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Kevin Shunji Ikuta, Lucien R Swetschinski, Gisela Robles Aguilar, Fablina Sharara, Tomislav Meštrović, Authia P Gray, Nicole Davis Weaver, Eve E Wool, Chieh Han, Anna Gershberg Hayoon and 555 more
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.
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Ikuta, K. S., Swetschinski, L. R., Aguilar, G. R., Sharara, F., Meštrović, T., Gray, A. P., Weaver, N. D., Wool, E. E., Han, C., Hayoon, A. G., Aali, A., Abate, S. M., Abbasi‐Kangevari, M., Abbasi-Kangevari, Z., Abd-Elsalam, S. M., Abebe, G., Abedi, A., Abhari, A. P., Abidi, H., … Naghavi, M. (2022). Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 400(10369), 2221–2248. https://doi.org/10.1016/s0140-6736(22)02185-7
Ikuta, Kevin Shunji, et al. "Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019." The Lancet, vol. 400, no. 10369, 2022, pp. 2221–2248, https://doi.org/10.1016/s0140-6736(22)02185-7.
Ikuta, Kevin Shunji, Lucien R Swetschinski, Gisela Robles Aguilar, Fablina Sharara, Tomislav Meštrović, Authia P Gray, Nicole Davis Weaver, et al. "Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019." The Lancet 400, no. 10369 (2022): 2221–2248. https://doi.org/10.1016/s0140-6736(22)02185-7.
Ikuta K. S., Swetschinski L. R., Aguilar G. R. [и др.] Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019 // The Lancet. — 2022. — Vol. 400, № 10369. — P. 2221–2248. — URL: https://doi.org/10.1016/s0140-6736(22)02185-7
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title = {{Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019}},
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journal = {The Lancet},
year = {2022},
volume = {400},
number = {10369},
pages = {2221--2248},
doi = {10.1016/s0140-6736(22)02185-7},
url = {https://doi.org/10.1016/s0140-6736(22)02185-7}
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AU - Chowdhury, Fazle Rabbi AU - Chu, Dinh‐Toi AU - Chukwu, Isaac Sunday AU - Dadras, Omid AU - Dagnaw, Fentaw Teshome AU - Dai, Xiaochen AU - Das, Saswati AU - Dastiridou, Anna AU - Debela, Sisay Abebe AU - Demisse, Fitsum Wolde AU - Demissie, Solomon AU - Dereje, Diriba AU - Derese, Msganaw AU - Desai, Hardik Dineshbhai AU - Dessalegn, Fikadu Nugusu AU - Dessalegni, Samuel Abebe A AU - Desye, Belay AU - Dhaduk, Kartik AU - Dhimal, Meghnath AU - Dhingra, Sameer AU - Diao, Nancy AU - Díaz, Daniel AU - Djalalinia, Shirin AU - Dodangeh, Milad AU - Dongarwar, Deepa AU - Dora, Bezabih Terefe AU - Dorostkar, Fariba AU - Dsouza, Haneil Larson AU - Dubljanin, Eleonora AU - Dunachie, Susanna Jane AU - Durojaiye, Oyewole Christopher AU - Edinur, Hisham Atan AU - Bekele, Habtamu AU - Ekholuenetale, Michael AU - Ekundayo, Temitope Cyrus AU - El‐Abid, Hassan AU - Elhadi, Muhammed AU - Elmonem, Mohamed A. AU - Emami, Amir AU - Bain, Luchuo Engelbert AU - Enyew, Daniel Berhanie AU - Erkhembayar, Ryenchindorj AU - Eshrati, Babak AU - Etaee, Farshid AU - Fagbamigbe, Adeniyi Francis AU - Falahi, Shahab AU - Fallahzadeh, Aida AU - Faraon, Emerito Jose A AU - Fatehizadeh, Ali AU - Fekadu, Ginenus AU - Fernandes, João Carlos AU - Ferrari, Allegra AU - Fetensa, Getahun AU - Filip, Irina AU - Fischer, Florian AU - Foroutan, Masoud