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Publication date: 2022-12-17
Volume: 400 Pages: 2221 - 2248
Publisher: Elsevier

Author:

Ikuta, Kevin S
Swetschinski, Lucien R ; Aguilar, Gisela Robles ; Sharara, Fablina ; Mestrovic, Tomislav ; Gray, Authia P ; Weaver, Nicole Davis ; Wool, Eve E ; Han, Chieh ; Hayoon, Anna Gershberg ; Aali, Amirali ; Abate, Semagn Mekonnen ; Abbasi-Kangevari, Mohsen ; Abbasi-Kangevari, Zeinab ; Abd-Elsalam, Sherief ; Abebe, Getachew ; Abedi, Aidin ; Abhari, Amir Parsa ; Abidi, Hassan ; Aboagye, Richard Gyan ; Absalan, Abdorrahim ; Ali, Hiwa Abubaker ; Acuna, Juan Manuel ; Adane, Tigist Demssew ; Addo, Isaac Yeboah ; Adegboye, Oyelola A ; Adnan, Mohammad ; Adnani, Qorinah Estiningtyas Sakilah ; Afzal, Muhammad Sohail ; Afzal, Saira ; Aghdam, Zahra Babaei ; Ahinkorah, Bright Opoku ; Ahmad, Aqeel ; Ahmad, Araz Ramazan ; Ahmad, Rizwan ; Ahmad, Sajjad ; Ahmad, Sohail ; Ahmadi, Sepideh ; Ahmed, Ali ; Ahmed, Haroon ; Ahmed, Jivan Qasim ; Rashid, Tarik Ahmed ; Ajami, Marjan ; Aji, Budi ; Akbarzadeh-Khiavi, Mostafa ; Akunna, Chisom Joyqueenet ; Al Hamad, Hanadi ; Alahdab, Fares ; Al-Aly, Ziyad ; Aldeyab, Mamoon A ; Aleman, Alicia ; Alhalaiqa, Fadwa Alhalaiqa Naji ; Alhassan, Robert Kaba ; Ali, Beriwan Abdulqadir ; Ali, Liaqat ; Ali, Syed Shujait ; Alimohamadi, Yousef ; Alipour, Vahid ; Alizadeh, Atiyeh ; Aljunid, Syed Mohamed ; Allel, Kasim ; Almustanyir, Sami ; Ameyaw, Edward Kwabena ; Amit, Arianna Maever L ; Anandavelane, Nivedita ; Ancuceanu, Robert ; Andrei, Catalina Liliana ; Andrei, Tudorel ; Anggraini, Dewi ; Ansar, Adnan ; Anyasodor, Anayochukwu Edward ; Arabloo, Jalal ; Aravkin, Aleksandr Y ; Areda, Demelash ; Aripov, Timur ; Artamonov, Anton A ; Arulappan, Judie ; Aruleba, Raphael Taiwo ; Asaduzzaman, Muhammad ; Ashraf, Tahira ; Athari, Seyyed Shamsadin ; Atlaw, Daniel ; Attia, Sameh ; Ausloos, Marcel ; Awoke, Tewachew ; Quintanilla, Beatriz Paulina Ayala ; Ayana, Tegegn Mulatu ; Azadnajafabad, Sina ; Jafari, Amirhossein Azari ; Darshan, BB ; Badar, Muhammad ; Badiye, Ashish D ; Baghcheghi, Nayereh ; Bagherieh, Sara ; Baig, Atif Amin ; Banerjee, Indrajit ; Barac, Aleksandra ; Bardhan, Mainak ; Barone-Adesi, Francesco ; Barqawi, Hiba Jawdat ; Barrow, Amadou ; Baskaran, Pritish ; Basu, Saurav ; Batiha, Abdul-Monim Mohammad ; Bedi, Neeraj ; Belete, Melaku Ashagrie ; Belgaumi, Uzma Iqbal ; Bender, Rose G ; Bhandari, Bharti ; Bhandari, Dinesh ; Bhardwaj, Pankaj ; Bhaskar, Sonu ; Bhattacharyya, Krittika ; Bhattarai, Suraj ; Bitaraf, Saeid ; Buonsenso, Danilo ; Butt, Zahid A ; dos Santos, Florentino Luciano Caetano ; Cai, Jiao ; Calina, Daniela ; Camargos, Paulo ; Camera, Luis Alberto ; Cardenas, Rosario ; Cevik, Muge ; Chadwick, Joshua ; Charan, Jaykaran ; Chaurasia, Akhilanand ; Ching, Patrick R ; Choudhari, Sonali Gajanan ; Chowdhury, Enayet Karim ; Chowdhury, Fazle Rabbi ; Chu, Dinh-Toi ; Chukwu, Isaac Sunday ; Dadras, Omid ; Dagnaw, Fentaw Teshome ; Dai, Xiaochen ; Das, Saswati ; Dastiridou, Anna ; Debela, Sisay Abebe ; Demisse, Fitsum Wolde ; Demissie, Solomon ; Dereje, Diriba ; Derese, Msganaw ; Desai, Hardik Dineshbhai ; Dessalegn, Fikadu Nugusu ; Dessalegni, Samuel Abebe A ; Desye, Belay ; Dhaduk, Kartik ; Dhimal, Meghnath ; Dhingra, Sameer ; Diao, Nancy ; Diaz, Daniel ; Djalalinia, Shirin ; Dodangeh, Milad ; Dongarwar, Deepa ; Dora, Bezabih Terefe ; Dorostkar, Fariba ; Dsouza, Haneil Larson ; Dubljanin, Eleonora ; Dunachie, Susanna J ; Durojaiye, Oyewole Christopher ; Edinur, Hisham Atan ; Ejigu, Habtamu Bekele ; Ekholuenetale, Michael ; Ekundayo, Temitope Cyrus ; El-Abid, Hassan ; Elhadi, Muhammed ; Elmonem, Mohamed A ; Emami, Amir ; Bain, Luchuo Engelbert ; Enyew, Daniel Berhanie ; Erkhembayar, Ryenchindorj ; Eshrati, Babak ; Etaee, Farshid ; Fagbamigbe, Adeniyi Francis ; Falahi, Shahab ; Fallahzadeh, Aida ; Faraon, Emerito Jose A ; Fatehizadeh, Ali ; Fekadu, Ginenus ; Fernandes, Joao C ; Ferrari, Allegra ; Fetensa, Getahun ; Filip, Irina ; Fischer, Florian ; Foroutan, Masoud ; Gaal, Peter Andras ; Gadanya, Muktar A ; Gaidhane, Abhay Motiramji ; Ganesan, Balasankar ; Gebrehiwot, Mesfin ; Ghanbari, Reza ; Nour, Mohammad Ghasemi ; Ghashghaee, Ahmad ; Gholamrezanezhad, Ali ; Gholizadeh, Abdolmajid ; Golechha, Mahaveer ; Goleij, Pouya ; Golinelli, Davide ; Goodridge, Amador ; Gunawardane, Damitha Asanga ; Guo, Yuming ; Das Gupta, Rajat ; Gupta, Sapna ; Gupta, Veer Bala ; Gupta, Vivek Kumar ; Guta, Alemu ; Habibzadeh, Parham ; Avval, Atlas Haddadi ; Halwani, Rabih ; Hanif, Asif ; Hannan, Md Abdul ; Harapan, Harapan ; Hassan, Shoaib ; Hassankhani, Hadi ; Hayat, Khezar ; Heibati, Behzad ; Heidari, Golnaz ; Heidari, Mohammad ; Heidari-Soureshjani, Reza ; Herteliu, Claudiu ; Heyi, Demisu Zenbaba ; Hezam, Kamal ; Hoogar, Praveen ; Horita, Nobuyuki ; Hossain, Md Mahbub ; Hosseinzadeh, Mehdi ; Hostiuc, Mihaela ; Hostiuc, Sorin ; Hoveidamanesh, Soodabeh ; Huang, Junjie ; Hussain, Salman ; Hussein, Nawfal R ; Ibitoye, Segun Emmanuel ; Ilesanmi, Olayinka Stephen ; Ilic, Irena M ; Ilic, Milena D ; Imam, Mohammad Tarique ; Immurana, Mustapha ; Inbaraj, Leeberk Raja ; Iradukunda, Arnaud ; Ismail, Nahlah Elkudssiah ; Iwu, Chidozie CD ; Iwu, Chinwe Juliana ; Merin, Linda J ; Jakovljevic, Mihajlo ; Jamshidi, Elham ; Javaheri, Tahereh ; Javanmardi, Fatemeh ; Javidnia, Javad ; Jayapal, Sathish Kumar ; Jayarajah, Umesh ; Jebai, Rime ; Jha, Ravi Prakash ; Joo, Tamas ; Joseph, Nitin ; Joukar, Farahnaz ; Jozwiak, Jacek Jerzy ; Kacimi, Salah Eddine Oussama ; Kadashetti, Vidya ; Kalankesh, Laleh R ; Kalhor, Rohollah ; Kamal, Vineet Kumar ; Kandel, Himal ; Kapoor, Neeti ; Karkhah, Samad ; Kassa, Bekalu Getnet ; Kassebaum, Nicholas J ; Katoto, Patrick Dmc ; Keykhaei, Mohammad ; Khajuria, Himanshu ; Khan, Abbas ; Khan, Imteyaz A ; Khan, Maseer ; Khan, Md Nuruzzaman ; Khan, Moien AB ; Khatatbeh, Moawiah Mohammad ; Khater, Mona M ; Kashani, Hamid Reza Khayat ; Khubchandani, Jagdish ; Kim, Hanna ; Kim, Min Seo ; Kimokoti, Ruth W ; Kissoon, Niranjan ; Kochhar, Sonali ; Kompani, Farzad ; Kosen, Soewarta ; Koul, Parvaiz A ; Laxminarayana, Sindhura Lakshmi Koulmane ; Lopez, Fiorella Krapp ; Krishan, Kewal ; Krishnamoorthy, Vijay ; Kulkarni, Vishnutheertha ; Kumar, Naveen ; Kurmi, Om P ; Kuttikkattu, Ambily ; Kyu, Hmwe Hmwe ; Lal, Dharmesh Kumar ; Lam, Judit ; Landires, Ivan ; Lasrado, Savita ; Lee, Sang-woong ; Lenzi, Jacopo ; Lewycka, Sonia ; Li, Shanshan ; Lim, Stephen S ; Liu, Wei ; Lodha, Rakesh ; Loftus, Michael J ; Lohiya, Ayush ; Lorenzovici, Laszlo ; Lotfi, Mojgan ; Mahmoodpoor, Ata ; Mahmoud, Mansour Adam ; Mahmoudi, Razzagh ; Majeed, Azeem ; Majidpoor, Jamal ; Makki, Alaa ; Mamo, Galana Ayana ; Manla, Yosef ; Martorell, Miquel ; Matei, Clara N ; McManigal, Barney ; Nasab, Entezar Mehrabi ; Mehrotra, Ravi ; Melese, Addisu ; Mendoza-Cano, Oliver ; Menezes, Ritesh G ; Mentis, Alexios-Fotios A ; Micha, Georgia ; Michalek, Irmina Maria ; de Sa, Ana Carolina Micheletti Gomide Nogueira ; Kostova, Neda Milevska ; Mir, Shabir Ahmad ; Mirghafourvand, Mojgan ; Mirmoeeni, Seyyedmohammadsadeq ; Mirrakhimov, Erkin M ; Mirza-Aghazadeh-Attari, Mohammad ; Misganaw, Abay Sisay ; Misganaw, Awoke ; Misra, Sanjeev ; Mohammadi, Esmaeil ; Mohammadi, Mokhtar ; Mohammadian-Hafshejani, Abdollah ; Mohammed, Shafiu ; Mohan, Syam ; Mohseni, Mohammad ; Mokdad, Ali H ; Momtazmanesh, Sara ; Monasta, Lorenzo ; Moore, Catrin E ; Moradi, Maryam ; Sarabi, Mostafa Moradi ; Morrison, Shane Douglas ; Motaghinejad, Majid ; Isfahani, Haleh Mousavi ; Khaneghah, Amin Mousavi ; Mousavi-Aghdas, Seyed Ali ; Mubarik, Sumaira ; Mulita, Francesk ; Mulu, Getaneh Baye B ; Munro, Sandra B ; Muthupandian, Saravanan ; Nair, Tapas Sadasivan ; Naqvi, Atta Abbas ; Narang, Himanshi ; Natto, Zuhair S ; Naveed, Muhammad ; Nayak, Biswa Prakash ; Naz, Shumaila ; Negoi, Ionut ; Nejadghaderi, Seyed Aria ; Kandel, Sandhya Neupane ; Ngwa, Che Henry ; Niazi, Robina Khan ; de Sa, Antonio