The World Health Organisation (WHO) cite Anti-Microbial Resistance (AMR) as a top global public health threat which is directly responsible for over a million deaths annually and contributing to nearly 5 million more¹. Despite this prominence there is limited literature credibly quantifying the prevalence of AMR strains acquired in hospital settings (nosocomial) or the associated excess mortality.

Pacific Life Re funded and contributed to research undertaken by the University of Leicester who undertook a meta-analysis of global studies pooling the evidence currently available.

The prevalence of AMR in hospital settings is high. Drawing on 34 hospital-based studies covering 20,658 patients across 18 countries, the University of Leicester found that over a third of hospital-acquired infections involved drug-resistant bacteria (pooled prevalence 36.5%).

Patients with resistant infections had a 58% higher adjusted risk of death than those with susceptible infections and for bloodstream infections.

The paper looks at geographic variations and highlights the lack of any studies in areas including Africa & the Middle East.  

Dr Daniel Pan, infectious diseases clinician, National Institute for Health and Care Research (NIHR) Doctoral Research Fellow at the University of Leicester, commented. “Hospitals are high-risk environments for acquiring drug-resistant infections because many patients receive antibiotics and have invasive procedures.

Even in settings where effective antibiotics should be available, resistant infections still carry an independent increase in the risk of dying. AMR doesn’t just threaten public health systems; it directly harms the individuals who acquire these infections.”

This work has helped us calibrate and refine Pacific Life Re’s internal AMR scenario model.

The results were published in September 2025 and are available here in The Lancet’s eClinical Medicine.