Antimicrobial Resistance as a Global Health Threat and the Need for a City-wide AMR Monitoring System: The Case of Bishkek

Kanymetova A.K.

Abdirazakov N.A.

Baiyzbekova D.A.

Ashyralieva D.O.

https://dx.doi.org/10.51350/zdravkg2026.1.3.17.139.147

Antimicrobial Resistance as a Global Health Threat and the Need for a City-wide AMR Monitoring System: The Case of Bishkek

Полный текст Full text

PDF (RUS)

Abstract About the authors References

Abstract

Introduction. Antimicrobial resistance (AMR) in the 21st century has firmly established itself as one of the leading global threats to health systems. The World Health Organization classifies AMR among the key threats to global health, emphasizing that the growing share of resistant strains undermines the effectiveness of antibacterial therapy and calls into question the safety of surgical procedures, transplantation, chemotherapy, and intensive care. Aim of the study. To synthesize international and regional experience in AMR surveillance and, on this basis, scientifically substantiate approaches to building an antimicrobial resistance monitoring system using the city of Bishkek as a case study, adapted to the conditions of the Kyrgyz Republic’s health system and aligned with the standards of GLASS, CAESAR, and EARSNet. Materials and methods. The article is a narrative and analytical review. The review includes: (1) global and regional reports of the World Health Organization and the European Centre for Disease Prevention and Control, as well as reports from the GLASS, EARS-Net, and CAESAR networks; (2) international publications on the global burden of AMR, its economic consequences, and surveillance models; (3) national regulatory and methodo- logical documents of the Kyrgyz Republic; and (4) reports and conceptual documents of international initiatives based on the “One Health” approach and projects implemented in Central Asian countries. Results and discussion. The review shows that, according to GLASS data, one in six laboratory-confirmed bacterial infections is already resistant to standard therapy, with the greatest AMR burden occurring in low- and middle-income countries. Gram-negative pathogens ( Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp., Pseudomonas aeruginosa ) play a particularly important role, demonstrating high levels of resistance to fluoroquinolones, third- and fourth-generation cephalosporins, and carbapenems. Robust surveillance systems require standardized laboratory diagnostic methods, clearly defined lists of priority pathogens and clinical specimens, and sustainable channels for data transmission and analysis. For Bishkek, as the country’s main medical center, key gaps were identified: the absence of stable local resistance maps, fragmentation of data between public and private laboratories, limited access of clinicians to aggregated data, and weak links with antimicrobial stewardship and infection prevention and control programs. Conclusion. The conducted review confirms that establishing an AMR monitoring system using Bishkek as a case study is scientifically and practically justified. Adapting the principles of GLASS, CAESAR, and EARS-Net to the conditions of Kyrgyzstan will make it possible to develop a list of priority pathogens and clinical specimens for surveillance and to create a prototype of a unified city-level AMR database. The proposed model may serve as a pilot framework for subsequent scaling to other regions of the country and for strengthening the resilience of the national health system to the AMR threat.

About the authors

Каныметова Асель Каныметовна, соискатель, руководитель Научно-практического центра инфекционного контроля и управления медицинскими отходами Национального института общественного здоровья МЗ, Бишкек, Кыргызская Республика

Абдиразаков Нурбек Алмазбекович, аспирант, врач-эпидемиолог Национального института общественного здоровья МЗ, Бишкек, Кыргызская Республика

Байызбекова Джайнагуль Алчинбековна, доктор медицинских наук, профессор, руководитель Центра анализа, управления рисками общественного здоровья и профилактики заболевания Национального института общественного здоровья МЗ, Бишкек, Кыргызская Республика

Ашыралиева Дамира Омурзаковна, соискатель, научный сотрудник Центра медицины окружающей среды, экологии человека и питания Национального института общественного здоровья МЗ, Бишкек, Кыргызская

Kanymetova Asel Kanymetovna, applicant, Head of the Scientific and Practical Center for Infection Control and Medical Waste Management of the National Institute of Public Health of the Ministry of Health, Bishkek, Kyrgyz Republic

