Περίληψη:
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.
Συγγραφείς:
Cassini, Alessandro
Hogberg, Liselotte Diaz
Plachouras,
Diamantis
Quattrocchi, Annalisa
Hoxha, Ana
Simonsen, Gunnar
Skov
Colomb-Cotinat, Melanie
Kretzschmar, Mirjam E. and
Devleesschauwer, Brecht
Cecchini, Michele
Ouakrim, Driss Ait and
Oliveira, Tiago Cravo
Struelens, Marc J.
Suetens, Carl and
Monnet, Dominique L.
Strauss, Reinhild
Mertens, Karl
Struyf,
Thomas
Catry, Boudewijn
Latour, Katrien
Ivanov, Ivan
Nikolaev
Dobreva, Elina Georgieva
Tambic Andrasevic, Arjana and
Soprek, Silvija
Budimir, Ana
Paphitou, Niki
Zemlickova,
Helena
Olsen, Stefan Schytte
Sonksen, Ute Wolff
Martin,
Pille
Ivanova, Marina
Lyytikainen, Outi
Jalava, Jari and
Coignard, Bruno
Eckmanns, Tim
Abu Sin, Muna
Haller,
Sebastian
Daikos, George L.
Gikas, Achilleas
Tsiodras,
Sotirios
Kontopidou, Flora
Toth, Akos
Hajdu, Agnes and
Guolaugsson, Olafur
Kristinsson, Karl G.
Murchan, Stephen and
Burns, Karen
Dsstat, Patrizio Pezzotti
Gagliotti, Carlo and
Dumpis, Uga
Liuimiene, Agne
Perrin, Monique
Borg, Michael A.
and de Greeff, Sabine C.
Monen, Jos C. M.
Koek, Mayke B. G. and
Elstrom, Petter
Zabicka, Dorota
Deptula, Aleksander and
Hryniewicz, Waleria
Canica, Manuela
Nogueira, Paulo Jorge and
Fernandes, Paulo Andre
Manageiro, Vera
Popescu, Gabriel Adrian
and Serban, Roxana Ioana
Schreterova, Eva
Litvova, Slavka and
Stefkovicova, Maria
Kolman, Jana
Klavs, Irena
Korosec, Ales
and Aracil, Belen
Asensio, Angel
Perez-Vazquez, Maria and
Billstrom, Hanna
Larsson, Sofie
Reilly, Jacqui S.
Johnson,
Alan
Hopkins, Susan
Burden Amr Collaborative Grp
