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Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019

Background: There are still no detailed data about the burden of bacterial antimicrobial resistance (AMR) in urinary tract infections (UTI). Concrete knowledge of global and regional bacterial AMR data is crucial for developing informed programs and policies to control bacterial AMR and for prudent...

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Autores principales: Li, Xuhui, Fan, Hua, Zi, Hao, Hu, Hankun, Li, Binghui, Huang, Jiao, Luo, Pengcheng, Zeng, Xiantao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147874/
https://www.ncbi.nlm.nih.gov/pubmed/35628941
http://dx.doi.org/10.3390/jcm11102817
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author Li, Xuhui
Fan, Hua
Zi, Hao
Hu, Hankun
Li, Binghui
Huang, Jiao
Luo, Pengcheng
Zeng, Xiantao
author_facet Li, Xuhui
Fan, Hua
Zi, Hao
Hu, Hankun
Li, Binghui
Huang, Jiao
Luo, Pengcheng
Zeng, Xiantao
author_sort Li, Xuhui
collection PubMed
description Background: There are still no detailed data about the burden of bacterial antimicrobial resistance (AMR) in urinary tract infections (UTI). Concrete knowledge of global and regional bacterial AMR data is crucial for developing informed programs and policies to control bacterial AMR and for prudent use of antibiotics to optimize antibiotic therapy in patients with UTI. This study aimed to provide comprehensive global and regional estimates for the AMR burden of UTI in 2019. Methods: Data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), including death, disability-adjusted life-years (DALYs), year lived with disability (YLD), and years of life lost (YLL) for bacterial AMR in UTI for 7 GBD super-regions, 21 regions, 14 pathogens, 13 antibiotic classes, and 66 pathogen-antibiotic combinations in 2019. The estimates were based on two counterfactual scenarios: drug-susceptible infection and no infection. Results: Globally, there were 64.89 thousand deaths (95% uncertainty interval [UI]: 45.86–93.35) attributed to and 0.26 million deaths (95% UI: 0.18–0.36) associated with bacterial AMR in UTI in 2019. Among regions, the all-age death rates were higher in southern Latin America, tropical Latin America, and Europe and lower in sub-Saharan Africa. Escherichia coli and Klebsiella pneumoniae accounted for more than 50% of deaths attributable to and associated with AMR, and resistance was high among multiple types of antibiotic class, including fluoroquinolones, carbapenems, and third-generation cephalosporins. There were 2 pathogen-drug combinations that caused more than 6000 resistance-attributable deaths: third-generation cephalosporin-resistant Escherichia coli and fluoroquinolone-resistant Escherichia coli. Conclusions: AMR in UTI is an unignorable health problem, both for the management of urology disease and for global antibiotic resistance. Special tailored strategies, including enhanced surveillance and rational use of antibiotics, should be developed for different regions according to the region-specific pathogen-antibiotic situations and resources.
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spelling pubmed-91478742022-05-29 Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019 Li, Xuhui Fan, Hua Zi, Hao Hu, Hankun Li, Binghui Huang, Jiao Luo, Pengcheng Zeng, Xiantao J Clin Med Article Background: There are still no detailed data about the burden of bacterial antimicrobial resistance (AMR) in urinary tract infections (UTI). Concrete knowledge of global and regional bacterial AMR data is crucial for developing informed programs and policies to control bacterial AMR and for prudent use of antibiotics to optimize antibiotic therapy in patients with UTI. This study aimed to provide comprehensive global and regional estimates for the AMR burden of UTI in 2019. Methods: Data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), including death, disability-adjusted life-years (DALYs), year lived with disability (YLD), and years of life lost (YLL) for bacterial AMR in UTI for 7 GBD super-regions, 21 regions, 14 pathogens, 13 antibiotic classes, and 66 pathogen-antibiotic combinations in 2019. The estimates were based on two counterfactual scenarios: drug-susceptible infection and no infection. Results: Globally, there were 64.89 thousand deaths (95% uncertainty interval [UI]: 45.86–93.35) attributed to and 0.26 million deaths (95% UI: 0.18–0.36) associated with bacterial AMR in UTI in 2019. Among regions, the all-age death rates were higher in southern Latin America, tropical Latin America, and Europe and lower in sub-Saharan Africa. Escherichia coli and Klebsiella pneumoniae accounted for more than 50% of deaths attributable to and associated with AMR, and resistance was high among multiple types of antibiotic class, including fluoroquinolones, carbapenems, and third-generation cephalosporins. There were 2 pathogen-drug combinations that caused more than 6000 resistance-attributable deaths: third-generation cephalosporin-resistant Escherichia coli and fluoroquinolone-resistant Escherichia coli. Conclusions: AMR in UTI is an unignorable health problem, both for the management of urology disease and for global antibiotic resistance. Special tailored strategies, including enhanced surveillance and rational use of antibiotics, should be developed for different regions according to the region-specific pathogen-antibiotic situations and resources. MDPI 2022-05-17 /pmc/articles/PMC9147874/ /pubmed/35628941 http://dx.doi.org/10.3390/jcm11102817 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Li, Xuhui
Fan, Hua
Zi, Hao
Hu, Hankun
Li, Binghui
Huang, Jiao
Luo, Pengcheng
Zeng, Xiantao
Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019
title Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019
title_full Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019
title_fullStr Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019
title_full_unstemmed Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019
title_short Global and Regional Burden of Bacterial Antimicrobial Resistance in Urinary Tract Infections in 2019
title_sort global and regional burden of bacterial antimicrobial resistance in urinary tract infections in 2019
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147874/
https://www.ncbi.nlm.nih.gov/pubmed/35628941
http://dx.doi.org/10.3390/jcm11102817
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