TY - JOUR
T1 - Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015
T2 - a population-level modelling analysis
AU - Burden of AMR Collaborative Group
AU - Cassini, Alessandro
AU - Högberg, Liselotte Diaz
AU - Plachouras, Diamantis
AU - Quattrocchi, Annalisa
AU - Hoxha, Ana
AU - Simonsen, Gunnar Skov
AU - Colomb-Cotinat, Mélanie
AU - Kretzschmar, Mirjam E.
AU - Devleesschauwer, Brecht
AU - Cecchini, Michele
AU - Ouakrim, Driss Ait
AU - Oliveira, Tiago Cravo
AU - Struelens, Marc J.
AU - Suetens, Carl
AU - Monnet, Dominique L.
AU - Strauss, Reinhild
AU - Mertens, Karl
AU - Struyf, Thomas
AU - Catry, Boudewijn
AU - Latour, Katrien
AU - Ivanov, Ivan N.
AU - Dobreva, Elina G.
AU - Tambic Andraševic, Arjana
AU - Soprek, Silvija
AU - Budimir, Ana
AU - Paphitou, Niki
AU - Žemlicková, Helena
AU - Schytte Olsen, Stefan
AU - Wolff Sönksen, Ute
AU - Märtin, Pille
AU - Ivanova, Marina
AU - Lyytikäinen, Outi
AU - Jalava, Jari
AU - Coignard, Bruno
AU - Eckmanns, Tim
AU - Abu Sin, Muna
AU - Haller, Sebastian
AU - Daikos, George L.
AU - Gikas, Achilleas
AU - Tsiodras, Sotirios
AU - Kontopidou, Flora
AU - Tóth, Ákos
AU - Hajdu, Ágnes
AU - Guólaugsson, Ólafur
AU - Kristinsson, Karl G.
AU - Murchan, Stephen
AU - Burns, Karen
AU - Pezzotti, Patrizio
AU - Johnson, Alan
AU - Hopkins, Susan
N1 - Publisher Copyright:
© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2019/1
Y1 - 2019/1
N2 - 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. Funding: European Centre for Disease Prevention and Control.
AB - 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. Funding: European Centre for Disease Prevention and Control.
UR - http://www.scopus.com/inward/record.url?scp=85058703581&partnerID=8YFLogxK
U2 - 10.1016/S1473-3099(18)30605-4
DO - 10.1016/S1473-3099(18)30605-4
M3 - Article
C2 - 30409683
AN - SCOPUS:85058703581
SN - 1473-3099
VL - 19
SP - 56
EP - 66
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 1
ER -