| By: |
Naghavi, Mohsen;
Vollset, Stein Emil;
Ikuta, Kevin S;
Swetschinski, Lucien R;
Gray, Authia P;
Wool, Eve E;
Robles Aguilar, Gisela;
Mestrovic, Tomislav;
Smith, Georgia;
Han, Chieh;
Hsu, Rebecca L;
Azzam, Ahmed Y.;
Babaei, Mahsa;
Babin, Francois-Xavier;
Badar, Muhammad;
Baig, Atif Amin;
Bajcetic, Milica;
Baker, Stephen;
Bardhan, Mainak;
Barqawi, Hiba Jawdat;
Basharat, Zarrin;
Chalek, Julian;
Basiru, Afisu;
Bastard, Mathieu;
Basu, Saurav;
Bayleyegn, Nebiyou Simegnew;
Belete, Melaku Ashagrie;
Bello, Olorunjuwon Omolaja;
Beloukas, Apostolos;
Berkley, James A;
Bhagavathula, Akshaya Srikanth;
Bhaskar, Sonu;
Araki, Daniel T;
Bhuyan, Soumitra S;
Bielicki, Julia A;
Briko, Nikolay Ivanovich;
Brown, Colin Stewart;
Browne, Annie J;
Buonsenso, Danilo;
Bustanji, Yasser;
Carvalheiro, Cristina G;
Castañeda-Orjuela, Carlos A;
Cenderadewi, Muthia;
Chung, Erin;
Chadwick, Joshua;
Chakraborty, Sandip;
Chandika, Rama Mohan;
Chandy, Sara;
Chansamouth, Vilada;
Chattu, Vijay Kumar;
Chaudhary, Anis Ahmad;
Ching, Patrick R;
Chopra, Hitesh;
Chowdhury, Fazle Rabbi;
Raggi, Catalina;
Chu, Dinh-Toi;
Chutiyami, Muhammad;
Cruz-Martins, Natalia;
da Silva, Alanna Gomes;
Dadras, Omid;
Dai, Xiaochen;
Darcho, Samuel D;
Das, Saswati;
De la Hoz, Fernando Pio;
Dekker, Denise Myriam;
Gershberg Hayoon, Anna;
Dhama, Kuldeep;
Diaz, Daniel;
Dickson, Benjamin Felix Rothschild;
Djorie, Serge Ghislain;
Dodangeh, Milad;
Dohare, Sushil;
Dokova, Klara Georgieva;
Doshi, Ojas Prakashbhai;
Dowou, Robert Kokou;
Dsouza, Haneil Larson;
Davis Weaver, Nicole;
Dunachie, Susanna J;
Dziedzic, Arkadiusz Marian;
Eckmanns, Tim;
Ed-Dra, Abdelaziz;
Eftekharimehrabad, Aziz;
Ekundayo, Temitope Cyrus;
El Sayed, Iman;
Elhadi, Muhammed;
El-Huneidi, Waseem;
Elias, Christelle;
Lindstedt, Paulina A;
Ellis, Sally J;
Elsheikh, Randa;
Elsohaby, Ibrahim;
Eltaha, Chadi;
Eshrati, Babak;
Eslami, Majid;
Eyre, David William;
Fadaka, Adewale Oluwaseun;
Fagbamigbe, Adeniyi Francis;
Fahim, Ayesha;
Smith, Amanda E;
Fakhri-Demeshghieh, Aliasghar;
Fasina, Folorunso Oludayo;
Fasina, Modupe Margaret;
Fatehizadeh, Ali;
Feasey, Nicholas A;
Feizkhah, Alireza;
Fekadu, Ginenus;
Fischer, Florian;
Fitriana, Ida;
Forrest, Karen M;
Altay, Umut;
Fortuna Rodrigues, Celia;
Fuller, John E;
Gadanya, Muktar A;
Gajdács, Márió;
Gandhi, Aravind P;
Garcia-Gallo, Esteban E;
Garrett, Denise O;
Gautam, Rupesh K;
Gebregergis, Miglas Welay;
Gebrehiwot, Mesfin;
Bhattacharjee, Natalia V;
Gebremeskel, Teferi Gebru;
Geffers, Christine;
Georgalis, Leonidas;
Ghazy, Ramy Mohamed;
