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Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. This report examines, for the first time, the current status of surveillance and information on AMR, in particular antibacterial resistance (ABR), at country level worldwide.

Key findings and public health implications of ABR are:

• Very high rates of resistance have been observed in bacteria that cause common health-care associated and community-acquired infections (e.g. urinary tract infection, pneumonia) in all WHO regions.

• There are significant gaps in surveillance, and a lack of standards for methodology, data sharing and coordination.

Key findings from AMR surveillance in disease-specific programmes are as follows:

• Although multidrug-resistant TB is a growing concern, it is largely under-reported, compromising control efforts.

• Foci of artemisinin resistance in malaria have been identified in a few countries. Further spread, or emergence in other regions, of artemisinin- resistant strains could jeopardize important recent gains in malaria control.      

• Increasing levels of transmitted anti-HIV drug resistance have been detected among patients starting antiretroviral treatment.

Surveillance of ABR and sources of data

There is at present no global consensus on methodology and data collection for ABR surveillance. Routine surveillance in most countries is often based on samples taken from patients with severe infections – particularly infections associated with health care, and those in which first-line treatment has failed. Community-acquired infections are almost certainly underrepresented among samples, leading to gaps in coverage of important patient groups.