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According to one estimate, more than 1.2 million people died in 2019 from an infection with an antibiotic-resistant pathogen.
From this point of view, this form of the disease is one of the leading causes of death worldwide, the group reports in the specialist magazine The Lancet.
Antibiotics kill bacteria or inhibit their growth - although not every antibiotic helps against every type of bacteria.
The germs, in turn, can become resistant to antibiotics, and the drugs then no longer have any effect.
There are bacteria that have become insensitive to several important antibiotics at the same time, we speak of multi-resistant germs.
For 2019, the researchers had compiled and analyzed data from specialist literature, hospital databases, monitoring systems and other sources.
Using statistical modelling, they predicted the disease burden for different regions – including those for which no data were available.
In total, the team looked at 204 countries and regions, 23 disease-causing bacteria and 88 combinations of bacteria and antibiotics.
They then estimated the number of deaths caused by antibiotic-resistant germs as follows:
In the first scenario, they assumed that people had not become infected with a resistant bacterium, but with one that antibiotics attacked as desired.
In this comparison, the resistant germs were responsible for 911,000 to 1.7 million deaths in 2019 - an average of 1.27 million.
This scenario shows the direct effect of antibiotic resistance.
In the second scenario, they assumed that people had not become infected with a resistant bacterium, but instead had no infection at all.
They came up with 3.6 to 6.6 million deaths.
This number is significantly higher because infections with bacteria can also be fatal, although they respond to antibiotics.
But it shows how many people died in connection with an infection with resistant germs.
The germs that most often caused problems with resistance included Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae and also the dreaded hospital germ MRSA - methicillin-resistant Staphylococcus aureus.
MRSA alone caused 100,000 deaths in the year examined.
»A clear signal that we must act now«
According to the study, countries in sub-Saharan Africa were hardest hit. There were about 24 deaths per 100,000 people. In rich nations, the rate was 13 deaths per 100,000 people. Children under the age of five are most at risk. According to the study, the biggest problem was infections of the deep respiratory tract caused by resistant bacteria, such as pneumonia, which, according to the calculation, claimed around 400,000 lives.
"These new data reveal the true extent of the problem of antibiotic resistance worldwide and are a clear signal that we must act now," said co-author Chris Murray of the University of Washington, according to a statement from the journal.
"We must use this data to correct course and drive innovation if we want to stay ahead of the race against antibiotic resistance."
The researchers cite the limited availability of data in some parts of the world and the different sources of the data, which can lead to bias, as weaknesses in their study.
In a comment on the study, Ramanan Laxminarayan from the US-India Center for Disease Dynamics describes the problem as an “overlooked pandemic”.
The number of deaths caused by antibiotic-resistant bacteria, at 1.3 million, is about as high as deaths from HIV and malaria combined.
Only Covid-19 and tuberculosis are responsible for even more deaths as infectious diseases - with the tuberculosis pathogen Mycobacterium tuberculosis also being counted in the study as a bacterium that can develop resistance.
Laxminarayan calls for more investment to prevent these infections, better use of antibiotics and development of new drugs.
wbr/dpa
