Navigating the ever-increasing challenges of antimicrobial resistance (AMR), which occurs when bacteria, viruses, fungi, or parasites no longer respond to antimicrobial treatment, has been a key theme at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) 2023 conference, says GlobalData, a leading data and analytics company.

Stephanie Kurdach, Infectious Disease Analyst at GlobalData, comments: “AMR often leads to persistent infections, an increased risk of spreading infection to others, severe illness, and possible death. Globally, millions of deaths annually are associated with AMR, and this is expected to increase in the coming decades. This highlights the urgent need to bring new antimicrobials to market.”

The World Health Organization (WHO) presented revised criteria and methodology for its Bacterial Priority Pathogens List (BPPL) – a list of antibiotic-resistant bacteria considered to pose the greatest threat to human health. The objectives of this list include increasing awareness of AMR, reducing the incidence of infection, and sustainably increasing investments in new medicines, diagnostics, vaccines, and other interventions.

Kurdach continues: “The release of the 2022-2023 BPPL, which is expected later this year, is highly anticipated, as AMR is a rapidly evolving topic of interest. The updated list includes assessments of mortality, incidence, non-fatal health burden, 10-year resistance trends, preventability, transmissibility, treatability, pipeline, and community burden.”

Drug-resistant bacterial infections such as tuberculosis (TB) have gained much attention in recent years. One notable presentation detailed a Phase II/III trial conducted in over 550 patients presenting with rifampin-resistant pulmonary tuberculosis (RR-TB). Of the patients who were administered bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM group), 89% had a favorable outcome compared to 52% in the standard-of-care group. BPaLM was deemed superior to the standard-of-care treatment, and subsequently, the WHO has updated its recommended treatment of RR-TB to reflect a 6-month course of BPaLM.

Aside from bacterial infections, data on antifungal resistance was also presented at ECCMID. Cryptococcus neoformans – the pathogen responsible for causing cryptococcal meningitis – was reported as a fungal priority pathogen in 2022 by the WHO. Cryptococcal meningitis is the leading cause of HIV death in sub-Saharan Africa. Encouraging data was presented from a Phase III study in Africa conducted among 814 HIV patients with cryptococcal meningitis. Patients received either a single-dose of liposomal amphotericin B (L-AMB), plus flucytosine and fluconazole or an active comparator. The experimental treatment was deemed non-inferior to the active comparator with mortality rates of 24.8% and 28.7%, respectively, after 10 weeks, as well as fewer adverse events.

Kurdach concludes: “In addition to presentations on drug resistant tuberculosis and cryptococcal meningitis, ECCMID 2023 also featured nearly 50 other presentations which included AMR as a key concern.”