The burden of bacterial antimicrobial resistance in the WHO Eastern Mediterranean Region 1990–2021: a cross-country systematic analysis with forecasts to 2050

作者：Tomislav Meštrović, Mohsen Naghavi, Gisela Robles Aguilar, Nicole Davis Weaver, Lucien R Swetschinski, Eve E Wool, Daniel T Araki, Anna Gershberg Hayoon, A B, Chieh Han, Kevin S Ikuta, Emily Rosenblad, Hasan Aalruz, Sherief Abd‐Elsalam, Armita Abedi, Hassan Abolhassani, Salahdein Aburuz, Saira Afzal, Aqeel Ahmad, Amir Mahmoud Ahmadzade, Ayman Ahmed, Haroon Ahmed, Abid Ali, Zahid Ali, Liaqat Ali, Syed Shujait Ali, Sabah Al-Marwani, Omar Almidani, Rami H. Al‐Rifai, Jaffar A. Al‐Tawfiq, Karem H. Alzoubi, Jessica Andretta Mendes, Jason R. Andrews, Jalal Arabloo, Mosab Arafat, Seyyed Shamsadin Athari, Maha Atout, Sina Azadnajafabad, Shahkaar Aziz, Khalil Azizian, Hiba Jawdat Barqawi, Zarrin Basharat, Neeraj Bedi, James A. Berkley, Natalia V. Bhattacharjee, Colin Brown, Yasser Bustanji, Ben S. Cooper, Nihar Ranjan Dash, Christiane Dolecek, Tim Eckmanns, Abdelaziz Ed‐Dra, Iman El Sayed, Muhammed Elhadi, Waseem El‐Huneidi, Christelle Elias, Sally Ellis, Ibrahim Elsohaby, Babak Eshrati, Ayesha Fahim, Ali Fatehizadeh, Muhammed Shaffi Fazaludeen Koya, Alireza Feizkhah, Denise O. Garrett, Ramy Mohamed Ghazy, Sama Ghoba, Konstantinos Giannakis, Rasool Haddadi, Mostafa Hadei, Sobia Ahsan Halim, Samer Hamidi, Ahmed I Hasaballah, Rumina Hasan, Hamidreza Hasani, Andrea Haselbeck, Simon Hay B, C, Kamal Hezam, Mehdi Hosseinzadeh, Rebecca Hsu, Nawfal R Hussein, Mohammad Tarique Imam, Kenneth Iregbu, Faisal Ismail, Abdollah Jafarzadeh, Mahsa Jalili, Reza Jalilzadeh Yengejeh, Elham Jamshidi, Nabi Jomehzadeh, Zul Kamal, Hengameh Kasraei, Faham Khamesipour, Feriha Fatima Khidri, Suwimon Khusuwan, Mohammed Kuddus, Hmwe Hmwe Kyu, Mansour Adam Mahmoud, DF Omar Makram DE, Elaheh Malakan Rad, Florian Marks, Barney McManigal, Ziad A. Memish, Muayad Aghali Merza, Nouh Saad Mohamed, Ali H. Mokdad, AmirAli Moodi Ghalibaf, Catrin E. Moore, Yousef Moradi, Parsa Mousavi, Florence N Mturi, Muhammad Muzaffar, Pirouz Naghavi, Hastyar Hama Rashid Najmuldeen, Shumaila Nargus, EB Zuhair Natto, Javaid Nauman, Muhammad Naveed, Robina Khan Niazi, Peter Olwoch, Aslam Pathan, Simone Perna, Andrew J. Pollard, Nameer Hashim Qasim, Fakher Rahim, Vafa Rahimi‐Movaghar, Hazem Ramadan, Elrashdy M. Redwan, Inayat Ur Rehman, Luis Felipe Reyes, Víctor Rosenthal, Tilleye Runghien, Basema Ahmad Saddik, Umar Saeed, Narjes Saheb Sharif‐Askari, Amirhossein Sahebkar, Morteza Saki, Zikria Saleem, Mohamed A. Saleh, Abdallah M Samy, Benn Sartorius, Mahan Shafie, Humaira Shah, Samiah Shahid, Moyad Shahwan, Sadia Shakoor, Mohammad Ali Shamshirgaran, Amin Sharifan, Emmanuel Edwar Siddig, Eric A. F. Simões, Georgia Smith, Sameh S. M. Soliman, Andy Stergachis, Shima Tabatabai, Razieh Tavakoli Oliaee, Reem Temsah, Samar Tharwat, Caroline Tigoi, Irfan Ullah, Saeed Ullah, Asokan Govindaraj Vaithinathan, Stein Emil Vollset, Yasir Waheed, Judd Walson GI, Muhammad Waqas, Phoebe Williams, Sajad Yaghoubi, Chun-Wei Yuan, Fathiah Zakham, Iman Zare, Mohammed G M Zeariya, Christopher J L Murray · 发表于：The Lancet Public Health · 年份：2025 · DOI：10.1016/s2468-2667(25)00201-4 · 被引用次数：21 · 研究领域：Antibiotic Use and Resistance、Antibiotic Resistance in Bacteria、Urinary Tract Infections Management

BACKGROUND: Antimicrobial resistance (AMR) is an urgent global crisis and one of the world's most complex challenges. Although there is increasing evidence of its impact on human mortality and morbidity, precise burden estimation has many challenges, and thus far has been elusive for the Eastern Mediterranean Region. Here, we present a comprehensive time-trend analysis of regional and country-level AMR burden estimates in the WHO Eastern Mediterranean Region (EMR), between 1990 and 2021, with forecasts up to 2050. METHODS: We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 11 infectious syndromes, 22 bacterial pathogens, and 84 pathogen-drug combinations for the WHO EMR and each of its countries from 1990 to 2021. Data were obtained from mortality registries, surveillance systems, hospital records, systematic literature reviews, and other sources. We based our modelling approach on five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths and DALYs attributable to ...