Golechha, Mahaveer;
Golinelli, Davide;
Gordon, Melita;
Gulati, Snigdha;
Gupta, Rajat Das;
Gupta, Sapna;
Giannakis, Konstantinos;
Gupta, Vijai Kumar;
Habteyohannes, Awoke Derbie;
Haller, Sebastian;
Harapan, Harapan;
Harrison, Michelle L;
Hasaballah, Ahmed I;
Hasan, Ikramul;
Hasan, Rumina Syeda;
Hasani, Hamidreza;
Haselbeck, Andrea Haekyung;
Fell, Frederick;
Hasnain, Md Saquib;
Hassan, Ikrama Ibrahim;
Hassan, Shoaib;
Hassan Zadeh Tabatabaei, Mahgol Sadat;
Hayat, Khezar;
He, Jiawei;
Hegazi, Omar E;
Heidari, Mohammad;
Hezam, Kamal;
Holla, Ramesh;
McManigal, Barney;
Holm, Marianne;
Hopkins, Heidi;
Hossain, Md Mahbub;
Hosseinzadeh, Mehdi;
Hostiuc, Sorin;
Hussein, Nawfal R;
Huy, Le Duc;
Ibáñez-Prada, Elsa D;
Ikiroma, Adalia;
Ilic, Irena M;
Ekapirat, Nattwut;
Islam, Sheikh Mohammed Shariful;
Ismail, Faisal;
Ismail, Nahlah Elkudssiah;
Iwu, Chidozie Declan;
Iwu-Jaja, Chinwe Juliana;
Jafarzadeh, Abdollah;
Jaiteh, Fatoumatta;
Jalilzadeh Yengejeh, Reza;
Jamora, Roland Dominic G;
Javidnia, Javad;
Mendes, Jessica Andretta;
Jawaid, Talha;
Jenney, Adam W J;
Jeon, Hyon Jin;
Jokar, Mohammad;
Jomehzadeh, Nabi;
Joo, Tamas;
Joseph, Nitin;
Kamal, Zul;
Kanmodi, Kehinde Kazeem;
Kantar, Rami S;
Runghien, Tilleye;
Kapisi, James Apollo;
Karaye, Ibraheem M;
Khader, Yousef Saleh;
Khajuria, Himanshu;
Khalid, Nauman;
Khamesipour, Faham;
Khan, Ajmal;
Khan, Mohammad Jobair;
Khan, Muhammad Tariq;
Khanal, Vishnu;
Srimokla, Oraya;
Khidri, Feriha Fatima;
Khubchandani, Jagdish;
Khusuwan, Suwimon;
Kim, Min Seo;
Kisa, Adnan;
Korshunov, Vladimir Andreevich;
Krapp, Fiorella;
Krumkamp, Ralf;
Kuddus, Mohammed;
Kulimbet, Mukhtar;
Abdelkader, Atef;
Kumar, Dewesh;
Kumaran, Emmanuelle A P;
Kuttikkattu, Ambily;
Kyu, Hmwe Hmwe;
Landires, Iván;
Lawal, Basira Kankia;
Le, Thao Thi Thu;
Lederer, Ingeborg Maria;
Lee, Munjae;
Lee, Seung Won;
Abd-Elsalam, Sherief;
Lepape, Alain;
Lerango, Temesgen Leka;
Ligade, Virendra S;
Lim, Cherry;
Lim, Stephen S;
Limenh, Liknaw Workie;
Liu, Chaojie;
Liu, Xiaofeng;
Liu, Xuefeng;
Loftus, Michael J;
Aboagye, Richard Gyan;
M Amin, Hawraz Ibrahim;
Maass, Kelsey Lynn;
Maharaj, Sandeep B;
Mahmoud, Mansour Adam;
Maikanti-Charalampous, Panagiota;
Makram, Omar M;
Malhotra, Kashish;
Malik, Ahmad Azam;
Mandilara, Georgia D;
Marks, Florian;
Abolhassani, Hassan;
Martinez-Guerra, Bernardo Alfonso;
Martorell, Miquel;
Masoumi-Asl, Hossein;
Mathioudakis, Alexander G;
May, Juergen;
McHugh, Theresa A;
Meiring, James;
Meles, Hadush Negash;
Melese, Addisu;
Melese, Endalkachew Belayneh;
Abualruz, Hasan;
