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May 1, 2025 – The World Health Organization (WHO) has released a major update to its Bacterial Priority Pathogens List (BPPL), underscoring the escalating global threat posed by antimicrobial resistance (AMR). The revised list, published in May 2024, aims to guide research, policy, and investment toward combating the most dangerous antibiotic-resistant bacteria.
AMR: A Growing Public Health Crisis
AMR continues to be a significant public health concern, with the German Center for Infection Research reporting that nearly 5 million deaths worldwide in 2019 were linked directly or indirectly to resistant bacterial infections. Despite the approval of 13 new antibiotics since the previous BPPL in 2017, resistance rates have continued to climb, rendering many of these new drugs less effective.
How the New List Was Compiled
Dr. Hatim Sati and his team from WHO’s Division of Antimicrobial Resistance led the update, using a mix of quantitative and qualitative criteria. The evaluation considered factors such as:
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Mortality and nonfatal disease burden
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Incidence and resistance trends over the past decade
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Preventability (e.g., through vaccines)
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Transmission dynamics
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Treatability and the current antibacterial pipeline
The team assessed 24 bacterial pathogens, categorizing them into critical, high, and medium priority levels based on their threat to public health.
Critical Pathogens Identified
Carbapenem-resistant Klebsiella pneumoniae emerged as the top concern, scoring 84% on the priority scale. Other critical, antibiotic-resistant gram-negative bacteria include:
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Acinetobacter species
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Escherichia coli
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Rifampicin-resistant Mycobacterium tuberculosis
Among community-acquired infections, the highest scores were noted for:
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Fluoroquinolone-resistant Salmonella enterica serotype Typhi (72%)
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Shigella species (70%)
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Neisseria gonorrhoeae (64%)
Other significant pathogens include Pseudomonas aeruginosa and Staphylococcus aureus. At the lower end of the list were penicillin-resistant group B streptococci.
Urgent Need for Action
The updated BPPL is intended to direct global health priorities, emphasizing the urgent need for:
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Continued research and development of new antibiotics
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Expanded access to existing medications
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Improved vaccine availability
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Strengthened infection prevention and control measures
Dr. Sati’s team highlighted the persistent burden of gram-negative bacteria and rifampicin-resistant tuberculosis, calling for focused and sustained investment to address these threats.
Prevention: The First Line of Defense
In a related commentary, Dr. David P. Moore of the University of the Witwatersrand stressed the importance of prevention, especially hand hygiene, as the most basic and effective measure to curb the spread of resistant pathogens in healthcare settings. He noted ongoing efforts to develop a vaccine against K. pneumoniae and to optimize antibiotic use to reduce resistance.
Looking Ahead
The updated WHO BPPL serves as a critical roadmap for governments, researchers, and healthcare providers worldwide. By prioritizing the most dangerous bacterial threats, the WHO hopes to galvanize coordinated action against the growing crisis of antimicrobial resistance.
Disclaimer:
This article is based on information reported by Medscape and the World Health Organization as of May 2024. It is intended for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. For more details, consult the original publication or a healthcare professional.
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