In May of this year, the World Health Organization released an updated version of the Bacterial Priority Pathogens List (BPPL), which classifies bacteria that pose the greatest risk to human health worldwide.
To create the updated list, WHO used a similar multi-criteria decision analysis methodology to the one used to build the list released in 2017. Prioritization criteria included mortality, global incidence of the pathogen, trend of resistance, non-fatal health burden, transmissibility, treatability, preventability, and the number of antibiotics in the development pipeline that are likely to be active for the pathogen.
The list features organisms like rifampicin-resistant Mycobacterium tuberculosis, Shigella spp., and carbapenem-resistant Enterobacterales. Five pathogen-antibiotic combinations were removed from the list in this new edition, while four others were added. The removed organisms were Providencia species, third-generation cephalosporin-resistant; Helicobacter pylori, clarithromycin-resistant; Campylobacter species, fluoroquinolone-resistant; Staphylococcus aureus, vancomycin-resistant; Streptococcus pneumoniae, penicillin non-susceptible. The following were added to the list in 2024: Mycobacterium tuberculosis, rifampicin-resistant; Group A Streptococci, macrolide-resistant; Group B Streptococci, penicillin-resistant; and Streptococcus pneumoniae, macrolide-resistant.
Since its first release in 2017, the BPPL has guided not only the clinical use of antibiotics and the collection of antimicrobial resistance (AMR) data, but also funding and research into the development of new antimicrobial drugs. In the intervening years, nine new antibiotics have been introduced that are effective against BPPL organisms, although the report notes that for almost all of those new antibiotics, resistant strains have already been discovered.
The original edition of the list has also been critical in surveillance, prevention, and control of antibiotic resistant organisms.
The global AMR landscape changes quickly and development of new antibiotics has not kept up. The main obstacle so far has been the lack of sufficient funding, which limits development of new antibiotics and access to existing ones where those drugs are needed the most.
The new version of the report addresses limitations in the 2017 edition and incorporates lessons learned from the subsequent seven years of analysis. Surveillance methods have advanced since the first list was published, and data from these methods has been included in the updated version. The COVID-19 pandemic had a significant impact on the evolution of AMR mainly through overuse of antibiotics, and results from analysis of that data have been incorporated. Critically, the list highlights where more work is required in the global fight against AMR, and proposes a path forward.
You can read the full updated BPPL here: https://www.who.int/publications/i/item/9789240093461 If you would like to learn more about the laboratory’s role in AMR prevention, our sister program offers a 12 week course and micro-certificate on Antimicrobial Susceptibility Testing and Interpretation. Click here for more details.
If you would like to learn more about the laboratory’s role in AMR prevention, our sister program offers a 12 week course and micro-certificate on Antimicrobial Susceptibility Testing and Interpretation. Click here for more details.
