- Published
- 2025-04-14
- Venue
- The Lancet Infectious Diseases, vol. 25, no. 9, pp. 1033-1043
- Cited by
- 898
- Open access
- Yes, hybrid
- DOI
- 10.1016/s1473-3099(25)00118-5
- PubMed
- 40245910
Abstract
BACKGROUND: The 2017 WHO Bacterial Priority Pathogens List (BPPL) has been instrumental in guiding global policy, research and development, and investments to address the most urgent threats from antibiotic-resistant pathogens, and it is a key public health tool for the prevention and control of antimicrobial resistance (AMR). Since its release, at least 13 new antibiotics targeting bacterial priority pathogens have been approved. The 2024 WHO BPPL aims to refine and build on the previous list by incorporating new data and evidence, addressing previous limitations, and improving pathogen prioritisation to better guide global efforts in combating AMR. METHODS: The 2024 WHO BPPL followed a similar approach to the first prioritisation exercise, using a multicriteria decision analysis framework. 24 antibiotic-resistant bacterial pathogens were scored based on eight criteria, including mortality, non-fatal burden, incidence, 10-year resistance trends, preventability, transmissibility, treatability, and antibacterial pipeline status. Pathogens were assessed on each of the criteria on the basis of available evidence and expert judgement. A preferences survey using a pairwise comparison was administered to 100 international experts (among whom 79 responded and 78 completed the survey) to determine the relative weights of the criteria. Applying these weights, the final ranking of pathogens was determined by calculating a total score in the range of 0-100% for each pathogen. Subgroup and sensitivity analyses were conducted to assess the impact of experts' consistency, background, and geographical origin on the stability of the rankings. An independent advisory group reviewed the final list, and pathogens were subsequently streamlined and grouped into three priority tiers based on a quartile scoring system: critical (highest quartile), high (middle quartiles), and medium (lowest quartile). FINDINGS: The pathogens' total scores ranged from 84% for the top-ranked bacterium (carbapenem-resistant Klebsiella pneumoniae) to 28% for the bottom-ranked bacterium (penicillin-resistant group B streptococci). Antibiotic-resistant Gram-negative bacteria (including K pneumoniae, Acinetobacter spp, and Escherichia coli), as well as rifampicin-resistant Mycobacterium tuberculosis, were ranked in the highest quartile. Among the bacteria commonly responsible for community-acquired infections, the highest rankings were for fluoroquinolone-resistant Salmonella enterica serotype Typhi (72%), Shigella spp (70%), and Neisseria gonorrhoeae (64%). Other important pathogens on the list include Pseudomonas aeruginosa and Staphylococcus aureus. The results of the preferences survey showed a strong inter-rater agreement, with Spearman's rank correlation coefficient and Kendall's coefficient of concordance both at 0·9. The final ranking showed high stability, with clustering of the pathogens based on experts' backgrounds and origins not resulting in any substantial changes to the ranking. INTERPRETATION: The 2024 WHO BPPL is a key tool for prioritising research and development investments and informing global public health policies to combat AMR. Gram-negative bacteria and rifampicin-resistant M tuberculosis remain critical priority pathogens, underscoring their persistent threat and the limitations of the current antibacterial pipeline. Focused efforts and sustained investments in novel antibacterials are needed to address AMR priority pathogens, which include high-burden antibiotic-resistant bacteria such as Salmonella and Shigella spp, N gonorrhoeae, and S aureus. Beyond research and development, efforts to address these pathogens should also include expanding equitable access to existing drugs, enhancing vaccine coverage, and strengthening infection prevention and control measures. FUNDING: This work is based on the development of the 2024 WHO BPPL, which was conducted by the WHO AMR Division through grants from the Government of Austria, the Government of Germany, the Government of Saudi Arabia, and the European Commission's Health Emergency Preparedness and Response Authority. TRANSLATIONS: For the Arabic, French, Italian, Japanese and Spanish translations of the abstract see Supplementary Materials section.
