Childhood sepsis burden: pathogens/antimicrobial-resistant bacteria, 1990-2021 and 2050 forecasts

作者：Zhu W, Jiang P, Yu J, Shen T, Yang X, Xu Y, Jin S, Jiang Y · 发表于：Frontiers in cellular and infection microbiology · 年份：2026 · DOI：10.3389/fcimb.2026.1855912 · 被引用次数：49 · 研究领域：Sepsis、Drug Resistance, Bacterial、Bacteria、Humans、Global Burden of Disease、Child, Preschool、Infant、Child、Anti-Bacterial Agents、Infant, Newborn、Global Health、Disability-Adjusted Life Years

BACKGROUND: To assess the global burden and trends of childhood sepsis, and to evaluate whether clarifying these aspects can provide a basis for formulating targeted prevention and treatment strategies for the condition. METHODS: Using the Global Burden of Disease (GBD) 2021 database, we analyzed sepsis in 0-14-year-olds, covering 62 pathogens (21 drug-resistant), 84 "pathogen-drug" combinations, 12 infection syndromes, and indicators (deaths, disability-adjusted life years [DALYs], age-standardized rates). Antimicrobial resistance (AMR) was defined by two counterfactual scenarios; an autoregressive integrated moving average (ARIMA) model forecast AMR-related sepsis to 2050. RESULTS: From 1990 to 2021, global sepsis-related deaths among children declined from 6.43 million to 2.24 million, and DALYs dropped from 578 million to 203 million. The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and DALY rate (ASDR) was -3.35 and -3.33, respectively. AMR-related sepsis burden also decreased, with notable declines in both AMR-associated and AMR-attributable deaths and DALYs. In 2021, the highest burden remained in Sub-Saharan Africa, while the lowest was in High-income regions. Leading pathogens causing child sepsis deaths included Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Bloodstream infections, lower respiratory infections, and diarrhea were the most common infection s...