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Antimicrobial resistance now causes more deaths than HIV/AIDS and malaria worldwide – new study

Mar 7, 2022

4 min

Dr Jonathan A. G. Cox



Antimicrobial resistance is spreading rapidly worldwide, and has even been likened to the next pandemic – one that many people may not even be aware is happening. A recent paper, published in Lancet, has revealed that antimicrobial resistant infections caused 1.27 millions deaths and were associated with 4.95 million deaths in 2019. This is greater than the number of people who died from HIV/AIDS and malaria that year combined.


Antimicobial resistance happens when infection-causing microbes (such as bacteria, viruses or fungi) evolve to become resistant to the drug designed to kill them. This means than an antibiotic will no longer work to treat that infection anymore.


The new findings makes it clear that antimicrobial resistance is progressing faster than the previous worst-case scenario estimates – which is of concern for everyone. The simple fact is that we’re running out of antibiotics that work. This could mean everyday bacterial infections become life-threatening again.


While antimicrobial resistance has been a problem since penicillin was discovered in 1928, our continued exposure to antibiotics has enabled bacteria and other pathogens to evolve powerful resistance. In some cases, these microbes are resistant even to multiple different drugs. This latest study now shows the current scale of this problem globally – and the harm it’s causing.


Global problem

The study involved 204 countries around the world, looking at data from 471 million individual patient records. By looking at deaths due to and associated with antimicrobial resistance, the team was then able to estimate the impact antimicrobial resistance had in each country.


Antimicrobial resistance was directly responsible for an estimated 1.27 million deaths worldwide and was associated with an estimated 4.95 millions deaths. In comparison, HIV/AIDS and malaria were estimated to have caused 860,000 and 640,000 deaths respectively the same year. The researchers also found that low- and middle-income countries were worst hit by antimicrobial resistance – although higher income countries also face alarmingly high levels.


They also found that of the 23 different types of bacteria studied, drug resistance in only six types of bacteria contributed to 3.57 million deaths. The report also shows that 70% of deaths that resulted from antimicrobial resistance were caused by resistance to antibiotics often considered the first line of defence against severe infections. These included beta-lactams and fluoroquinolones, which are commonly prescribed for many infections, such as urinary tract, upper- and lower-respiratory and bone and joint infections.


This study highlights a very clear message that global antimicrobial resistance could make everyday bacterial infections untreatable. By some estimates, antimicrobial resistance could cause 10 million deaths per year by 2050. This would overtake cancer as a leading cause of death worldwide.


Next pandemic

Bacteria can develop antimicrobial resistance in a number of ways.


First, bacteria develop antimicrobial resistance naturally. It’s part of the normal push and pull observed throughout the natural world. As we get stronger, bacteria will get stronger too. It’s part of our co-evolution with bacteria – they’re just quicker at evolving than we are, partly because they replicate faster and get more genetic mutations than we do.


But the way we use antibiotics can also cause resistance.


For example, one common cause is if people fail to complete a course of antibiotics. Although people may feel better a few days after starting antibiotics, not all bacteria are made equal. Some may be slower to be affected by the antibiotic than others. This means that if you stop taking the antibiotic early, the bacteria that were initially able to avoid the effect of the antibiotics will be able to multiply, thus passing their resistance on.


Likewise, taking antibiotics unnecessarily can help bacteria to evolve resistance to antibiotics faster. This is why it’s important not to take antibiotics unless they’re prescribed, and to only use them for the infection they’re prescribed for.


Resistance can also be spread from person to person. For example, if someone who has antibiotic-resistant bacteria in their nose sneezes or coughs, it may be spread to people nearby. Research also shows that antimicrobial resistance can be spread through the environment, such as in unclean drinking water.


The causes driving this global antimicrobial resistance crisis are complex. Everything from how we take antibiotics to environmental pollution with antimicrobial chemicals, use of antibiotics in agriculture and even preservatives in our shampoo and toothpaste are all contributing to resistance. This is why a global, unified effort will be needed to make a difference.


