Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Multidrug-resistant bacterial infections cause more than 19,000 excess deaths a year in Thailand alone, according to a study published today in eLife Sciences Publications. In a first for Thailand, the study systematically examined microbiology laboratory and hospital databases from nine public hospitals in Northeast Thailand and compared them to Thailand’s national death registry to estimate that 19,122 deaths in Thailand in 2010 were excess deaths caused by multidrug-resistant bacterial infections.

© MORU. Photographer: Direk Limmathurotsakul

7 September 2016, Bangkok (Thailand) – Multidrug-resistant bacterial infections cause more than 19,000 excess deaths a year in Thailand alone, according to a study published today in eLife Sciences Publications.

In a first for Thailand, the study systematically examined microbiology laboratory and hospital databases from nine public hospitals in Northeast Thailand and compared them to Thailand’s national death registry to estimate that 19,122 deaths in Thailand in 2010 were excess deaths caused by multidrug-resistant bacterial infections.

Noting that Thailand’s death rate from multidrug-resistant bacterial infections was high given its smaller population relative to the United States and Europe, the study authors warned that similarly high death rates due to multidrug-resistant bacterial infection were likely to be found in other low and middle-income countries, such as China, India and Indonesia.

“Our study estimates that multidrug-resistant bacterial infections caused an excess of 19,122 deaths in Thailand in 2010. This is large compared to the 23,000 deaths a year estimated in the much more populous USA (316 million population in 2013) and the 25,000 deaths a year in the European Union (500 million population in 2007),” said study senior author Dr. Direk Limmathurotsakul, Head of Microbiology at MORU and Assistant Professor at Mahidol University (Thailand).

“We also show that the proportion of multidrug-resistant bacteria found in patients is increasing and that the burden of antibiotic resistance in Thailand is deteriorating over time,” said Dr. Limmathurotsakul.

“We expect to find similar high rates of multidrug resistant bacterial infections in other low and middle income countries, particularly where broad spectrum antibiotics such as ceftriaxone, ceftazidime and carbapenem are commonly available and used, such as in China, India and Indonesia,” said Dr. Limmathurotsakul.

Antimicrobial resistance is a growing global problem. In low and middle-income countries, bacteria resistant to many commonly used antibiotics are spreading, driven by rising incomes, greater use of affordable antibiotics by both humans and animals, a lack of control of antimicrobial use in hospitals and poor control of over-the-counter sales.

The study authors said that better national estimates on the epidemiology and burden of multidrug resistant bacterial infections could be improved by integrating information from readily available databases in Thailand and other low and middle-income countries.

“The impact of drug-resistant bacterial infections is already considerable – and getting worse. If it’s not to overwhelm Asia’s prosperity and the world’s economic, health and life expectancy gains, we need to take drug resistance seriously and invest heavily in its defeat – now, “ said study collaborator Dr. Nick Day, Director of MORU and Professor at the University of Oxford (UK).

“More systematic studies should be done in low and middle-income countries. We should focus on how to compare the antimicrobial resistance situation in countries where settings, resources for diagnostic tests and laboratory methodologies are different. Finally, we will need to identify where resources and attentions are most needed to effectively fight antimicrobial resistance,” said Prof Day.

Led by researchers at Ministry of Public Health and the Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine and Siriraj Hospital, Mahidol University, in Thailand, and the University of Oxford and University of Cambridge in the United Kingdom, the study was funded by the Ministry of Public Health (Thailand) and the Wellcome Trust (UK).

“This study makes for grim reading, confirming that there were over 19,000 deaths in Thailand due to drug resistance in 2010, a figure which is likely to have risen since. It’s yet another warning to the global community that drug resistant infections are killing people now and we must not wait any longer to take action,” said Dr Jeremy Farrar, Director of the Wellcome Trust.

“Drug resistance is a global issue, which affects all of us whether we live in London or in Bangkok, and all countries need to be part of any solution. We cannot tackle drug resistant infections by isolating our actions to single countries or continents.  At the UN General Assembly later this month we urgently need governments to commit to strategies that combat drug resistance," said Dr Farrar.

Reference:

Lim et al. Epidemiology and Burden of Multidrug-resistant Bacterial Infection in a Developing Country. eLife 6 Sept 2016, http://dx.doi.org/10.7554/eLife.18082

For post publication access to abstract and full text:  http://dx.doi.org/10.7554/eLife.18082

Authors and contributors:

This work was conducted by: Cherry Lim, Emi Takahashi, Maliwan Hongsuwan, Visanu Thamlikitkul, Vanaporn Wuthiekanun, Soawapak Hinjoy, Nicholas Day, Sharon Peacock and Direk Limmathurotsakul.

Similar stories

Pint of Science Thailand is back

MORU Bangkok Public Engagement

Live and on-line from Bangkok! Be ready for Thursday 13th May, when Pint of Science Thailand will stream live from Bangkok. Join us via Facebook, YouTube or right here from the Pint of Science Thailand website as we journey from bacterial infections to viruses, discover how clinical trials work, and how scientific development is seen in the eyes of the law!

Innovative strategies for engaging communities with malaria research

MORU Bangkok Public Engagement

For World Malaria Day 2021, F1000 Research Blog spoke to Professor Phaik Yeong Cheah about her research focussed on drama and arts-based community engagement for malaria research, published with Wellcome Open Research.

New project’s child-appropriate primaquine doses could have significant impact on global burden of malaria

MORU Bangkok

On Sunday 25 April, World Malaria Day, the Developing Paediatric Primaquine (DPP) project will launch its website. DPP will produce children-appropriate primaquine doses that could both cut malaria deaths in vulnerable African children by blocking transmission of P. falciparum malaria and reduce P. vivax malaria more widely.

Researchers call for access to Ivermectin for young children

MORU Bangkok Publication Research

Millions of children weighing less than 15kg are currently denied access to Ivermectin treatment due to insufficient safety data being available to support a change to the current label indication. The WorldWide Antimalarial Resistance Network’s new meta-analysis provides evidence that supports removing this barrier and improving treatment equity.

New report highlights growing concern of vaccine falsification

MORU Bangkok

The Medicine Quality Research Group has published a new Medical Product Quality Report focussing on increasing issues around substandard and falsified (SF) COVID-19 vaccines. With the implementation of the key innovations of COVID-19 vaccines, there have been growing numbers of reports of SF vaccines in the public domain. Given the vital role they will play in ending the pandemic and protecting the global population but severe issues with equitable access, SF vaccines are highly likely to be a growing problem.

Evidence supports WHO recommendation for primaquine combined with ACTs to block Plasmodium falciparum transmission

MORU Bangkok Publication Research

Evidence from a new study, initiated by the Primaquine Roll Out Group and conducted at WWARN, supports the World Health Organization (WHO) recommendation for use of 0.25mg/kg dose of primaquine (PQ) combined with artemisinin-based combination therapies (ACT) to block Plasmodium falciparum transmission.