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.
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.
复制标题
DOI：
10.1016/s1473-3099(18)30605-4
复制
发表时间：
2019-01
期刊：
影响因子：
--
通讯作者：
Burden of AMR Collaborative Group
中科院分区：
文献类型：
--
作者：
Cassini A;Högberg LD;Plachouras D;Quattrocchi A;Hoxha A;Simonsen GS;Colomb-Cotinat M;Kretzschmar ME;Devleesschauwer B;Cecchini M;Ouakrim DA;Oliveira TC;Struelens MJ;Suetens C;Monnet DL;Burden of AMR Collaborative Group
由抗药性细菌引起的感染正在威胁着现代医疗保健。然而，估计其发病率，并发症和归因死亡率是具有挑战性的。我们的目的是估计2015年欧盟和欧洲经济区（EEA）国家由耐药细菌引起的公共卫生问题的感染负担，以病例数、可归因死亡和残疾调整生命年（DADs）衡量。我们根据欧洲抗菌素耐药性监测网络（EARS-Net）2015年的数据估计了16种抗生素耐药性-细菌组合的感染发生率，该数据已针对人口覆盖率进行了国家校正。我们将血液感染（BSI）的数量乘以转换因子，该转换因子来自欧洲疾病预防和控制中心2011-12年欧洲急性护理医院医疗保健相关感染的点流行率调查，以估计非BSI的数量。我们在系统回顾文献的基础上开发了五种感染的疾病结局模型。根据2015年1月1日至2015年12月31日期间收集的EARS-Net数据，我们估计有671689例（95%不确定区间[UI] 583148 - 763966）耐药菌感染，其中63.5%（671689例中的426277例）与医疗保健有关。 这些感染估计造成33 110人（28 480-38 430人）死亡和874 541人（768 837-989 068人）死亡。 欧盟和欧洲经济区的婴儿（1岁以下）和65岁及以上人群的负担最高，自2007年以来有所增加，意大利和希腊最高。我们的研究结果提出了五种类型的耐药细菌感染的健康负担，这是第一次，在Dods。与其他传染病相比，欧盟和欧洲经济区的耐药性细菌感染的估计负担很大，并且自2007年以来有所增加。我们的负担估计为公共卫生决策者优先考虑传染病干预措施提供了有用的信息。欧洲疾病预防和控制中心。
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.