be avoided yearly by providing universal access to safe drinking water and effective sanitation in community settings, they found.

Further, 1.82 lakh deaths a year could be saved by expanding the rollout of some paediatric vaccines, such as pneumococcal vaccines which help protect against pneumonia and meningitis, along with introducing new ones, such as RSV vaccines for pregnant women, the researchers found.

"Our findings highlight how public health actions to prevent infections in the first place should be prioritised as a strategy to tackle AMR as these methods have the potential to drastically reduce the number of deaths from AMR-associated infections," said co-author Yewande Alimi of Africa Centres for Disease Control and Prevention (CDC).

"If we can focus on improving infection control methods, water and sanitation and vaccination in LMICs then it should be possible to reduce the number of deaths linked with AMR by 10 per cent by 2030," said Alimi.

Along with preventing infections in the first place, the authors also looked at evidence for preventing resistance emerging in bacteria.

Antibiotic stewardship (reducing the use of antibiotics when the benefit to patients is limited) is thought to reduce the selection pressure on bacteria to develop resistance, however, there is a lack of research in this area.

"The currently limited evidence on the impact of antibiotic stewardship on AMR from low-and middle-income countries does not mean it is not a key intervention that needs focus but rather makes it difficult to anticipate the effects of antibiotic stewardship in those countries.

"We urgently need studies to investigate the impact to help inform future policies and interventions fit for different contexts," said co-author Esmita Charani of the University of Cape Town, South Africa.