Urgent change is needed in many industries to slow the spread of antimicrobial resistance. Of the greatest importance is using the antibiotics we have smarter. Combination therapy could hold the answer to slowing down antimicrobial resistance. This involves using several drugs in combination, rather than one drug on its own – making it more difficult for bacteria to evolve resistance, while still successfully treating an infection.


The next pandemic is already here – so further investment in research that looks at how we can stop this problem will be key.

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Dr Jonathan A. G. Cox

Dr Jonathan A. G. Cox

Lecturer in Microbiology

Dr Cox's research interests surround the discovery of new antibiotics & identifying the mechanisms by which those antibiotics kill bacteria.

Health SciencesBiochemistryAntibioticsAntimicrobial ResistanceMicro-Organisms

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Dr Souza added: “The proposed biomaterial has the potential to drastically improve treatment outcomes of bone tumour patients by reducing cancer recurrence, implant-site infection rates, and implant failure rates leading to reduced time in hospital beds, less use of antibiotics, and fewer revision surgeries. Taken together, these benefits could improve survival rates, functionality and quality of life of bone cancer patients.” Other members of the team include the hospital’s Professor Adrian Gardner, director of research and development and Mr Jonathan Stevenson, orthopaedic oncology and arthroplasty consultant, Dr Eirini Theodosiou from Aston University and Professor Joao Lopes from the Brazilian Aeronautics Institute of Technology. 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For media inquiries in relation to this release, contact Nicola Jones, Press & Communications Manager on 07941194168 or email: n.jones6@aston.ac.uk

4 min

Babies respond positively to smell of foods experienced in the womb according to study co-led at Aston University

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Newborns whose mothers had taken carrot powder capsules when pregnant were more likely to react favourably to the smell of carrot. Likewise, babies whose mothers had taken kale powder capsules while pregnant reacted more positively to the kale scent. Research co-lead author and supervisor Professor Nadja Reissland, of the Fetal and Neonatal Research Lab, Department of Psychology, Durham University, said: “Our analysis of the babies’ facial expressions suggests that they appear to react more favourably towards the smell of foods their mothers ate during the last months of pregnancy. Potentially this means we could encourage babies to react more positively towards green vegetables, for example, by exposing them to these foods during pregnancy. “In that respect, the memory of food the mother consumes during pregnancy appears to establish a preference for those smells and potentially could help to establish healthy eating habits at a young age.” This study is a follow-up to a 2022 research paper where the researchers used 4D ultrasound scans at 32 and 36 gestational weeks to study foetal facial expressions after their pregnant mothers had ingested a single dose of either 400mg of carrot or kale capsules. Foetuses exposed to carrot showed more “laughter-face” responses while those exposed to kale showed more “cry-face” responses. For the latest study, the researchers followed up 32 babies from the original research paper – 16 males and 16 females – from 36 weeks gestation until approximately three weeks after birth. Mothers consumed either carrot or kale capsules every day for three consecutive weeks until birth. When the babies were about three weeks old, the research team tested newborns’ reactions to kale, carrot, and a control odour. Separate wet cotton swabs dipped in either carrot or kale powders, or water as the control, were held under each infant’s nose and their reaction to the different smells was captured on video. The babies did not taste the swabs. Scientists then analysed the footage to see how the newborns reacted and compared these reactions with those seen before the babies were born to understand the effects of repeated flavour exposure in the last trimester of pregnancy. The research team found that, from the foetal to newborn period, there was an increased frequency in “laughter-face” responses and a decreased frequency in “cry-face” responses to the smell the babies had experienced before birth. Humans experience flavour through a combination of taste and smell. In foetuses, this happens through inhaling and swallowing the amniotic fluid in the womb. Research co-lead author Dr Beyza Ustun-Elayan carried out the research while doing her PhD at Durham University. Dr Ustun-Elayan, who is now based at the University of Cambridge, said: “Our research showed that foetuses can not only sense and distinguish different flavours in the womb but also start learning and establish memory for certain flavours if exposed to them repeatedly. This shows that the process of developing food preferences begins much earlier than we thought, right from the womb. By introducing these flavours early on, we might be able to shape healthier eating habits in children from the start.” The researchers stress that their findings are a baseline study only. They say that longer follow-up studies are needed to understand long-term impacts on child eating behaviour. They add that further research would also need to be carried out on a larger group of infants, at different points in time. They say that the absence of a control group not exposed to specific flavours makes it challenging to fully disentangle developmental changes in the babies from the effects of repeated flavour exposure. Future research should also factor in post-birth flavour experiences, such as some milk formulas known to have a bitter taste, which could impact babies’ responses to the smell of bitter and non-bitter vegetables. The research involved the children of white British mothers, and the researchers say that future studies should be widened to explore how different cultural dietary practices might influence foetal receptivity to a broader array of flavours. 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3 min

