Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019

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dc.creatorVivek Anand Ojha
dc.creatorAkinkunmi Paul Okekunle
dc.creatorOsaretin Christabel Okonji
dc.creatorAndrew T. Olagunju
dc.creatorAli Ahmed
dc.creatorBolajoko Olubukunola Olusanya
dc.creatorAhmed Omar Bali
dc.creatorEmad Omer
dc.creatorNikita Otstavnov
dc.creatorBilcha Oumer
dc.creatorMahesh P. A.
dc.creatorJagadish Rao Padubidri
dc.creatorKeyvan Pakshir
dc.creatorTamás Palicz
dc.creatorAdrian Pana
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dc.creatorShahina Pardhan
dc.creatorJose L. Paredes
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dc.creatorEun-cheol Park
dc.creatorSeoyeon Park
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dc.date.accessioned2024-09-18T19:54:39Z
dc.date.accessioned2025-09-08T22:49:18Z
dc.date.available2024-09-18T19:54:39Z
dc.date.issued2022
dc.description.abstractContexto: Reduzir a carga de morte devido a infecção é uma prioridade urgente de saúde pública global. Estudos anteriores estimaram o número de mortes associadas a infecções resistentes a medicamentos e sepse e descobriram que as infecções continuam sendo uma das principais causas de morte globalmente. Entender a carga global de patógenos bacterianos comuns (suscetíveis e resistentes a antimicrobianos) é essencial para identificar as maiores ameaças à saúde pública. Até onde sabemos, este é o primeiro estudo a apresentar estimativas globais abrangentes de mortes associadas a 33 patógenos bacterianos em 11 principais síndromes infecciosas. Métodos: Estimamos mortes associadas a 33 gêneros ou espécies bacterianas em 11 síndromes infecciosas em 2019 usando métodos do Estudo de Carga Global de Doenças, Lesões e Fatores de Risco (GBD) 2019, além de um subconjunto dos dados de entrada descritos no estudo de Carga Global de Resistência Antimicrobiana 2019. Este estudo incluiu 343 milhões de registros individuais ou isolados cobrindo 11.361 anos de localização de estudo. Usamos três etapas de modelagem para estimar o número de mortes associadas a cada patógeno: mortes nas quais a infecção teve um papel, a fração de mortes devido à infecção que são atribuíveis a uma determinada síndrome infecciosa e a fração de mortes devido a uma síndrome infecciosa que são atribuíveis a um determinado patógeno. As estimativas foram produzidas para todas as idades e para homens e mulheres em 204 países e territórios em 2019. Intervalos de incerteza (UIs) de 95% foram calculados para estimativas finais de mortes e infecções associadas aos 33 patógenos bacterianos seguindo métodos GBD padrão, tomando os 2,5º e 97,5º percentis em 1000 sorteios posteriores para cada quantidade de interesse. Resultados: De uma estimativa de 13,7 milhões (95% UI 10,9–17,1) de mortes relacionadas à infecção em 2019, houve 7,7 milhões de mortes (5,7–10,2) associadas aos 33 patógenos bacterianos (resistentes e suscetíveis a antimicrobianos) nas 11 síndromes infecciosas estimadas neste estudo. Estimamos que as mortes associadas aos 33 patógenos bacterianos compreendem 13,6% (10,2–18,1) de todas as mortes globais e 56,2% (52,1–60,1) de todas as mortes relacionadas à sepse em 2019. Cinco principais patógenos — Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae e Pseudomonas aeruginosa — foram responsáveis ​​por 54,9% (52,9–56,9) das mortes entre as bactérias investigadas. As síndromes infecciosas e patógenos mais mortais variaram de acordo com a localização e a idade. A taxa de mortalidade padronizada por idade associada a esses patógenos bacterianos foi mais alta na super-região da África Subsaariana, com 230 mortes (185–285) por 100.000 habitantes, e mais baixa na super-região de alta renda, com 52,2 mortes (37,4–71,5) por 100.000 habitantes. S aureus foi a principal causa bacteriana de morte em 135 países e também foi associado à maioria das mortes em indivíduos com mais de 15 anos, globalmente. Entre crianças menores de 5 anos, S pneumoniae foi o patógeno associado à maioria das mortes. Em 2019, mais de 6 milhões de mortes ocorreram como resultado de três síndromes infecciosas bacterianas, com infecções respiratórias inferiores e infecções da corrente sanguínea causando mais de 2 milhões de mortes cada e infecções peritoneais e intra-abdominais causando mais de 1 milhão de mortes. Interpretação: Os 33 patógenos bacterianos que investigamos neste estudo são uma fonte substancial de perda de saúde globalmente, com variação considerável em sua distribuição entre síndromes infecciosas e locais. Comparado com as causas subjacentes de morte de Nível 3 do GBD, as mortes associadas a essas bactérias seriam classificadas como a segunda principal causa de morte globalmente em 2019; portanto, elas devem ser consideradas uma prioridade urgente para intervenção dentro da comunidade global de saúde. As estratégias para lidar com o fardo das infecções bacterianas incluem prevenção de infecções, uso otimizado de antibióticos, capacidade aprimorada de análise microbiológica, desenvolvimento de vacinas e uso aprimorado e mais difundido das vacinas disponíveis. Essas estimativas podem ser usadas para ajudar a definir prioridades para necessidade, demanda e desenvolvimento de vacinas.
dc.format.mimetypepdf
dc.identifier.issn01406736
dc.identifier.urihttps://hdl.handle.net/1843/76646
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofThe Lancet
dc.rightsAcesso Aberto
dc.subjectMortalidade
dc.subjectBactérias Patogênicas
dc.subjectInfectologia
dc.subjectSaúde Pública
dc.subject.otherMortality
dc.subject.otherPathogenic microorganisms
dc.subject.otherInfectology
dc.subject.otherPublic Health
dc.titleGlobal mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
dc.title.alternativeMortalidade global associada a 33 patógenos bacterianos em 2019: uma análise sistemática para o Estudo de Carga Global de Doenças 2019
dc.typeArtigo de periódico
local.citation.epage2248
local.citation.issue10369
local.citation.spage2221
local.citation.volume400
local.description.resumoBackground: 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 11361 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 100000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100000 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.
local.publisher.countryBrasil
local.publisher.departmentDAT - DEPARTAMENTO DE ATENCAO SAUDE TRABALHADOR
local.publisher.initialsUFMG
local.url.externahttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02185-7/fulltext

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