WHO releases 2024 list of bacteria threatening human health

Sunday, 19 May, 2024
Photo Courtesy: WHO

The World Health Organization (WHO) has released its updated Bacterial Priority Pathogens List (BPPL) 2024 highlighting the development of new and necessary treatments to stop the spread of antimicrobial resistance (AMR).

Building on the 2017 edition, the 2024 list features 15 families of antibiotic-resistant bacteria grouped into critical, high, and medium categories, and it incorporates new evidence and expert insights to guide research and development for new antibiotics and promote international coordination to foster innovation.

AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to medicines, making people sicker and increasing the risk of disease spread, illness, and death. In addition, it is driven in large part by the misuse and overuse of antimicrobials.

According to Dr Yukiko Nakatani, WHO’s Assistant Director-General for Antimicrobial Resistance ad interim, "by mapping the global burden of drug-resistant bacteria and assessing their impact on public health, this list is key to guiding investment and grappling with the antibiotics pipeline and access crisis".

Dr Nakatani adds that since the release of the first list, "the threat of antimicrobial resistance has intensified, eroding the efficacy of numerous antibiotics and putting many of the gains of modern medicine at risk".

The critical priority pathogens, such as gram-negative bacteria resistant to last-resort antibiotics, and Mycobacterium tuberculosis resistant to the antibiotic rifampicin, present major global threats due to their high burden, and ability to resist treatment and spread resistance to other bacteria, WHO said in a statement.

"Gram-negative bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well," the statement read.

Notable among these are Gram-negative bacteria resistant to last-resort antibiotics, drug-resistant mycobacterium tuberculosis, and other high-burden resistant pathogens such as Salmonella, Shigella, Neisseria gonorrhoeae, Pseudomonas aeruginosa, and Staphylococcus aureus.

High-priority pathogens, such as Salmonella and Shigella, are of particularly high burden in low- and middle-income countries, along with Pseudomonas aeruginosa and Staphylococcus aureus, which pose significant challenges in healthcare settings.

Other high-priority pathogens, such as antibiotic-resistant Neisseria gonorrhoeae and Enterococcus faecium, present unique public health challenges, including persistent infections and resistance to multiple antibiotics, necessitating targeted research and public health interventions.

Medium-priority pathogens include Group A and B Streptococci -- both new to the updated list -- Streptococcus pneumoniae, and Haemophilus influenzae.

These present a high disease burden and require increased attention, especially in vulnerable populations including paediatric and elderly populations, particularly in resource-limited settings.

“Antimicrobial resistance jeopardizes our ability to effectively treat high-burden infections, such as tuberculosis, leading to severe illness and increased mortality rates," Dr Jérôme Salomon, WHO's Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases, said in a statement.

The WHO BPPL 2024 includes the following bacteria:

Acinetobacter baumannii, carbapenem-resistant;

Enterobacterales, third-generation cephalosporin-resistant; and

Enterobacterales, carbapenem-resistant;

Mycobacterium tuberculosis, rifampicin-resistant (included after an independent analysis with parallel tailored criteria, and subsequent application of an adapted multi-criteria decision analysis matrix).  


Salmonella Typhi, fluoroquinolone-resistant

Shigella spp., fluoroquinolone-resistant

Enterococcus faecium, vancomycin-resistant

Pseudomonas aeruginosa, carbapenem-resistant

Non-typhoidal Salmonella, fluoroquinolone-resistant

Neisseria gonorrhoeae, third-generation cephalosporin- and/or fluoroquinolone-resistant

Staphylococcus aureus, methicillin-resistant


Group A streptococci, macrolide-resistant

Streptococcus pneumoniae, macrolide-resistant

Haemophilus influenzae, ampicillin-resistant

Group B streptococci, penicillin-resistant

(Graphic courtesy: WHO)

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