Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis

作者：Christopher J L Murray, Kevin S Ikuta, Fablina Sharara, Lucien R Swetschinski, Gisela Robles Aguilar, Authia P Gray, Chieh Han, Catherine Bisignano, Puja C Rao, Eve E Wool, Sarah Charlotte Johnson, Annie J. Browne, Michael G. Chipeta, Frederick Fell, Sean Hackett, Georgina Haines–Woodhouse, Bahar H. Kashef Hamadani, Emmanuelle A. P. Kumaran, Barney McManigal, Sureeruk Achalapong, Ramesh Agarwal, Samuel Akech, Samuel B Albertson, John Amuasi, Jason R. Andrews, Aleskandr Aravkin, Elizabeth A. Ashley, François-Xavier Babin, Freddie Bailey, Stephen Baker, Buddha Basnyat, Adrie Bekker, Rose Bender, James A. Berkley, B. Adhisivam, Julia Bielicki, Suppawat Boonkasidecha, James Bukosia, Cristina Gardonyi Carvalheiro, Carlos A Castañeda-Orjuela, Vilada Chansamouth, Suman Chaurasia, Sara Chiurchiù, Fazle Rabbi Chowdhury, Rafai Clotaire Donatien, Aislinn Cook, Ben S. Cooper, Tim R. Cressey, Elia Criollo-Mora, Matthew Cunningham, Saffiatou Darboe, Nicholas Day, Maia De Luca, Клара Докова, Angela Dramowski, Susanna Dunachie, Thuy Duong Bich, Tim Eckmanns, Daniel Eibach, Amir Emami, Nicholas Feasey, Natasha Fisher-Pearson, Karen Forrest, Coralith Garcia, Denise O. Garrett, Petra Gastmeier, Ababi Zergaw Giref, Rachel Greer, Vikas Gupta, Sebastian Haller, Andrea Haselbeck, Simon I Hay, Marianne Holm, Susan Hopkins, Yingfen Hsia, Kenneth Iregbu, Jan Jacobs, Daniel Jarovsky, Fatemeh Javanmardi, Adam Jenney, Meera Khorana, Suwimon Khusuwan, Niranjan Kissoon, Elsa Kobeissi, Tomislav Kostyanev, Fiorella Krapp, Ralf Krumkamp, Ajay Kumar, Hmwe Hmwe Kyu, Cherry Lim, Kruy Lim, Direk Limmathurotsakul, Michael J. Loftus, Miles Lunn, Jianing Ma, Anand Manoharan, Florian Marks, Jürgen May, Mayfong Mayxay, Neema Mturi, Tatiana Múnera‐Huertas, Patrick Musicha, Lilian A Musila, Marisa Márcia Mussi‐Pinhata, Ravi Naidu, Tomoka Nakamura, Ruchi Nanavati, Sushma Nangia, Paul N. Newton, Chanpheaktra Ngoun, Amanda Novotney, Davis Nwakanma, Christina W. Obiero, Theresa J. Ochoa, Antonio Olivas‐Martínez, Piero Olliaro, Edna Ooko, Edgar Ortíz‐Brizuela, Pradthana Ounchanum, Gideok D Pak, José Luis Paredes, Anton Y. Peleg, Carlo Perrone, Thong Phe, Koukeo Phommasone, Nishad Plakkal, Alfredo Ponce‐de‐León, Mathieu Raad, Tanusha Ramdin, Sayaphet Rattanavong, Amy Riddell, Tamalee Roberts, Julie V. Robotham, Anna Roca, Víctor Rosenthal, Kristina E. Rudd, Neal Russell, Hélio S. Sader, Weerawut Saengchan, Jesse Schnall, John A. Scott, Samroeng Seekaew, Mike Sharland, Madhusudhan Shivamallappa, José Sifuentes‐Osornio, Andrew J. H. Simpson, Nicolas Steenkeste, Andrew J. Stewardson, Temenuga Stoeva, Nidanuch Tasak, Areerat Thaiprakong, Guy Thwaites, Caroline Tigoi, Claudia Turner, Paul Turner, H. Rogier van Doorn, Sithembiso Velaphi, Avina Vongpradith, Manivanh Vongsouvath, Huong T L Vu, Timothy R. Walsh, Judd L. Walson, Seymour Waner, Tri Wangrangsimakul, Prapass Wannapinij, Teresa M. Wozniak, Tracey E M W Young Sharma, Kalvin Yu, Peng Zheng, Benn Sartorius, Alan D Lopez, Andy Stergachis, Catrin E. Moore, Christiane Dolecek, Mohsen Naghavi · 发表于：The Lancet · 年份：2022 · DOI：10.1016/s0140-6736(21)02724-0 · 被引用次数：15974 · 研究领域：Antibiotic Use and Resistance、Antibiotic Resistance in Bacteria、Urinary Tract Infections Management

BACKGROUND: Antimicrobial resistance (AMR) poses a major threat to human health around the world. Previous publications have estimated the effect of AMR on incidence, deaths, hospital length of stay, and health-care costs for specific pathogen-drug combinations in select locations. To our knowledge, this study presents the most comprehensive estimates of AMR burden to date. METHODS: We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 23 pathogens and 88 pathogen-drug combinations in 204 countries and territories in 2019. We obtained data from systematic literature reviews, hospital systems, surveillance systems, and other sources, covering 471 million individual records or isolates and 7585 study-location-years. We used predictive statistical modelling to produce estimates of AMR burden for all locations, including for locations with no data. Our approach can be divided into five broad components: number of deaths where infection played a role, proportion of infectious deaths attributable to a given infectious syndrome, proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antibiotic of interest, and the excess risk of death or duration of an infection associated with this resistance. Using these components, we estimated disease burden based on two counterfactuals: deaths attributable to AMR (based on an alternative scenario in which all dru...