Minervini, Giuseppe;
Mohamed, Nouh Saad;
Mohammed, Shafiu;
Mohan, Syam;
Mokdad, Ali H;
Monasta, Lorenzo;
Moodi Ghalibaf, AmirAli;
Moore, Catrin E;
Moradi, Yousef;
Mossialos, Elias;
Abubakar, Usman;
Mougin, Vincent;
Mukoro, George Duke;
Mulita, Francesk;
Muller-Pebody, Berit;
Murillo-Zamora, Efren;
Musa, Sani;
Musicha, Patrick;
Musila, Lillian A;
Muthupandian, Saravanan;
Nagarajan, Ahamarshan Jayaraman;
Abukhadijah, Hana J;
Naghavi, Pirouz;
Nainu, Firzan;
Nair, Tapas Sadasivan;
Najmuldeen, Hastyar Hama Rashid;
Natto, Zuhair S;
Nauman, Javaid;
Nayak, Biswa Prakash;
Nchanji, G Takop;
Ndishimye, Pacifique;
Negoi, Ionut;
Aburuz, Salahdein;
Negoi, Ruxandra Irina;
Nejadghaderi, Seyed Aria;
Nguyen, QuynhAnh P;
Noman, Efaq Ali;
Nwakanma, Davis C;
O'Brien, Seamus;
Ochoa, Theresa J;
Odetokun, Ismail A;
Ogundijo, Oluwaseun Adeolu;
Ojo-Akosile, Tolulope R;
Abu-Zaid, Ahmed;
Okeke, Sylvester Reuben;
Okonji, Osaretin Christabel;
Olagunju, Andrew T;
Olivas-Martinez, Antonio;
Olorukooba, Abdulhakeem Abayomi;
Olwoch, Peter;
Onyedibe, Kenneth Ikenna;
Ortiz-Brizuela, Edgar;
Osuolale, Olayinka;
Ounchanum, Pradthana;
Achalapong, Sureerak;
Oyeyemi, Oyetunde T;
P A, Mahesh Padukudru;
Paredes, Jose L;
Parikh, Romil R;
Patel, Jay;
Patil, Shankargouda;
Pawar, Shrikant;
Peleg, Anton Y;
Peprah, Prince;
Perdigão, João;
Addo, Isaac Yeboah;
Perrone, Carlo;
Petcu, Ionela-Roxana;
Phommasone, Koukeo;
Piracha, Zahra Zahid;
Poddighe, Dimitri;
Pollard, Andrew J;
Poluru, Ramesh;
Ponce-De-Leon, Alfredo;
Puvvula, Jagadeesh;
Qamar, Farah Naz;
Adekanmbi, Victor;
Qasim, Nameer Hashim;
Rafai, Clotaire Donatien;
Raghav, Pankaja;
Rahbarnia, Leila;
Rahim, Fakher;
Rahimi-Movaghar, Vafa;
Rahman, Mosiur;
Rahman, Muhammad Aziz;
Ramadan, Hazem;
Ramasamy, Shakthi Kumaran;
Adeyeoluwa, Temitayo Esther;
Ramesh, Pushkal Sinduvadi;
Ramteke, Pramod W;
Rana, Rishabh Kumar;
Rani, Usha;
Rashidi, Mohammad-Mahdi;
Rathish, Devarajan;
Rattanavong, Sayaphet;
Rawaf, Salman;
Redwan, Elrashdy Moustafa Mohamed;
Reyes, Luis Felipe;
Adnani, Qorinah Estiningtyas Sakilah;
Roberts, Tamalee;
Robotham, Julie V;
Rosenthal, Victor Daniel;
Ross, Allen Guy;
Roy, Nitai;
Rudd, Kristina E;
Sabet, Cameron John;
Saddik, Basema Ahmad;
Saeb, Mohammad Reza;
Saeed, Umar;
Adzigbli, Leticia Akua;
Saeedi Moghaddam, Sahar;
Saengchan, Weeravoot;
Safaei, Mohsen;
Saghazadeh, Amene;
Saheb Sharif-Askari, Narjes;
Sahebkar, Amirhossein;
Sahoo, Soumya Swaroop;
Sahu, Maitreyi;
Saki, Morteza;
Salam, Nasir;
Afzal, Muhammad Sohail;
Saleem, Zikria;
Saleh, Mohamed A;
