Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis.
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cross Infection
/ epidemiology
Disabled Persons
Drug Resistance, Bacterial
Female
Global Health
Greece
/ epidemiology
Humans
Incidence
Infant
Infant, Newborn
Italy
/ epidemiology
Male
Middle Aged
Prevalence
Quality-Adjusted Life Years
Young Adult
Journal
The Lancet. Infectious diseases
ISSN: 1474-4457
Titre abrégé: Lancet Infect Dis
Pays: United States
ID NLM: 101130150
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
29
06
2018
revised:
28
08
2018
accepted:
25
09
2018
pubmed:
10
11
2018
medline:
10
5
2020
entrez:
10
11
2018
Statut:
ppublish
Résumé
Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs). We estimated the incidence of infections with 16 antibiotic resistance-bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011-12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature. From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148-763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480-38 430) attributable deaths and 874 541 (768 837-989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece. Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases. European Centre for Disease Prevention and Control.
Sections du résumé
BACKGROUND
Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs).
METHODS
We estimated the incidence of infections with 16 antibiotic resistance-bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011-12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature.
FINDINGS
From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148-763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480-38 430) attributable deaths and 874 541 (768 837-989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece.
INTERPRETATION
Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases.
FUNDING
European Centre for Disease Prevention and Control.
Identifiants
pubmed: 30409683
pii: S1473-3099(18)30605-4
doi: 10.1016/S1473-3099(18)30605-4
pmc: PMC6300481
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
56-66Investigateurs
Reinhild Strauss
(R)
Karl Mertens
(K)
Thomas Struyf
(T)
Boudewijn Catry
(B)
Katrien Latour
(K)
Ivan N Ivanov
(IN)
Elina G Dobreva
(EG)
Arjana Tambic Andraševic
(A)
Silvija Soprek
(S)
Ana Budimir
(A)
Niki Paphitou
(N)
Helena Žemlicková
(H)
Stefan Schytte Olsen
(S)
Ute Wolff Sönksen
(U)
Pille Märtin
(P)
Marina Ivanova
(M)
Outi Lyytikäinen
(O)
Jari Jalava
(J)
Bruno Coignard
(B)
Tim Eckmanns
(T)
Muna Abu Sin
(M)
Sebastian Haller
(S)
George L Daikos
(GL)
Achilleas Gikas
(A)
Sotirios Tsiodras
(S)
Flora Kontopidou
(F)
Ákos Tóth
(Á)
Ágnes Hajdu
(Á)
Ólafur Guólaugsson
(Ó)
Karl G Kristinsson
(KG)
Stephen Murchan
(S)
Karen Burns
(K)
Patrizio Pezzotti
(P)
Carlo Gagliotti
(C)
Uga Dumpis
(U)
Agne Liuimiene
(A)
Monique Perrin
(M)
Michael A Borg
(MA)
Sabine C de Greeff
(SC)
Jos Cm Monen
(JC)
Mayke Bg Koek
(MB)
Petter Elstrøm
(P)
Dorota Zabicka
(D)
Aleksander Deptula
(A)
Waleria Hryniewicz
(W)
Manuela Caniça
(M)
Paulo Jorge Nogueira
(PJ)
Paulo André Fernandes
(PA)
Vera Manageiro
(V)
Gabriel A Popescu
(GA)
Roxana I Serban
(RI)
Eva Schréterová
(E)
Slavka Litvová
(S)
Mária Štefkovicová
(M)
Jana Kolman
(J)
Irena Klavs
(I)
Aleš Korošec
(A)
Belén Aracil
(B)
Angel Asensio
(A)
María Pérez-Vázquez
(M)
Hanna Billström
(H)
Sofie Larsson
(S)
Jacqui S Reilly
(JS)
Alan Johnson
(A)
Susan Hopkins
(S)
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
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