AU - Gaál, Péter AU - Gadanya, Muktar A AU - Gaidhane, Abhay Motiramji AU - Ganesan, Balasankar AU - Gebrehiwot, Mesfin AU - Ghanbari, Reza AU - Nour, Mohammad Ghasemi AU - Ghashghaee, Ahmad AU - Gholamrezanezhad, Ali AU - Gholizadeh, Abdolmajid AU - Golechha, Mahaveer AU - Goleij, Pouya AU - Golinelli, Davide AU - Goodridge, Amador AU - Gunawardane, Damitha Asanga AU - Guo, Yuming AU - Gupta, Rajat Das AU - Gupta, Sapna AU - Gupta, Veer Bala AU - Gupta, Vivek AU - Guta, Alemu AU - Habibzadeh, Parham AU - Avval, Atlas Haddadi AU - Halwani, Rabih AU - Hanif, Asif AU - Hasan, Md. Mehedi AU - Harapan, Harapan AU - Hassan, Shoaib AU - Hassankhani, Hadi AU - Hayat, Khezar AU - Heibati, Behzad AU - Heidari, Golnaz AU - Heidari, Mohammad AU - Heidari‐Soureshjani, Reza AU - Herţeliu, Claudiu AU - Heyi, Demisu Zenbaba AU - Hezam, Kamal AU - Hoogar, Praveen AU - Horita, Nobuyuki AU - Hossain, Md Mahbub AU - Hosseinzadeh, Mehdi AU - Hostiuc, Mihaela AU - Hostiuc, Sorin AU - Hoveidamanesh, Soodabeh AU - Huang, Junjie AU - Hussain, Salman AU - Hussein, Nawfal Rasheed AU - Ibitoye, Segun Emmanuel AU - Ilesanmi, Olayinka Stephen AU - Ilić, Irena AU - Ilić, Milena AU - Imam, Mohammad Tarique AU - Immurana, Mustapha AU - Inbaraj, Leeberk Raja AU - Iradukunda, Arnaud AU - Ismail, Nahlah Elkudssiah AU - Iwu, Chidozie C D AU - Iwu, Chinwe Juliana AU - J, Linda Merin AU - Jakovljević, Mihajlo AU - Jamshidi, Elham AU - Javaheri, Tahereh AU - Javanmardi, Fatemeh AU - Javidnia, Javad AU - Jayapal, Sathish Kumar AU - Jayarajah, Umesh AU - Jebai, Rime AU - Jha, Ravi Prakash AU - Joó, Tamás AU - Joseph, Nitin AU - Joukar, Farahnaz AU - Jozwiak, Jacek Jerzy AU - Kacimi, Salah Eddine Oussama AU - Kadashetti, Vidya AU - Kalankesh, Laleh Ranandeh AU - Kalhor, Rohollah AU - Kamal, Vineet Kumar AU - Kandel, Himal AU - Kapoor, Neeti AU - Karkhah, Samad AU - Kassa, Bekalu Getnet AU - Kassebaum, Nicholas J AU - Katoto, Patrick DMC AU - Keykhaei, Mohammad AU - Khajuria, Himanshu AU - Khan, Abbas AU - Khan, Imteyaz Ahmad AU - Khan, Maseer AU - Khan, Md Nuruzzaman AU - Khan, Moien AB AU - Khatatbeh, Moawiah Mohammad AU - Khater, Mona M AU - Kashani, Hamid Reza Khayat AU - Khubchandani, Jagdish AU - Kim, Han‐Na AU - Kim, Min Seo AU - Kimokoti, Ruth W AU - Kissoon, Niranjan “Tex” AU - Kochhar, Sonali AU - Kompani, Farzad AU - Kosen, Soewarta AU - Koul, Parvaiz Ahmad AU - Laxminarayana, Sindhura Lakshmi Koulmane AU - Krapp, Fiorella AU - Krishan, Kewal AU - Krishnamoorthy, Vijay AU - Kulkarni, Vishnutheertha AU - Kumar, Naveen AU - Kurmi, Om AU - Kuttikkattu, Ambily AU - Kyu, Hmwe Hmwe AU - Lal, Dharmesh Kumar AU - Lám, Judit AU - Landires, Iván AU - Lasrado, Savita AU - Lee, Sang-woong AU - Lenzi, Jacopo AU - Lewycka, Sonia Odette AU - Li, Shanshan AU - Lim, Stephen S AU - Liu, Wei Yong AU - Lodha, Rakesh AU - Loftus, Michael J. 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AU - Murray, Christopher J L AU - Naghavi, Mohsen TI - Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019 JO - The Lancet VL - 400 IS - 10369 SP - 2221 EP - 2248 PY - 2022 DA - 2022/11/21 DO - 10.1016/s0140-6736(22)02185-7 UR - https://doi.org/10.1016/s0140-6736(22)02185-7 ER -
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