Samodra, Yoseph Leonardo;
Samy, Abdallah M;
Saravanan, Aswini;
Satpathy, Maheswar;
Schumacher, Austin E;
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Seekaew, Samroeng;
Shafie, Mahan;
Afzal, Saira;
Shah, Pritik A;
Shahid, Samiah;
Shahwan, Moyad Jamal;
Shakoor, Sadia;
Shalev, Noga;
Shamim, Muhammad Aaqib;
Shamshirgaran, Mohammad Ali;
Shamsi, Anas;
Sharifan, Amin;
Shastry, Rajesh P;
Agodi, Antonella;
Shetty, Mahabalesh;
Shittu, Aminu;
Shrestha, Sunil;
Siddig, Emmanuel Edwar;
Sideroglou, Theologia;
Sifuentes-Osornio, Jose;
Silva, Luís Manuel Lopes Rodrigues;
Simões, Eric A F;
Simpson, Andrew J H;
Singh, Amit;
Ahlstrom, Austin J;
Singh, Surjit;
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Aziz, Shahkaar |
| Abstract: |
Background: Antimicrobial (AMR) poses an important global health challenge in
the 21st century. A previous study has quantified the global and regional
burden of AMR for 2019, followed with additional publications that provided
more detailed estimates for several WHO regions by country. To date, there
have been no studies that produce comprehensive estimates of AMR burden across
locations that encompass historical trends and future forecasts. Methods: We
estimated all-age and age-specific deaths and disability-adjusted life-years
(DALYs) attributable to and associated with bacterial AMR for 22 pathogens, 84
pathogen–drug combinations, and 11 infectious syndromes in 204 countries and
territories from 1990 to 2021. We collected and used multiple cause of death
data, hospital discharge data, microbiology data, literature studies, single
drug resistance profiles, pharmaceutical sales, antibiotic use surveys,
mortality surveillance, linkage data, outpatient and inpatient insurance
claims data, and previously published data, covering 520 million individual
records or isolates and 19 513 study-location-years. We used statistical
modelling to produce estimates of AMR burden for all locations, including
those with no data. Our approach leverages the estimation of five broad
component quantities: the number of deaths involving sepsis; 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 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 attributable to and
associated with AMR, which we define based on two counterfactuals;
respectively, an alternative scenario in which all drug-resistant infections
are replaced by drug-susceptible infections, and an alternative scenario in
which all drug-resistant infections were replaced by no infection.