Putting least calorific meals first on menu makes teenagers more likely to order them according to a study co-led at Aston University

The research was carried out by the University of Birmingham’s Katie Edwards and Aston University’s Jackie Blissett and James Reynolds Both the availability of high-calorie options and their position on the menu affects teenagers’ choices Restaurants provide an important location for implementing low-cost and high-reach interventions to tackle obesity. New research from the University of Birmingham and Aston University has found that putting lower-calorie meal choices at the top of a restaurant menu, and reducing the availability of high-calorie options, makes teenagers more likely to order the healthier options. Childhood obesity rates have been increasing year on year, with government pledges and targets to reduce obesity unfulfilled or missed. Restaurants are a common food environment for adolescents, with one fifth of children consuming meals out at least once a week. The study has been published in the journal Appetite. Dr Katie Edwards, research fellow in psychology at the University of Birmingham and a visiting researcher at Aston University, who led the study, said: “Childhood obesity is a significant public health challenge. A key period for targeting dietary intervention is adolescence, when young people become more independent, making their own decisions about diet and socialising with friends more. Interventions have targeted healthy eating at home and at school, but we wanted to see how altering restaurant menus can impact the choices teenagers make.” The researchers asked 432 13 to 17-year-olds to take part in an online experiment. They presented the teenagers with three different menus, with five starters, ten main courses and five desserts in separate sections, as one would find on a standard restaurant menu. Each menu was slightly different; one which reduced the number of high-calorie options on offer, one with menu positioning of low- to high-calorie meals, one which combined the availability and position interventions, and then one ‘typical’ menu. The participants were asked to select a starter, main and dessert from each menu. The experiment showed that the availability and the position interventions resulted in significantly lower calorie meal choices, compared to the choices made from the menu with no intervention (the ‘typical’ menu). The average number of calories for a selected meal reduced from 2099.78 to 1992.13 when the items were ordered from least to highest calorie content. The availability intervention reduced it from 2134.26 kcal to 1956.18 kcal. The group who had the combined availability and positioning intervention menu saw their meals’ calorie value plummet from 2173.60 kcal to 1884.44 kcal. The study also found that the positioning intervention had the biggest impact on main course choices. The availability intervention and the combined interventions, on the other hand, did not have a big impact on the calorie value of main course choices. The availability intervention had the most impact on starter choices. None of the interventions had a significant impact on dessert choices. Dr Edwards said: “Main menu choices saw the biggest reduction in calories following the position intervention, going from 1104.17 kcal to 1045.16 kcal, while the availability intervention saw the biggest reduction in the starter option. While not all interventions saw statistically significant reductions for all courses, each intervention saw a significant reduction in the calorie content of the overall meals.” Dr James Reynolds, senior lecturer in psychology at Aston University, said: “People tend to consume higher calorie meals when they eat out, so restaurants provide an important location for implementing low-cost and high-reach interventions which can encourage healthier eating in teenagers. Many restaurants are already required to display calorie information on their menus, but our research has shown that tactics like altering the position or availability of high-calorie options on menus could also be a useful tool in trying to reduce obesity and help young people make healthier choices. The next step for this research would be to replicate the study in restaurant settings.” Read the full paper in the journal Appetite at https://www.sciencedirect.com/science/article/pii/S0195666324005749

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