Tolentino Nogueira ; Noroozi, Nafise ; Nouraei, Hasti ; Nowroozi, Ali ; Nunez-Samudio, Virginia ; Nutor, Jerry John ; Nzoputam, Chimezie Igwegbe ; Nzoputam, Ogochukwu Janet ; Oancea, Bogdan ; Obaidur, Rahman Md ; Ojha, Vivek Anand ; Okekunle, Akinkunmi Paul ; Okonji, Osaretin Christabel ; Olagunju, Andrew T ; Olusanya, Bolajoko Olubukunola ; Bali, Ahmed Omar ; Omer, Emad ; Otstavnov, Nikita ; Oumer, Bilcha ; Mahesh, PA ; Padubidri, Jagadish Rao ; Pakshir, Keyvan ; Palicz, Tamas ; Pana, Adrian ; Pardhan, Shahina ; Paredes, Jose L ; Parekh, Utsav ; Park, Eun-Cheol ; Park, Seoyeon ; Pathak, Ashish ; Paudel, Rajan ; Paudel, Uttam ; Pawar, Shrikant ; Toroudi, Hamidreza Pazoki ; Peng, Minjin ; Pensato, Umberto ; Pepito, Veincent Christian Filipino ; Pereira, Marcos ; Peres, Mario FP ; Perico, Norberto ; Petcu, Ionela-Roxana ; Piracha, Zahra Zahid ; Podder, Indrashis ; Pokhrel, Nayanum ; Poluru, Ramesh ; Postma, Maarten J ; Pourtaheri, Naeimeh ; Prashant, Akila ; Qattea, Ibrahim ; Rabiee, Mohammad ; Rabiee, Navid ; Radfar, Amir ; Raeghi, Saber ; Rafiei, Sima ; Raghav, Pankaja Raghav ; Rahbarnia, Leila ; Rahimi-Movaghar, Vafa ; Rahman, Mosiur ; Rahman, Muhammad Aziz ; Rahmani, Amir Masoud ; Rahmanian, Vahid ; Ram, Pradhum ; Ranjha, Muhammad Modassar Ali Nawaz ; Rao, Sowmya J ; Rashidi, Mohammad-Mahdi ; Rasul, Azad ; Ratan, Zubair Ahmed ; Rawaf, Salman ; Rawassizadeh, Reza ; Razeghinia, Mohammad Sadegh ; Redwan, Elrashdy Moustafa Mohamed ; Regasa, Misganu Teshoma ; Remuzzi, Giuseppe ; Reta, Melese Abate ; Rezaei, Nazila ; Rezapour, Aziz ; Riad, Abanoub ; Ripon, Rezaul Karim ; Rudd, Kristina E ; Saddik, Basema ; Sadeghian, Saeid ; Saeed, Umar ; Safaei, Mohsen ; Safary, Azam ; Safi, Sher Zaman ; Sahebazzamani, Maryam ; Sahebkar, Amirhossein ; Sahoo, Harihar ; Salahi, Saina ; Salahi, Sarvenaz ; Salari, Hedayat ; Salehi, Sana ; Kafil, Hossein Samadi ; Samy, Abdallah M ; Sanadgol, Nima ; Sankararaman, Senthilkumar ; Sanmarchi, Francesco ; Sathian, Brijesh ; Sawhney, Monika ; Saya, Ganesh Kumar ; Senthilkumaran, Subramanian ; Seylani, Allen ; Shah, Pritik A ; Shaikh, Masood Ali ; Shaker, Elaheh ; Shakhmardanov, Murad Ziyaudinovich ; Sharew, Mequannent Melaku ; Sharifi-Razavi, Athena ; Sharma, Purva ; Sheikhi, Rahim Ali ; Sheikhy, Ali ; Shetty, Pavanchand H ; Shigematsu, Mika ; Shin, Jae Il ; Shirzad-Aski, Hesamaddin ; Shivakumar, KM ; Shobeiri, Parnian ; Shorofi, Seyed Afshin ; Shrestha, Sunil ; Sibhat, Migbar Mekonnen ; Sidemo, Negussie Boti ; Sikder, Mustafa Kamal ; Silva, Luis Manuel Lopes Rodrigues ; Singh, Jasvinder A ; Singh, Paramdeep ; Singh, Surjit ; Siraj, Md Shahjahan ; Siwal, Samarjeet