AI Corner: Example of AI in Use: The Lancet Global Report on Antibiotic Resistance

 AI Corner

This is an example of using AI prompts in different ways to get different AI views on the same source material.

This past week, September 16, LANCET published a 28-page global report on the crisis of antibiotic resistance.   It was covered in forums like Washington Post, as well as Nature; there was an Op Ed in Lancet.

Global report on antibiotic resistance (AMR) in Lancet and associated news.

• https://www.washingtonpost.com/science/2024/09/16/antibiotic-resistance-39-million-deaths-2050-study/ 
• https://www.nature.com/articles/d41586-024-03033-w
• https://www.nature.com/articles/d41586-024-02971-9 
• https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01867-1/fulltext 
• https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(22)00087-3.pdf    op ed

Here, as a learning exercise, we gave Chat GPT 4 (subscription) three tasks.  In the first, summarize each input.   In the second, write a consolidated essay on the inputs.   Third, look at the 28 page original paper and highlight three key topics that were NOT discussed in the news articles provided.

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AI REPORT

Here are summaries of the articles, op-ed, and major report you uploaded about antibiotic resistance:

1. Washington Post Article (2024): The article highlights the projected impact of antimicrobial resistance (AMR), warning that over 39 million people could die from drug-resistant infections by 2050. The study shows a sharp rise in deaths, particularly among older adults, with South Asia and sub-Saharan Africa expected to be hardest hit. A key driver is the misuse and overuse of antibiotics, which accelerates resistance. The article stresses the importance of global cooperation and measures like antibiotic stewardship, clean water access, and vaccine development to mitigate the crisis​.

2. Nature News Report (2024): This report reiterates the projection that 40 million people may die due to drug-resistant infections by 2050, with the elderly population being most affected. The rise in resistant bacteria, like Acinetobacter baumannii, is emphasized. Solutions proposed include wider access to appropriate antibiotics, research into Gram-negative drug resistance, and prioritization of regions like South Asia and Latin America. The report underscores the need for more investment in healthcare quality and infection prevention measures​.

3. Lancet Op-Ed (2022): The op-ed describes AMR as a "hidden pandemic" that is growing alongside more visible health crises like COVID-19. It points out that AMR often extends hospital stays and increases mortality, especially in low-resource settings. The authors call for more attention and funding for preventing infections, better antibiotic use, and access to effective antibiotics, drawing a parallel to the global response to HIV, which receives far more funding despite AMR causing more deaths​.

4. Nature Expert Opinions (2024): Experts from Bangladesh, Brazil, Nigeria, and the Middle East discuss region-specific challenges and solutions for AMR. In Bangladesh, data collection on resistance and improved neonatal care are prioritized. In Brazil, infection control in hospitals and public awareness campaigns are needed. Nigeria focuses on access to healthcare and sanitation, while in the Middle East, political instability complicates efforts to control resistance. The common theme is the need for tailored approaches and global investment​.

5. Lancet Global Report on AMR (2024): This 28-page report is a comprehensive analysis of AMR trends from 1990 to 2021, with forecasts up to 2050. The report estimates that 1.14 million deaths in 2021 were directly attributable to bacterial AMR, and this number is expected to increase by 69.6% by 2050. Older adults, particularly those over 70, are projected to bear the largest burden. The report highlights the increasing resistance of pathogens like Staphylococcus aureus and Gram-negative bacteria. It calls for a multi-pronged approach involving improved healthcare, access to antibiotics, and development of new drugs, particularly targeting Gram-negative bacteria​.

These documents collectively emphasize the urgency of global action on antimicrobial resistance, with targeted interventions in low- and middle-income countries, more research and development of new antibiotics, and efforts to reduce inappropriate antibiotic use.

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Write a consolidated article for experts.

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Title: The Global Threat of Antimicrobial Resistance: A Health Policy Crisis Foretold

As antimicrobial resistance (AMR) rapidly escalates into a global health crisis, the 2024 Lancet report underscores the urgent need for coordinated action. With projections of 39-40 million deaths by 2050, the growing body of evidence calls for health policy reform, significant investment, and international collaboration to avert a catastrophic public health burden.

The Lancet’s newly published 28-page report, Global Burden of Antimicrobial Resistance 1990–2021, provides the most comprehensive analysis to date, documenting the rise of bacterial resistance from 1990 and forecasting the potential consequences through 2050. The report highlights that AMR was responsible for 1.14 million deaths in 2021 alone, with 4.71 million deaths associated with resistant infections. Without global intervention, AMR deaths are projected to increase by 69.6% by 2050, disproportionately affecting vulnerable populations such as older adults, particularly in low- and middle-income countries (LMICs) like South Asia and sub-Saharan Africa​.

Key Findings of the Lancet Report

The report provides sobering statistics on how antimicrobial resistance has evolved over the last 30 years. Meticillin-resistant Staphylococcus aureus (MRSA) infections saw a stark rise, contributing to 550,000 deaths globally in 2021, while Gram-negative bacteria like Escherichia coli and Acinetobacter baumannii, which are resistant to carbapenems, have also seen an alarming increase in fatalities. The report forecasts that by 2050, nearly 2 million people will die from drug-resistant infections annually, with over 65% of these deaths occurring in individuals aged over 70​​.

