Global alarm: one in six infections with resistant bacteria in 2023
The World Health Organization (WHO) released a stark new report showing that about one in six laboratory-confirmed bacterial infections causing common illnesses worldwide in 2023 were resistant to antibiotic treatments. The findings, drawn from the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS), highlight a troubling upward trend across countries and pathogen-antibiotic pairs.
From 2018 to 2023, resistance rose in more than 40% of the monitored pathogen–antibiotic combinations, with an average annual increase of 5–15%. The data, reported by over 100 countries, underscores how antimicrobial resistance (AMR) is eroding the effectiveness of drugs that once reliably treated infections.
New insights: 22 antibiotics and 8 key pathogens
For the first time, the Global antibiotic resistance surveillance report 2025 provides prevalence estimates across 22 antibiotics used to treat urinary, gastrointestinal, bloodstream infections, and gonorrhoea. The report covers eight common bacterial pathogens: Acinetobacter spp., Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, non‑typhoidal Salmonella spp., Shigella spp., Staphylococcus aureus and Streptococcus pneumoniae. These organisms are linked to a range of serious infections and, in many cases, sepsis or organ failure when treatment fails.
Among the most troubling trends is the rising resistance of Gram‑negative bacteria, particularly E. coli and K. pneumoniae, to first‑line drugs such as third‑generation cephalosporins. Globally, more than 40% of E. coli and over 55% of K. pneumoniae isolates are resistant to these commonly used antibiotics. In parts of Africa, resistance in these pathogens to cephalosporins exceeds 70%.
Regional hotspots and the burden on health systems
WHO estimates show the highest resistance in the South‑East Asia and Eastern Mediterranean regions, where about one in three infections are resistant. In the African Region, roughly one in five infections shows resistance. The geographic pattern reflects disparities in health system capacity, diagnostic access, and the ability to implement infection prevention and control measures.
The report also flags growing resistance to other critical drugs, including carbapenems and fluoroquinolones, which are increasingly losing effectiveness against E. coli, K. pneumoniae, Salmonella, and Acinetobacter. Once rare, carbapenem resistance is becoming more common, narrowing the window of treatment options and pushing clinicians toward last‑resort therapies that are often costly and less accessible in low‑ and middle‑income countries.
A call to strengthen surveillance and action
Although GLASS participation has risen—from 25 countries in 2016 to 104 in 2023—nearly half of countries did not report data in 2023. About the same proportion lacked robust systems to generate reliable AMR data. This gap is particularly worrisome for nations facing the greatest burden, where surveillance capacity is weakest and infection prevention measures are most needed.
In 2024, governments committed to the UN General Assembly’s AMR declaration, endorsing a One Health approach that aligns human, animal, and environmental health actions. The WHO urges countries to strengthen laboratory infrastructure and surveillance, ensuring data is high-quality, geographically representative, and shared to guide local treatment guidelines and national policies.
What needs to happen next
WHO calls on all countries to report high‑quality AMR and antimicrobial use data to GLASS by 2030. Achieving this target will require investments in laboratory capacity, data systems, and cross‑sector collaboration. Health authorities should harmonize treatment guidelines with local resistance patterns and ensure access to quality diagnostics, vaccines, and essential medicines. Innovation remains critical, including the development of next‑generation antibiotics and rapid molecular tests that can guide timely, effective therapy.
Ultimately, fighting AMR demands sustained, coordinated action across healthcare facilities, community settings, and national and international policy spheres. Responsible antibiotic use, enhanced diagnostics, and robust surveillance are essential to protecting the gains of modern medicine and safeguarding patient outcomes worldwide.
