TY - JOUR
TI - 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
AU - Cassini, Alessandro
AU - Hogberg, Liselotte Diaz
AU - Plachouras,
AU - Diamantis
AU - Quattrocchi, Annalisa
AU - Hoxha, Ana
AU - Simonsen, Gunnar
AU - Skov
AU - Colomb-Cotinat, Melanie
AU - Kretzschmar, Mirjam E. and
AU - Devleesschauwer, Brecht
AU - Cecchini, Michele
AU - Ouakrim, Driss Ait and
AU - Oliveira, Tiago Cravo
AU - Struelens, Marc J.
AU - Suetens, Carl and
AU - Monnet, Dominique L.
AU - Strauss, Reinhild
AU - Mertens, Karl
AU - Struyf,
AU - Thomas
AU - Catry, Boudewijn
AU - Latour, Katrien
AU - Ivanov, Ivan
AU - Nikolaev
AU - Dobreva, Elina Georgieva
AU - Tambic Andrasevic, Arjana and
AU - Soprek, Silvija
AU - Budimir, Ana
AU - Paphitou, Niki
AU - Zemlickova,
AU - Helena
AU - Olsen, Stefan Schytte
AU - Sonksen, Ute Wolff
AU - Martin,
AU - Pille
AU - Ivanova, Marina
AU - Lyytikainen, Outi
AU - Jalava, Jari and
AU - Coignard, Bruno
AU - Eckmanns, Tim
AU - Abu Sin, Muna
AU - Haller,
AU - Sebastian
AU - Daikos, George L.
AU - Gikas, Achilleas
AU - Tsiodras,
AU - Sotirios
AU - Kontopidou, Flora
AU - Toth, Akos
AU - Hajdu, Agnes and
AU - Guolaugsson, Olafur
AU - Kristinsson, Karl G.
AU - Murchan, Stephen and
AU - Burns, Karen
AU - Dsstat, Patrizio Pezzotti
AU - Gagliotti, Carlo and
AU - Dumpis, Uga
AU - Liuimiene, Agne
AU - Perrin, Monique
AU - Borg, Michael A.
AU - and de Greeff, Sabine C.
AU - Monen, Jos C. M.
AU - Koek, Mayke B. G. and
AU - Elstrom, Petter
AU - Zabicka, Dorota
AU - Deptula, Aleksander and
AU - Hryniewicz, Waleria
AU - Canica, Manuela
AU - Nogueira, Paulo Jorge and
AU - Fernandes, Paulo Andre
AU - Manageiro, Vera
AU - Popescu, Gabriel Adrian
AU - and Serban, Roxana Ioana
AU - Schreterova, Eva
AU - Litvova, Slavka and
AU - Stefkovicova, Maria
AU - Kolman, Jana
AU - Klavs, Irena
AU - Korosec, Ales
AU - and Aracil, Belen
AU - Asensio, Angel
AU - Perez-Vazquez, Maria and
AU - Billstrom, Hanna
AU - Larsson, Sofie
AU - Reilly, Jacqui S.
AU - Johnson,
AU - Alan
AU - Hopkins, Susan
AU - Burden Amr Collaborative Grp
JO - The Lancet Infectious Diseases
PY - 2019
VL - 19
TODO - 1
SP - 56-66
PB - Elsevier Sci Ltd, Exeter, United Kingdom
SN - null
TODO - 10.1016/S1473-3099(18)30605-4
TODO - null
TODO - 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.
Copyright (c) 2018 The Author(s). Published by Elsevier Ltd. This is an
Open Access article under the CC BY 4.0 license.
ER -