Key findings from WHO's GLASS report

by Sam Willcocks

The World Health Organisation has just published its third report on Global Antimicrobial Resistance and Use Surveillance System (GLASS). Initiated in 2015, GLASS was conceived as a means of collecting, analysing, interpreting and sharing AMR data among participating countries. It aims to monitor antimicrobial use, and AMR prevalence in medicine, the food chain, and the environment. It is also a means by which the implementation of surveillance systems across countries can be assessed and enables informed, data-driven recommendations to be made to countries seeking to improve their response to AMR.     

GLASS represents a vast public resource, with data representing more than two million patients from 66 countries around the world, although 91 countries in total have signed up to the programme. The report features country-by-country breakdowns, including a new metric introduced in 2019, total antimicrobial consumption. The report acknowledges a need for better environmental surveillance, and is trialling several approaches with its partners to enable this dataset to be included in the next report.

I have summarised some of the key findings of the report below; for expert commentary, readers may be interested to watch this interview by Prof Hanan Balkhy, including her thoughts on how COVID-19 may impact AMR:


GLASS report highlights:

  • The number of AMR surveillance sites around the world is increasing, in both hospitals and outpatient settings, and particularly in lower income countries.
  • Resistance of blood-stream isolated Acinetobacter spp to carbapenems and aminoglycosides remains high, as does fluoroquinolone and third generation cephalosporin resistance among Escherichia coli and Klebsiella pneumoniae isolates.
  • Urinary-tract isolated E. coli and K. pneumoniae demonstrate resistance to multiple different antibiotic classes.
  • There are high levels of AMR among genital-isolated Neisseria gonorrhoeae to ciprofloxacin.
  • Several emerging AMR events including:
    • the first detection of daptomycin resistance in a clinical methicillin-resistant S. aureus isolate.
    • the first detection of XDR E. coli with blaKPC and mcr-1 genes.
    • the first detection of N. meningitidis serogroup Y with no sensitivity to cefotaxime.
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