1808. Burden of infectious diseases and bacterial antimicrobial resistance in China, 2019: a systematic analysis

BACKGROUND: Whether on a global scale or within China, the issue of bacterial antimicrobial resistance (AMR) has become a pressing concern. This study aimed to comprehensively investigate the disease burden of infectious diseases and AMR in China. METHODS: Data on infectious diseases and AMR were collected by the Global Antimicrobial Resistance Burden study 2019 database. Our analysis steps consisted of 5 broad components: estimating the disease burdens of the total and 12 infectious syndromes by age and sex; describing the burden caused by 43 pathogens; calculating the burden caused by bacterial AMR in two scenarios (AMR associated deaths, AMR attributable deaths), respectively; estimating the AMR burden of 22 bacteria; calculating the burden of AMR by 22 bacteria and 19 antibiotics combinations. RESULTS: In 2019, there were an estimated 1.3 million (95% UI 0.8-1.9) infection-related deaths in China, accounting for 12.1% of the total deaths for that year. Males were 1.5 times more affected than females. Bloodstream infections was the largest fatal burden syndrome, associating with 521392 deaths (286307-870583), followed by lower respiratory infections (373175 deaths), and peritoneal and intra-abdominal infections (152087 deaths). These five leading pathogens were S aureus, A baumannii, E coli, S pneumoniae, and E spp., which were associated with 41.2% (502658/1218693) of all infection-related deaths. The pathogens of different infectious syndromes exhibit significant heterogeneity. In 2019, 602561 deaths were associated with bacterial AMR, including 145465 deaths attributable to bacterial AMR. Six leading pathogen-drug combinations were responsible for more than 0.5 million deaths in 2019: macrolides resistance S aureus, fourth-generation cephalosporins resistance A baumannii, carbapenems resistance A baumannii, third-generation cephalosporins resistance A baumannii, aminopenicillin resistance E coli, macrolides resistance S pneumoniae. [Figure: see text] [Figure: see text] CONCLUSION: This study provides the comprehensive assessment of the burden of infectious diseases and bacterial AMR in China. The annual death toll of 1.3 million infection-related deaths, including 600000 deaths related to antibiotic resistance, requires sufficient attention. DISCLOSURES: All Authors: No reported disclosures