Antibiotic Resistance as a Global Problem: Mechanisms of Development, Control and Forecasting Using the GLASS Programme

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Relevance: In 2016, at the high level of the UN General Assembly, the steady growth of antimicrobial resistance (AMR) was recognised as a global problem and is currently considered one of the 10 most serious threats to humanity [14, 49]. Since bacteria are capable of adapting to new drugs in extremely short periods of time, and the development of new antibiotics requires enormous financial and time investments, the problem cannot be solved without combining efforts to control AMR at the national and global levels [1, 2]. The GLASS system (Global Antimicrobial Resistance Surveillance System), launched by the World Health Organization (WHO), is the main tool playing a fundamental role in combating the growth of AMR, providing global surveillance of this problem through active international cooperation [54, 1, 2].

Objective: to analyse the effectiveness of epidemiological control and prediction of AMR based on data from various sources as a result of the participation of different countries and regions of the world in the GLASS programme.

Methods: A literature review was conducted using various databases, including PubMed, ScienceDirect, Google Scholar, and Web of Science, focusing on studies dedicated to AMR issues from 2000 to 2024. Search terms included "antibiotic resistance," "resistance mechanisms," "AMR epidemiology," and "prevalence of resistant pathogens." A total of 80 articles were selected based on the specified criteria, including resistance mechanisms, epidemiological data on the prevalence of certain pathogens, nosological forms of bacterial infections caused by resistant strains and their outcomes, as well as the quality of public health services.

Results: The GLASS system tracks the resistance of the eight most common bacterial "problem" pathogens (including E. coli, S. aureus, K. pneumoniae, etc.) to 22 antibiotics [49, 50]. Data from 104 countries on more than 23 million confirmed cases of infections caused by "problematic" pathogens between 2016 and 2023 were collected and analysed [58, 59, 61].

It was found that, on average, 17.2% of bacterial infections worldwide are caused by resistant strains, and the increase in resistance is steadily growing across regions from year to year and globally amounts to 17.9%, ranging from 3.5% to 39.5% depending on the combination of infection, pathogen and antibiotic [63, 70]. Serious problems have also been identified in the following areas: data collection, microbiological diagnosis, and irrational use of antibiotics, especially in low- and middle-income countries, which further accelerates the spread of resistant pathogens on a global scale [76, 77]. The results highlight three dominant pathways of resistance: target site modification, enzymatic degradation (e.g. β-lactamases), and horizontal gene transfer via plasmids and transposons. Notably, resistance to last-line antibiotics (e.g., colistin, carbapenems) is increasing in pathogens such as Klebsiella pneumoniae and Acinetobacter baumannii, with treatment failure rates exceeding 50% in some regions [3]. 

Conclusion: AMR is a quantifiable, escalating crisis that undermines decades of progress in infectious disease control. Addressing the problem requires coordinated action by the international community. The GLASS programme is an effective tool for epidemiological surveillance of AMR growth and for developing timely recommendations for AMR control. In this regard, WHO calls on all countries to provide the GLASS system with quality data by 2030. This is necessary for the development of accurate treatment protocols and long-term strategies for the survival of humanity in the "post-antibiotic era".