The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis

作者：T. Meštrović, G. Robles Aguilar, Lucien R. Swetschinski, K. Ikuta, Authia Gray, Nicole Davis Weaver, Chieh Han, Eve E. Wool, Anna Gershberg Hayoon, Simon Iain Hay, C. Dolecek, B. Sartorius, C. Murray, Isaac Yeboah Addo, B. Ahinkorah, Ayman Ahmed, M. Aldeyab, K. Allel, R. Ancuceanu, A. Anyasodor, M. Ausloos, F. Barra, A. Bhagavathula, D. Bhandari, Sonu Bhaskar, N. Cruz-Martins, A. Dastiridou, K. Dokova, E. Dubljanin, O. Durojaiye, A. Fagbamigbe, Simone Ferrero, Péter Gaál, Veera Gupta, V. Gupta, Vikrant Gupta, C. Herțeliu, Salman T. Hussain, I. Ilic, M. Ilic, E. Jamshidi, Tamás Joó, A. Karch, A. Kisa, S. Kısa, T. Kostyanev, H. Kyu, J. Lám, G. Lopes, A. Mathioudakis, A. Mentis, I. Michalek, M. A. Moni, C. Moore, Francesk Mulita, I. Negoi, R. Negoi, Tamas Palicz, A. Pană, J. Perdigão, I. Petcu, N. Rabiee, D. Rawaf, S. Rawaf, M. Shakhmardanov, Aziz Sheikh, Luís Manuel Lopes Rodrigues Silva, V. Skryabin, A. Skryabina, B. Socea, A. Stergachis, Temenuga Stoeva, Chandra Datta Sumi, A. Thiyagarajan, M. Tovani-Palone, Metin Yesiltepe, S. Zaman, M. Naghavi · 发表于：Lancet Public Health · 年份：2022 · DOI：10.1016/s2468-2667(22)00225-0 · 被引用次数：301 · 研究领域：Medicine

Summary Background Antimicrobial resistance (AMR) represents one of the most crucial threats to public health and modern health care. Previous studies have identified challenges with estimating the magnitude of the problem and its downstream effect on human health and mortality. To our knowledge, this study presents the most comprehensive set of regional and country-level estimates of AMR burden in the WHO European region to date. Methods We estimated deaths and disability-adjusted life-years attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen–drug combinations for the WHO European region and its countries in 2019. Our methodological approach consisted of 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 attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). Data were solicited fr...