Estimating the burden of antimicrobial resistance: a systematic literature review.
Estimating the burden of antimicrobial resistance: a systematic literature review.
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DOI：
10.1186/s13756-018-0336-y
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发表时间：
2018
影响因子：
5.5
通讯作者：
Robotham JV
中科院分区：
文献类型：
--
作者：
Naylor NR;Atun R;Zhu N;Kulasabanathan K;Silva S;Chatterjee A;Knight GM;Robotham JV
需要准确估计抗菌素耐药性（AMR）的负担，以确定这一全球威胁在健康和成本方面的严重程度，并对旨在解决这一问题的干预措施进行成本效益评估。本综述旨在建立用于估计AMR负担的替代方法，以评估当前的证据基础。检索MEDLINE、EMBASE、Scopus、EconLit、PubMed和灰色文献。纳入了2013年1月至2015年12月期间发表的评价AMR（来自任何微生物）对患者、付款人/提供者和经济负担影响的英语研究。使用预先规定的标准对标题/摘要进行独立筛选，然后进行全文筛选。使用Newcastle-Ottawa和Philips检查表得出研究质量评分（从0到1）。提取的研究数据用于比较研究方法和由此产生的负担估计，根据角度。货币成本已转换为2013年美元。在5187例唯一检索中，纳入了214项研究。187项研究估计了患者健康，75项研究估计了支付者/提供者，11项研究估计了经济负担。64%的纳入研究为单中心研究。大多数估计患者或提供者/支付者负担的研究使用回归技术。48%估计死亡负担的研究发现耐药性的显著影响，医疗系统的额外成本从不显著到每年10亿美元不等，而经济负担从每例21，832美元到超过3万亿美元的GDP损失不等。患者、支付者/提供者和经济负担研究的中位质量评分（四分位距）分别为0.67（0.56-0.67）、0.56（0.46-0.67）和0.53（0.44-0.60）。这项研究强调了根据所选择的结果和观点可能发生的方法论假设和偏见。目前，在负担估计方面存在相当大的差异，这反过来可能导致不准确的干预评估和糟糕的政策/投资决定。未来的研究应利用本评论中提出的建议。该系统性综述已在PROSPERO注册（PROSPERO CRD 42016037510）。本文的在线版本（10.1186/s13756-018-0336-y）包含补充材料，可供授权用户使用。
Accurate estimates of the burden of antimicrobial resistance (AMR) are needed to establish the magnitude of this global threat in terms of both health and cost, and to paramaterise cost-effectiveness evaluations of interventions aiming to tackle the problem. This review aimed to establish the alternative methodologies used in estimating AMR burden in order to appraise the current evidence base. MEDLINE, EMBASE, Scopus, EconLit, PubMed and grey literature were searched. English language studies evaluating the impact of AMR (from any microbe) on patient, payer/provider and economic burden published between January 2013 and December 2015 were included. Independent screening of title/abstracts followed by full texts was performed using pre-specified criteria. A study quality score (from zero to one) was derived using Newcastle-Ottawa and Philips checklists. Extracted study data were used to compare study method and resulting burden estimate, according to perspective. Monetary costs were converted into 2013 USD. Out of 5187 unique retrievals, 214 studies were included. One hundred eighty-seven studies estimated patient health, 75 studies estimated payer/provider and 11 studies estimated economic burden. 64% of included studies were single centre. The majority of studies estimating patient or provider/payer burden used regression techniques. 48% of studies estimating mortality burden found a significant impact from resistance, excess healthcare system costs ranged from non-significance to $1 billion per year, whilst economic burden ranged from $21,832 per case to over $3 trillion in GDP loss. Median quality scores (interquartile range) for patient, payer/provider and economic burden studies were 0.67 (0.56-0.67), 0.56 (0.46-0.67) and 0.53 (0.44-0.60) respectively. This study highlights what methodological assumptions and biases can occur dependent on chosen outcome and perspective. Currently, there is considerable variability in burden estimates, which can lead in-turn to inaccurate intervention evaluations and poor policy/investment decisions. Future research should utilise the recommendations presented in this review. This systematic review is registered with PROSPERO (PROSPERO CRD42016037510). The online version of this article (10.1186/s13756-018-0336-y) contains supplementary material, which is available to authorized users.
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影响因子：
5.2
作者：
Andria, Nizar;Henig, Oryan;Paul, Mical
通讯作者：
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影响因子：
14.2
作者：
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通讯作者：
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DOI：
10.1155/2014/429536
发表时间：
2014-02-01
期刊：
CANADIAN JOURNAL OF GASTROENTEROLOGY
影响因子：
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作者：
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通讯作者：
Tandon, Puneeta
影响因子：
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作者：
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通讯作者：
Kong, D. C. M.
DOI：
10.1097/inf.0000000000000769
发表时间：
2015-09
期刊：
The Pediatric infectious disease journal
影响因子：
--
作者：
Bergin SP;Thaden JT;Ericson JE;Cross H;Messina J;Clark RH;Fowler VG Jr;Benjamin DK Jr;Hornik CP;Smith PB;Antibacterial Resistance Leadership Group
通讯作者：
Antibacterial Resistance Leadership Group