Abdirazakov Nurbek Almazbekovich, postgraduate student, epidemiologist, National Institute of Public Health, Ministry of Health, Bishkek, Kyrgyz Republic

Baiyzbekova Dzhainagul Alchinbekovna, Doctor of Medical Sciences, Professor, Head of the Center for Analysis and Management of Public Health Risks National Institute of Public Health of the Ministry of Health, Bishkek, Kyrgyz Republic

Ashyralieva Damira Omurzakovna, applicant, research fellow, Center for Environmental Medicine, Human Ecology and Nutrition, National Institute of Public Health, Ministry of Health, Bishkek, Kyrgyz Republic

Каныметова Асел Каныметовна, талапкер, Саламаттыкты сактоо министрлигинин Коомдук саламаттыкты сактоо улуттук институтунун инфекцияны көзөмөлдөө жана медициналык калдыктарды башкаруу боюнча илимий-практикалык борборунун жетекчиси, Бишкек, Кыргыз Республикасы

Абдиразаков Нурбек Алмазбекович, аспирант, Саламаттыкты сактоо министрлигинин Коомдук саламаттыкты сактоо улуттук институтунун эпидемиолог дарыгери, Бишкек, Кыргыз Республикасы

Байызбекова Джайнагүл Алчынбековна, медицина илимдеринин доктору, профессор, Саламаттыкты сактоо министрлигинин Коомдук саламаттыкты сактоо тобокелдиктерин талдоо, Коомдук саламаттыкты сактоо улуттук институтунун, башкаруу жана оорулардын алдын алуу борборунун жетекчиси, Бишкек, Кыргыз Республикасы

Ашыралиева Дамира Өмүрзаковна, талапкер, Саламаттыкты сактоо министрлигинин Коомдук саламаттыкты сактоо улуттук институтун Айлана-чөйрөнү коргоо медицинасы, адам экологиясы жана тамактануу борборунун изилдөөчүсү, Бишкек, Кыргыз Республикасы

References

1. World Health Organization. Ten threats to global health in 2019. Geneva: WHO; 2019.

2. Murray C.J.L. et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022; 399(10325): Vol 399 February 12, 2022.- Р. 629–655.(The Lancet)

3. Naghavi M. et al. Global burden of bacterial antimicrobial resistance 1990–2021. The Lancet. 2024.(PubMed)

4. O’Neill J. Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance. London; 2016.

5. World Health Organization. Global antimicrobial resistance and use surveillance system (GLASS) report 2025. Geneva: WHO; 2025.(Всемирная организация здравоохранения)

6. WHO warns of surging levels of antibiotic resistance. Reuters; 13 Oct 2025.(Reuters)

7. Lack of access to antibiotics is driving spread of superbugs, finds research. The Guardian; 30 Apr 2025.

8. ECDC. Surveillance of antimicrobial resistance in Europe, 2024 data. Stockholm: European Centre for Disease Prevention and Control; 2025.(ECDC)

9. WHO. Global Antimicrobial Resistance and Use Surveillance System (GLASS): initiative and methods. Geneva: WHO; 2023.(Всемирная организация здравоохранения)

10. WHO Regional Office for Europe. Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR): network overview. Copenhagen: WHO/Europe; 2021–2022.(Всемирная организация здравоохранения)

11. WHO Regional Office for Europe. CAESAR external quality assessment (EQA) report 2013–2020. Copenhagen: WHO/Europe; 2022.(Всемирная организация здравоохранения)

12. FAO. Kazakhstan strengthens veterinary laboratories in AMR surveillance with support from FAO and the Pandemic Fund. 28 Apr 2025.(FAOHome)

13. FAO / Pandemic Fund. Pandemic preparedness and response through a One Health approach in Europe and Central Asia. Project description; 2023–2025.(FAOHome)

14. WHO/Europe. Kyrgyzstan launches national survey on antimicrobial resistance with WHO support. News release; 16 Aug 2024.(Всемирная организация здравоохранения)

15. UN Kyrgyzstan. Kyrgyzstan launches the world’s first national survey on the prevalence, health and economic impact of AMR in bloodstream infections. 5 Jun 2024.(The United Nations in Kyrgyz Republic)