Rates of infection and exposure

There is emerging evidence of increased rates of infection and resistant infection, as well as higher levels of antimicrobial exposure, in individuals with factors commonly associated with health inequalities.

Ethnic minorities, deprived individuals and inclusion health groups, such as vulnerable migrants (including asylum seekers and refugees, unaccompanied asylum-seeking children, people who have been trafficked, undocumented migrants (those who are living in the UK with no legal status) and low paid migrant workers) have consistently been shown to be at higher risk of infections, including TB, sexually transmitted infections and MSSA (methicillin-susceptible Staphylococcus aureus).

Higher levels of antibiotic use have also been identified within groups such as older adults, especially those in residential care and those living in areas with higher levels of deprivation.

Vulnerable migrants often rely on alternative routes of antibiotic supply because of barriers faced in accessing healthcare within the UK. This may lead to higher rates of inappropriate antibiotic use within this population.

A meta-analysis highlighted that the risk of resistance persists for at least 12 months in individuals after each intake of an antibiotic. Healthy people who have not had contact with healthcare can carry resistant bacteria, which can then spread from person-to-person in the community or from patient-to-patient in hospital.