Improving the estimation of the global burden of antimicrobial resistant infections
Improving the estimation of the global burden of antimicrobial resistant infections
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DOI：
10.1016/s1473-3099(19)30276-2
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发表时间：
2019-11-01
影响因子：
56.3
通讯作者：
Peacock, Sharon J.
中科院分区：
文献类型：
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作者：
Limmathurotsakul, Direk;Dunachie, Susanna;Peacock, Sharon J.
估计已经获得抗菌素耐药性(AMR)的病原体引起的感染造成的全球疾病负担，对于资源分配和为国家和全球层面的AMR行动计划提供信息至关重要。然而，人们普遍承认，缺乏可靠和可接受的方法来确定负担。在这个个人观点中，我们讨论了用于量化AMR细菌感染死亡率的方法的基本假设、特征、局限性和可比性。我们表明，以前的研究中估计的AMR的全球负担是不可比较的，因为它们的方法、假设和用于产生估计的数据不同。以前研究的分析框架是不充分的，我们得出结论，需要一种新的方法来估计AMR感染造成的死亡。新方法的创新将需要开发机制，系统地收集大量广泛和高质量的临床数据集，以支持对负担的准确评估，并结合针对AMR的干预措施的决策和资源分配。我们确定了所需的关键行动，并呼吁以创新的思维和解决方案来解决这些问题。
Estimating the global burden of disease from infections caused by pathogens that have acquired antimicrobial resistance (AMR) is essential for resource allocation and to inform AMR action plans at national and global levels. However, the scarcity of robust and accepted methods to determine burden is widely acknowledged. In this Personal View, we discuss the underlying assumptions, characteristics, limitations, and comparability of the approaches used to quantify mortality from AMR bacterial infections. We show that the global burdens of AMR estimated in previous studies are not comparable because of their different methodological approaches, assumptions, and data used to generate the estimates. The analytical frameworks from previous studies are inadequate, and we conclude that a new approach to the estimation of deaths caused by AMR infection is needed. The innovation of a new approach will require the development of mechanisms to systematically collect a clinical dataset of substantial breadth and quality to support the accurate assessment of burden, combined with decision-making and resource allocation for interventions against AMR. We define key actions required and call for innovative thinking and solutions to address these problems.