Topics in microbiology and infection: a review of the BSMT conference

Professor Alasdair MacGowan, Professor of Antimicrobial Therapeutics, University of Bristol, set the scene with an authoritative overview of the development of antimicrobial resistance (AMR) and approaches to controlling it.

As described in a seminal report The global burden of bacterial antimicrobial resistance in 2019: a systematic analysis, published in The Lancet in 2022, death rates associated and attributable to AMR are highest in sub-Saharan Africa, closely followed by South Asia and Eastern Europe. Globally, Escherichia coli is the leading pathogen for deaths associated with resistance, followed (in order) by Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. Lower respiratory tract infections are most associated with death rates associated and attributable to antimicrobial resistance.

The local AMR situation was described using the latest English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report, published in November 2022 (other reports are available for Northern Ireland, Scotland and Wales). In England, the incidence of bloodstream infection (BSI) caused by E. coli and S. pneumoniae decreased noticeably during 2020–2021 in comparison to other key pathogens, such as K. pneumoniae and Enterococcus, which could be described as having an increasing trend. In comparison to Gram-negative BSI, there is little change reported in the incidence of resistance
in S. aureus (MSSA and MRSA) and S. pneumoniae BSI.