Singh ; Skryabin, Valentin Yurievich ; Skryabina, Anna Aleksandrovna ; Socea, Bogdan ; Solomon, Damtew Damtew ; Song, Yimeng ; Sreeramareddy, Chandrashekhar T ; Suleman, Muhammad ; Abdulkader, Rizwan Suliankatchi ; Sultana, Saima ; Szocska, Miklos ; Tabatabaeizadeh, Seyed-Amir ; Tabish, Mohammad ; Taheri, Majid ; Taki, Elahe ; Tan, Ker-Kan ; Tandukar, Sarmila ; Tat, Nathan Y ; Tat, Vivian Y ; Tefera, Belay Negash ; Tefera, Yibekal Manaye ; Temesgen, Gebremaryam ; Temsah, Mohamad-Hani ; Tharwat, Samar ; Thiyagarajan, Arulmani ; Tleyjeh, Imad I ; Troeger, Christopher E ; Umapathi, Krishna Kishore ; Upadhyay, Era ; Tahbaz, Sahel Valadan ; Valdez, Pascual R ; Van den Eynde, Jef ; van Doorn, H Rogier ; Vaziri, Siavash ; Verras, Georgios-Ioannis ; Viswanathan, Harimadhav ; Vo, Bay ; Waris, Abdul ; Wassie, Gizachew Tadesse ; Wickramasinghe, Nuwan Darshana ; Yaghoubi, Sajad ; Yahya, Gahin Abdulraheem Tayib Yahya ; Jabbari, Seyed Hossein Yahyazadeh ; Yigit, Arzu ; Yigit, Vahit ; Yon, Dong Keon ; Yonemoto, Naohiro ; Zahir, Mazyar ; Zaman, Burhan Abdullah ; Bin Zaman, Sojib ; Zangiabadian, Moein ; Zare, Iman ; Zastrozhin, Mikhail Sergeevich ; Zhang, Zhi-Jiang ; Zheng, Peng ; Zhong, Chenwen ; Zoladl, Mohammad ; Zumla, Alimuddin ; Hay, Simon ; Dolecek, Christiane ; Sartorius, Benn ; Murray, Christopher JL ; Naghavi, Mohsen

Keywords:

Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, STREPTOCOCCUS-PNEUMONIAE, STRATEGIES, VACCINES, SEPSIS, INFECTIONS, GUIDELINES, MANAGEMENT, CHILDREN, HEALTH, IMPACT, Child, Male, Female, Humans, Global Burden of Disease, Syndrome, Africa South of the Sahara, Global Health, Bacterial Infections, Risk Factors, Bacteria, Sepsis, GBD 2019 Antimicrobial Resistance Collaborators, 11 Medical and Health Sciences, 32 Biomedical and clinical sciences, 42 Health sciences

Abstract:

BACKGROUND: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. METHODS: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. FINDINGS: From an estimated 13·7 million (95% UI 10·9-17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7-10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2-18·1) of all global deaths and 56·2% (52·1-60·1) of all sepsis-related deaths in 2019. Five leading pathogens-Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa-were responsible for 54·9% (52·9-56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185-285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4-71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. INTERPRETATION: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. FUNDING: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund.