FOI publishes a plausible worst-case scenario of antibiotic-resistant bacteria


Antibiotic-resistant bacteria are a growing global problem and the cause of nearly 25,000 deaths in Europe annually. FOI shows that the risks posed by an increasing antibiotic resistance are extremely relevant for Sweden too.

On assignment from the Swedish Civil Contingencies Agency (MSB), FOI has created and, jointly with a number of other expert authorities, analysed a scenario that highlights the severe challenges to be faced in dealing with the increasing prevalence of antibiotic-resistant bacteria. The scenario suggests that a situation in which 5 per cent of the population of southern Sweden become carriers of antibiotic-resistant intestinal bacteria is possible, or even likely, within the next 10-15 years.


“We wanted to create a challenging and worst-case scenario with relevance to the Swedish authorities now working on the issue. We therefore created a cross-sectoral scenario in which the intestinal bacteria E. coli with resistance to carbapenems (a type of antibiotic) is being spread by humans, animals, via food and in the environment. The resulting assessment that five per cent of the population could become carriers of the resistant bacteria within 10-15 years was both astonishing and frightening,” says Anna Lindberg, an analyst at FOI.


Sweden is active, both nationally and internationally, in developing preventive measures to reduce the infective spread of antibiotic-resistant bacteria. Results from the scenario workshop show that there is room for more work in all the relevant sectors. But the resultant changes need to be implemented not only in Sweden but also on a global level.


“Unless one gains control of the situation internationally, it will be very difficult to control things in Sweden. There are, for example, studies which show how Swedish tourists have been infected by antibiotic-resistant bacteria while on holiday abroad,” says Anna Lindberg.

Among the most taxing problems is how to detect antibiotic bacteria in time. The study shows that today’s methods are not adequate for the detection of increased levels of E. coli resistant to carbapenems in humans, in animals and in the environment. The majority of the cases encountered have occurred in hospitals and there is a risk that some cases may not have been reported.


The study highlights a number of challenges and makes proposals for measures that might be taken. More research is needed in this area and decisions need to be taken in the near future. Parts of the work have recently been published in the journal Health Security.


“It is very gratifying that our results, and the method we have used to create and analyse this scenario, have been published. Our hope is that others may be inspired by this approach to work with forward-looking studies in this field,” says Anna Lindberg in conclusion.