The 2025 report1 from the WHO Global Antibiotic Resistance Surveillance System (GLASS) calls for actions to combat the increasing global threat of antimicrobial resistance (AMR), and finds that it disproportionately affects regions with lower levels of surveillance and less comprehensive public health programs.
Read part 1 of this 2-part series.
"Priority should be given to increasing participation in underrepresented regions by expanding the number of contributing facilities and strengthening core surveillance infrastructure to close gaps in global coverage," the GLASS investigators propose.
The report also calls for countries to implement better integrated intervention programs that include infection prevention and control, water, sanitation and hygiene, vaccination, antimicrobial stewardship, and strengthening laboratory services.
"The diverse, localized nature of AMR requires comprehensive, context-specific response; interventions should be tailored to local resistance patterns and health system capacity, avoiding a one-size-fits-all approach," the GLASS investigators advise.
With particular concern for the increase in Gram negative pathogens such as carbapenem-resistant Acinetobacter spp. and Enterobacterales, the report considersgreater investment in research and development of new antibiotics, as an "urgent priority".In addition, it calls for scaling up of diagnostics for targeted antibiotic therapy to preserve treatment efficacy.
Specific trends of concern include:
- Resistance of Acinetobacter sppto imipenem in bloodstream infections is increasing globally by 5.3% annually.
- Resistance of E coli to imipenem is increasing globally by 12.5% annually in bloodstream infections, and by 8.5% in urinary tract infections.
- Resistance of K pneumoniae to imipenem is increasing globally by 15.3% annually in blood stream infections, and by 12.9% in urinary tract infections.
(While the percentage resistance in 2023 was 16.7% globally, the report notes that it was highest in the South-East Asia region, at 41.2%.Similarly, the percentage resistance in urinary tract infection globally was 10.9%, while it was 31.1% in the South-East Asia region.)
Although the report notes that there has been a four-fold increase in countries participating in GLASS from 2016 to 2023, the report urges lagging countries to improve their capacity to conduct AMR surveillance by reaching across diverse populations, and strengthening laboratories and data systems.
"First countries should integrate surveillance into routine clinical practice and develop nationally representative AMR surveillance systems for both community- and hospital-acquired infections, covering all levels of the health-care system and all geographical regions," the GLASS investigators urge.
What You Need to Know
The WHO’s 2025 GLASS report highlights that antimicrobial resistance (AMR) continues to rise worldwide, with the greatest impact in regions lacking strong surveillance systems and comprehensive public health programs.
Resistance among Gram-negative bacteria—especially Acinetobacter spp, E coli, and K pneumoniae—is climbing rapidly, with some strains showing annual increases of over 15% in bloodstream infections, underscoring the need for new antibiotics and expanded diagnostic capacity.
The report calls for countries to integrate AMR surveillance into routine healthcare, expand access to quality diagnostics, and invest in interoperable digital data systems to achieve the 2024 global goal of 80% diagnostic coverage and strengthen evidence-based antimicrobial stewardship.
They also urge countries to strengthen access to quality-assured diagnostics for bacteriology and mycology across every tier of the health care system, to ensure the capacity to test for the bacterial and fungal pathogens prioritized by GLASS for resistance.
"This is essential to meet the target set in the 2024 political declaration on AMR, which calls for at least 80% of countries to achieve such diagnostic capacity," the GLASS investigators point out.
An additional factor that is called for to strengthen surveillance systems is increased investment in digital information systems with standardized data formats, harmonized terminology and interoperable platforms.
Such improved technology, the report explains, can curate surveillance data useful "for setting treatment guidelines, guiding procurement decisions—eg, essential medicine lists, supporting stewardship and monitoring the impact of interventions."
Reference
1.WHO. Global Antibiotic Resistance Surveillance Report 2025. 2025, October 13. https://www.who.int/publications/i/item/9789240116337.