Cite this paper
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- APA 7
Sati, H. F., Carrara, E., Savoldi, A., Hansen, P., Garlasco, J., Campagnaro, E., Boccia, S., Castillo-Polo, J. A., Magrini, E., García-Vello, P., Wool, E. E., Gigante, V., Duffy, E. M., Cassini, A., Huttner, B. D., Ramón-Pardo, P., Naghavi, M., Mirzayev, F., E, M. Z., … Nyaruhirira, A. U. (2025). The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance. The Lancet Infectious Diseases, 25(9), 1033–1043. https://doi.org/10.1016/s1473-3099(25)00118-5
- MLA 9
Sati, Hatim F., et al. "The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance." The Lancet Infectious Diseases, vol. 25, no. 9, 2025, pp. 1033–1043, https://doi.org/10.1016/s1473-3099(25)00118-5.
- Chicago
Sati, Hatim F., Elena Carrara, Alessia Savoldi, Paul Hansen, Jacopo Garlasco, Enrica Campagnaro, Simone Boccia, et al. "The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance." The Lancet Infectious Diseases 25, no. 9 (2025): 1033–1043. https://doi.org/10.1016/s1473-3099(25)00118-5.
- GOST
Sati H. F., Carrara E., Savoldi A. [и др.] The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance // The Lancet Infectious Diseases. — 2025. — Vol. 25, № 9. — P. 1033–1043. — URL: https://doi.org/10.1016/s1473-3099(25)00118-5
- BibTeX
@article{sati2025bacterial, title = {{The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance}}, author = {Hatim F. Sati and Elena Carrara and Alessia Savoldi and Paul Hansen and Jacopo Garlasco and Enrica Campagnaro and Simone Boccia and Juan Antonio Castillo-Polo and Eugenia Magrini and Pilar García-Vello and Eve E Wool and Valeria Gigante and Erin M Duffy and Alessandro Cassini and Benedikt David Huttner and Pilar Ramón-Pardo and Mohsen Naghavi and Fuad Mirzayev and Matteo Zignol E and Alexandra Cameron and Evelina Tacconelli and Aaron Aboderin and Majed Al Ghoribi and Jameela Al-Salman and Afreenish Amir and Anucha Apisarnthanarak and Martin Blaser and Amany El-Sharif and Sabiha Essack and Stephan Harbarth and Xun Huang and Geetanjali Kapoor and Gwenan M. Knight and Jeremiah Chakaya Muhwa and Dominique L. Monnet and Timothée Ousassa and Rosa Sacsaquispe and Juliëtte Severin and Motoyuki Sugai and Neelam Taneja and Alaine Umubyeyi Nyaruhirira}, journal = {The Lancet Infectious Diseases}, year = {2025}, volume = {25}, number = {9}, pages = {1033--1043}, doi = {10.1016/s1473-3099(25)00118-5}, url = {https://doi.org/10.1016/s1473-3099(25)00118-5} }- RIS
TY - JOUR AU - Sati, Hatim F. AU - Carrara, Elena AU - Savoldi, Alessia AU - Hansen, Paul AU - Garlasco, Jacopo AU - Campagnaro, Enrica AU - Boccia, Simone AU - Castillo-Polo, Juan Antonio AU - Magrini, Eugenia AU - García-Vello, Pilar AU - Wool, Eve E AU - Gigante, Valeria AU - Duffy, Erin M AU - Cassini, Alessandro AU - Huttner, Benedikt David AU - Ramón-Pardo, Pilar AU - Naghavi, Mohsen AU - Mirzayev, Fuad AU - E, Matteo Zignol AU - Cameron, Alexandra AU - Tacconelli, Evelina AU - Aboderin, Aaron AU - Ghoribi, Majed Al AU - Al-Salman, Jameela AU - Amir, Afreenish AU - Apisarnthanarak, Anucha AU - Blaser, Martin AU - El-Sharif, Amany AU - Essack, Sabiha AU - Harbarth, Stephan AU - Huang, Xun AU - Kapoor, Geetanjali AU - Knight, Gwenan M. AU - Muhwa, Jeremiah Chakaya AU - Monnet, Dominique L. AU - Ousassa, Timothée AU - Sacsaquispe, Rosa AU - Severin, Juliëtte AU - Sugai, Motoyuki AU - Taneja, Neelam AU - Nyaruhirira, Alaine Umubyeyi TI - The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance JO - The Lancet Infectious Diseases VL - 25 IS - 9 SP - 1033 EP - 1043 PY - 2025 DA - 2025/04/14 DO - 10.1016/s1473-3099(25)00118-5 UR - https://doi.org/10.1016/s1473-3099(25)00118-5 ER -
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