THE WORLD Health Organization (WHO) has released its updated 2024 Bacterial Priority Pathogens List (BPPL), offering clinicians and researchers a more granular framework for guiding antimicrobial stewardship, surveillance, and therapeutic development efforts.
Maintaining methodological continuity with the 2017 list, the updated prioritisation applied a multicriteria decision analysis framework to 24 antibiotic-resistant bacterial pathogens. Each was assessed across eight weighted criteria, including mortality, incidence, resistance trends, treatability, and pipeline status, using current data and expert judgement. Seventy-eight of 100 invited international experts completed a pairwise preference survey to generate the relative weightings, and total scores (0–100%) were calculated for each pathogen. Final rankings were categorised into critical, high, or medium priority tiers based on quartile distribution. Subgroup and sensitivity analyses evaluated consistency across geographical and professional backgrounds, with an independent advisory group reviewing the final outputs.
Carbapenem-resistant Klebsiella pneumoniae led the list with a total score of 84%, followed by other high-priority Gram-negative pathogens including Acinetobacter spp and Escherichia coli. Rifampicin-resistant Mycobacterium tuberculosis also remained in the highest tier. Among community-acquired infections, fluoroquinolone-resistant Salmonella enterica serotype Typhi (72%), Shigella spp (70%), and Neisseria gonorrhoeae (64%) ranked highest. Other notable inclusions were Pseudomonas aeruginosa and Staphylococcus aureus. The preference survey demonstrated high concordance (Spearman’s and Kendall’s coefficients both 0.9), and stratified analyses revealed no significant impact of expert background or region on overall rankings.
The revised BPPL strengthens clinical and policy tools to address AMR by aligning priorities with current resistance dynamics and pipeline vulnerabilities. Gram-negative organisms and M. tuberculosis remain critical priority pathogens, reinforcing the need for sustained research and development, expanded access to existing therapeutics, and integrated infection control strategies.
Reference
Sati H et al. The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance. Lancet Infect Dis. 2025; DOI: https://doi.org/10.1016/S1473-3099(25)00118-5.
