The UK Chief Medical Officer’s Annual Report 2025: Infections offers a stark reminder that antimicrobial resistance (AMR) remains one of the most serious and steadily escalating risks to public health. While the report spans a wide terrain — ageing populations, infection prevention, and emerging threats — its treatment of AMR is particularly urgent.
The report identifies AMR as a “substantial and growing threat,” highlighting resistance across all major antimicrobial classes: antibiotics, antivirals, antifungals, and antiparasitics. This reinforces a trend already evident in national surveillance, which shows rising rates of resistant infections in England over recent years. AMR is framed not as a distant possibility but as a tangible threat capable of undermining routine medical care — surgery, transplants, and chemotherapy — if treatment options continue to diminish.
Antimicrobial stewardship emerges as a cornerstone of the UK’s response. Appropriate prescribing, reduced misuse, and responsible public behaviour are described as essential to slowing resistance. However, stewardship alone is insufficient, with the report warning of a stagnant antimicrobial pipeline.
The document also emphasises systemic factors that accelerate resistant infections. Healthcare settings, especially those caring for older adults, remain high-risk environments for transmission if infection prevention and control (IPC) practices are under-resourced. The report stresses that effective IPC depends on adequate staffing, well-designed facilities, and strong governance. Inconsistent IPC, particularly in settings involving vulnerable populations, risks amplifying both ordinary and drug-resistant infections.
On diagnostics, Professor Whitty’s call for better detection of rare, imported, and emerging infections implicitly demands expanded diagnostic capacity, from microbiology laboratories to genomic surveillance. Accurate diagnosis is noted as essential for antimicrobial stewardship. Similarly, robust diagnostic systems are crucial for supporting IPC, enabling early identification and containment of resistant pathogens in healthcare environments.
Professor Whitty’s report notes that the group affected most by severe infections is the oldest in our society, when historically the greatest burden would be faced by children. Respiratory infections and urinary tract infections remain the most common reasons primary care consultations and hospital admissions. Given existing diagnostics can diagnose infections rapidly and guide best antibiotic treatment, changes to improve adoption of diagnostics would undoubtedly improve patient outcomes and reduce strain in both primary and secondary care. Therefore, we are pleased that the report recommends improving diagnostic access in primary care — with CRP and rapid Strep-A tests specifically highlighted — and the use of tools potentially optimised by AI.
Taken together, the CMO’s 2025 report illustrates an urgent need for coordinated national action on AMR — spanning stewardship, IPC, research, and innovation. But it also highlights an opportunity: integrating diagnostics more prominently into national infection strategy and expanding diagnostic access in primary care. Without better testing and surveillance, the UK risks losing ground in the fight against one of the century’s most significant health threats.
