Summary of Priority Pathogens Lists by WHO, CDC, and ESKAPE
A summary of priority pathogens categorized by WHO, CDC, and ESKAPE, detailing bacteria such as Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium, Staphylococcus aureus, and more. The list highlights critical, serious, and urgent classifications for various resistant strains and provides sources and references for further information.
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Summary of WHO PPL, CDC, and ESKAPE pathogen lists John H. Rex, MD Source: http://amr.solutions/blog/who-priority-pathogens-list Last updated: 22 Dec 2017 WHO PPL, CDC, & ESKAPE 1
Bacteria (WHO category) WHO (2017) CDC (2013) ESKAPE (2008-9) Acinetobacter baumannii, carbapenem-R Critical Serious (MDR) Yes Pseudomonas aeruginosa, carbapenem-R Critical Serious (MDR) Yes Urgent (carbapenem-R) Serious (ESBL+) Enterobacteriaceae, carbapenem-R, 3rd-gen ceph-R (ESBL+) Critical Yes Enterococcus faecium, vancomycin-R High Serious (VRE) Yes Serious (MRSA) Concerning (VRSA) Staphylococcus aureus, methicillin-R, vancomycin-I/R High Yes Helicobacter pylori, clarithromycin-R High Campylobacter spp., fluoroquinolone-R High Serious (drug-R) Salmonellae spp., fluoroquinolone-R High Serious (drug-R) Neisseria gonorrhoeae, 3rd-gen ceph-R, fluoroquinolone-R High Urgent (drug-R) Streptococcus pneumoniae, penicillin-NS Medium Serious (drug-R) Haemophilus influenzae, ampicillin-R Medium Shigella spp., fluoroquinolone-R Medium Serious Clostridium difficile Urgent Candida spp. fluconazole-R Serious (Flu-R) M. tuberculosis Serious (drug-R) Group A Streptococcus Concerning (erythro-R) Group B Streptococcus Concerning (clinda-R) WHO PPL, CDC, & ESKAPE 2
Sources & References WHO 2017 PPL (aka, Priority Bacterial Pathogens List) Downloaded 27 Feb 2017 from http://www.who.int/medicines/publications/WHO-PPL- Short_Summary_25Feb-ET_NM_WHO.pdf See also Tacconelli et al., Lancet ID, Dec 2017: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30753- 3/fulltext CDC 2013 Threat List Downloaded 28 Feb 2017 from https://www.cdc.gov/drugresistance/pdf/ar- threats-2013-508.pdf ESKAPE Rice LB. Federal funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. J Infect Dis. 2008;197(8):1079-81. Boucher HW et al. Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of America. Clinical Infectious Diseases. 2009;48(1):1-12. WHO PPL, CDC, & ESKAPE 3
Background: First vs. Best Data source: https://en.wikipedia.org/wiki/Timeline_of_antibiotics). 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2015 1 1 Arsenicals (2) Sulfas (9) 1 1 1 1 1 1 1 1 1 Core messages from this analysis of the 26 discrete classes discovered to date: Of these, 12 classes have one drug whereas one class (beta-lactams) has 63 drugs. When more than one in a class, the span from first to next (2nd in class) ranges from a few years to decades. Time from first to last is usually decades. Beta-lactams (63) 1 1 1 1 1 1 1 1 1 1 2 2 1 2 7 1 4 5 1 3 3 2 2 3 1 1 1 1 6 1 1 1 1 1 Peptides (1) 1 Aminoglycosides (9) 1 1 1 1 1 1 1 1 1 Tetracyclines (8) 1 1 1 1 1 1 1 1 Amphenicols (2) 1 1 Macrolides (9) 1 1 1 3 1 1 1 Glycopeptides (5) 1 1 1 1 1 Polymyxins (1) 1 Streptogramins (3) 1 1 1 Nitroimidazoles (2) 1 1 DHFRs (2) 1 1 Fusidic acids (1) 1 Fusafungines (1) 1 Quin-Fluoroquins (12) 1 1 1 1 3 2 3 Rifamycins (2) 1 1 Lincosamides (1) 1 Fosfomycins (1) 1 Monobactams (1) 1 Pseudomonic acids (1) 1 Ansamycins (1) 1 Oxazolidinones (2) 1 1 Lipopeptides (1) 1 Summary Singletons and multi-drug classes occur at similar rates First-in-class is not necessarily best Macrocycles (1) 1 Diarylquinolines (1) 1 Decoding of the more obscure names Macrocycle = Fidaxomycin; Ansamycin = Rifaximin; Pseudomonic acid = Mupirocin (topical); Fusafungin = fusafungine; Peptides = Gramicidin S WHO PPL, CDC, & ESKAPE 4