One of the most concerning trends identified is the disparate impact of AMR based on geography. While deaths among children under 5 have decreased by more than 50%, the mortality rate for individuals over 70 has increased by over 80%, signaling that an aging population will exacerbate the AMR crisis​. Regions like South Asia and Latin America are expected to experience the highest mortality rates unless swift interventions are implemented.

Coverage in the Media

Major media outlets have taken note of the escalating crisis. The Washington Post highlights the same report's grim forecast of 39 million deaths from AMR by 2050, framing it as an impending disaster unless global action is taken. The article emphasizes the importance of antibiotic stewardship and calls for an international response to improve access to clean water, vaccines, and antibiotic development​.

In Nature News, a detailed analysis of the report notes that more than 92 million lives could be saved between 2025 and 2050 with better healthcare and access to antibiotics, underlining the immense potential for preventative strategies. However, experts caution that without these interventions, millions will continue to die from preventable infections​.

Op-Ed: The Overlooked Pandemic

An op-ed published in The Lancet earlier in 2022 referred to AMR as a “shadow pandemic,” calling attention to how it operates alongside but out of view compared to the high-profile crisis of COVID-19. The authors highlight how AMR leads to prolonged hospital stays, higher healthcare costs, and needless deaths, particularly in low-resource settings where access to second-line antibiotics is limited​. The op-ed stresses that the global health community cannot afford to ignore this growing threat, especially when it disproportionately affects poorer regions. Its message is clear: while AMR may not receive the same visibility as viral pandemics, it poses an equally formidable challenge to global health infrastructure.

Health Policy Implications: A Call to Action

The 28-page Lancet report makes it abundantly clear that targeted health policy reforms are essential to curbing the AMR crisis. Key recommendations include:

1. Global Surveillance and Data Collection: AMR data is often inconsistent or incomplete, particularly in LMICs. Policies that mandate more comprehensive data collection can help health authorities understand the true scale of the problem and direct resources where they are most needed.

2. Antibiotic Stewardship: Misuse and overuse of antibiotics, both in clinical and agricultural settings, are primary drivers of resistance. Stricter regulations around antibiotic prescription and use, combined with public awareness campaigns, are critical in curbing AMR.

3. Investment in New Antibiotics and Vaccines: The pipeline for new antibiotics, particularly those targeting Gram-negative bacteria, must be expanded. Coupled with the development of vaccines that prevent infections in the first place, this could reduce the burden of drug-resistant infections.

4. Health System Strengthening: As the media coverage and the report both highlight, improvements in healthcare infrastructure, particularly in LMICs, will be vital. Hospitals need better infection prevention controls, and access to clean water and sanitation must be expanded to reduce infection rates.

5. Targeted Regional Solutions: Expert opinions gathered by Nature emphasize the need for tailored solutions. In Bangladesh, for instance, improving maternal and neonatal care could prevent infections that often lead to antibiotic use. In Brazil, simple hospital hygiene measures could drastically reduce AMR in clinical settings​.

Conclusion

The Lancet report and subsequent media coverage paint a stark picture of the global health burden posed by antimicrobial resistance. Health policy experts must prioritize AMR in their agendas, pushing for more funding, research, and international collaboration. As AMR death rates climb, particularly among the elderly and in LMICs, the window for meaningful intervention is narrowing. The solution, as highlighted by the report and echoed across the media, lies in a comprehensive, globally coordinated response—one that addresses both the misuse of antibiotics and the systemic issues that contribute to resistant infections. If ignored, AMR could rival the deadliest pandemics of the modern era.

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What are three of the most important findings in the 28 page global report, that were * NOT *   discussed in the Washington Post, in Nature news item, or in the Lancet Op Ed?

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Here are three important findings from the 28-page Lancet report on antimicrobial resistance (AMR) that were not covered in the Washington Post, Nature news item, or the Lancet Op-Ed:

1. Carbapenem-Resistant Gram-Negative Bacteria Surge: The Lancet report highlights that the resistance to carbapenems, a class of last-resort antibiotics, has surged more than any other antibiotic class. Between 1990 and 2021, deaths associated with carbapenem-resistant Gram-negative bacteria, such as Escherichia coli and Acinetobacter baumannii, increased significantly. Deaths linked to these bacteria rose from 619,000 in 1990 to over 1.03 million in 2021, underscoring the critical need for new antibiotics specifically targeting Gram-negative pathogens​.

2. Disparity Between Deaths and DALYs (Disability-Adjusted Life Years): While the report projects a 69.6% increase in deaths due to AMR from 2022 to 2050, the increase in disability-adjusted life years (DALYs) is much smaller, at 9.4%. This disparity suggests that while AMR will lead to more deaths, the overall health impact on surviving populations may not escalate at the same rate. This nuance highlights the complex nature of AMR's future burden, with death tolls rising more rapidly than overall disease impact, partially due to the concentration of deaths among older populations​.

3. Impact of Sepsis and Non-Respiratory Infections: The report delves into the significant role of sepsis and non-respiratory infections, such as bloodstream infections and intra-abdominal infections, in driving AMR-related deaths. Sepsis mortality is particularly highlighted as an important contributor to AMR deaths, and the study emphasizes the need for better infection control and management of these non-respiratory infections, which have not received as much focus as respiratory diseases in media coverage​.

These findings bring to light important aspects of the AMR crisis that deserve more attention in public discussions and policy-making.