Additionally, we produced global and regional forecasts of AMR burden until
2050 for three scenarios: a reference scenario that is a probabilistic
forecast of the most likely future; a Gram-negative drug scenario that assumes
future drug development that targets Gram-negative pathogens; and a better
care scenario that assumes future improvements in health-care quality and
access to appropriate antimicrobials. We present final estimates aggregated to
the global, super-regional, and regional level. Findings: In 2021, we
estimated 4·71 million (95% UI 4·23–5·19) deaths were associated with
bacterial AMR, including 1·14 million (1·00–1·28) deaths attributable to
bacterial AMR. Trends in AMR mortality over the past 31 years varied
substantially by age and location. From 1990 to 2021, deaths from AMR
decreased by more than 50% among children younger than 5 years yet increased
by over 80% for adults 70 years and older. AMR mortality decreased for
children younger than 5 years in all super-regions, whereas AMR mortality in
people 5 years and older increased in all super regions. For both deaths
associated with and deaths attributable to AMR, meticillin-resistant
Staphylococcus aureus increased the most globally (from 261000 associated
deaths [95% UI 150000–372 000] and 57200 attributable deaths [34100–80 300] in
1990, to 550 000 associated deaths [500000–600000] and 130000 attributable
deaths [113000–146 000] in 2021). Among Gram-negative bacteria, resistance to
carbapenems increased more than any other antibiotic class, rising from 619000
associated deaths (405 000–834000) in 1990, to 1·03 million associated deaths
(909000–1·16 million) in 2021, and from 127 000 attributable deaths (82
100–171000) in 1990, to 216 000 (168 000–264000) attributable deaths in 2021.
There was a notable decrease in non-COVID-related infectious disease in 2020
and 2021. Our forecasts show that an estimated 1·91 million (1·56–2·26) deaths
attributable to AMR and 8·22 million (6·85–9·65) deaths associated with AMR
could occur globally in 2050. Super-regions with the highest all-age AMR
mortality rate in 2050 are forecasted to be south Asia and Latin America and
the Caribbean. Increases in deaths attributable to AMR will be largest among
those 70 years and older (65·9% [61·2–69·8] of all-age deaths attributable to
AMR in 2050). In stark contrast to the strong increase in number of deaths due
to AMR of 69·6% (51·5–89·2) from 2022 to 2050, the number of DALYs showed a
much smaller increase of 9·4% (–6·9 to 29·0) to 46·5 million (37·7 to 57·3) in
2050. Under the better care scenario, across all age groups, 92·0 million
deaths (82·8–102·0) could be cumulatively averted between 2025 and 2050,
through better care of severe infections and improved access to antibiotics,
and under the Gram negative drug scenario, 11·1 million AMR deaths (9·08–13·2)
could be averted through the development of a Gram negative drug pipeline to
prevent AMR deaths. Interpretation: This study presents the first
comprehensive assessment of the global burden of AMR from 1990 to 2021, with
results forecasted until 2050. Evaluating changing trends in AMR mortality
across time and location is necessary Lancet 2024; 404: 1199–226 Published
Online September 16, 2024 https://doi.org/10.1016/ S0140-6736(24)01867-1 See
Comment page 1172 *Collaborators listed at the end of the Article
Correspondence to: Christopher J L Murray, Department of Health Metrics
Sciences, Institute for Health Metrics and Evaluation, University of
Washington School of Medicine, Seattle, WA 98195, USA cjlm@uw.edu Articles
1200 www.thelancet.com Vol 404 September 28, 2024 to understand how this
important global health threat is developing and prepares us to make informed
decisions regarding interventions. Our findings show the importance of
infection prevention, as shown by the reduction of AMR deaths in those younger
than 5 years. Simultaneously, our results underscore the concerning trend of
AMR burden among those older than 70 years, alongside a rapidly ageing global
community. The opposing trends in the burden of AMR deaths between younger and
older individuals explains the moderate future increase in global number of
DALYs versus number of deaths. Given the high variability of AMR burden by
location and age, it is important that interventions combine infection
prevention, vaccination, minimisation of inappropriate antibiotic use in
farming and humans, and research into new antibiotics to mitigate the number
of AMR deaths that are forecasted for 2050. |
| Date: |
2024 |
| URL: |
https://d.repec.org/n?u=RePEc:zbw:ifwkie:306603 |