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1. Using priorities between human and livestock bacterial antimicrobial resistance (AMR) to identify data gaps in livestock AMR surveillance

Author

Narmada Venkateswaran, Lucien R. Swetschinski, Christina Fastl, Carlotta Di Bari, Nicola G. Criscuolo, Ranya Mulchandani, Cheng Zhao, Tomislav Meštrović, Kevin S. Ikuta, Sara Babo Martins, Lucy A. Coyne, João Sucena Afonso, Ben Huntington, Jonathan Rushton, Brecht Devleesschauwer, Benn Sartorius, Thomas P. Van Boeckel, and David M. Pigott

Subjects
Antimicrobial resistance, Data gaps, Surveillance, Livestock, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Bacterial antimicrobial resistance (AMR) is a global threat to both humans and livestock. Despite this, there is limited global consensus on data-informed, priority areas for intervention in both sectors. We compare current livestock AMR data collection efforts with other variables pertinent to human and livestock AMR to identify critical data gaps and mutual priorities. Methods We globally synthesized livestock AMR data from open-source surveillance reports and point prevalence surveys stratified for six pathogens (Escherichia coli, Staphylococcus aureus, non-typhoidal Salmonella, Campylobacter spp., Enterococcus faecalis, Enterococcus faecium) and eleven antimicrobial classes important in human and veterinary use, published between 2000 and 2020. We also included all livestock species represented in the data: cattle, chickens, pigs, sheep, turkeys, ducks, horses, buffaloes, and goats. We compared this data with intended priorities calculated from: disability-adjusted life years (DALYs), livestock antimicrobial usage (AMU), livestock biomass, and a global correlation exercise between livestock and human proportion of resistant isolates. Results Resistance to fluoroquinolones and macrolides in Staphylococcus aureus were identified as priorities in many countries but, less than 10% of these reported livestock AMR data. Resistance data for Escherichia coli specific to cattle, chickens, and pigs, which we prioritized, were also well collected. AMR data collection on non-typhoidal Salmonella and other livestock species were often not prioritized. Of 232 categories prioritized by at least one country, data were only collected for 48% (n = 112). Conclusions The lack of livestock AMR data globally for broad resistance in Staphylococcus aureus could underplay their zoonotic threat. Countries can bolster livestock AMR data collection, reporting, and intervention setting for Staphylococcus aureus as done for Escherichia coli. This framework can provide guidance on areas to strengthen AMR surveillance and decision-making for humans and livestock, and if done routinely, can adapt to resistance trends and priorities.

Published
2024
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2. Global mortality associated with 33 bacterial pathogens in 2019

Author

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

Subjects
Male, Bacteria, Syndrome, Bacterial Infections, General Medicine, Global Health, Global Burden of Disease, Risk Factors, Sepsis, Humans, Female, Mortality, Child, Africa South of the Sahara
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.

Published
2022

4. The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis

Author

Tomislav Mestrovic, Gisela Robles Aguilar, Lucien R Swetschinski, Kevin S Ikuta, Authia P Gray, Nicole Davis Weaver, Chieh Han, Eve E Wool, Anna Gershberg Hayoon, Simon I Hay, Christiane Dolecek, Benn Sartorius, Christopher J L Murray, Isaac Yeboah Addo, Bright Opoku Ahinkorah, Ayman Ahmed, Mamoon A Aldeyab, Kasim Allel, Robert Ancuceanu, Anayochukwu Edward Anyasodor, Marcel Ausloos, Fabio Barra, Akshaya Srikanth Bhagavathula, Dinesh Bhandari, Sonu Bhaskar, Natália Cruz-Martins, Anna Dastiridou, Klara Dokova, Eleonora Dubljanin, Oyewole Christopher Durojaiye, Adeniyi Francis Fagbamigbe, Simone Ferrero, Peter Andras Gaal, Veer Bala Gupta, Vijai Kumar Gupta, Vivek Kumar Gupta, Claudiu Herteliu, Salman Hussain, Irena M Ilic, Milena D Ilic, Elham Jamshidi, Tamas Joo, André Karch, Adnan Kisa, Sezer Kisa, Tomislav Kostyanev, Hmwe Hmwe Kyu, Judit Lám, Graciliana Lopes, Alexander G Mathioudakis, Alexios-Fotios A Mentis, Irmina Maria Michalek, Mohammad Ali Moni, Catrin E Moore, Francesk Mulita, Ionut Negoi, Ruxandra Irina Negoi, Tamás Palicz, Adrian Pana, João Perdigão, Ionela-Roxana Petcu, Navid Rabiee, David Laith Rawaf, Salman Rawaf, Murad Ziyaudinovich Shakhmardanov, Aziz Sheikh, Luís Manuel Lopes Rodrigues Silva, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Andy Stergachis, Temenuga Zhekova Stoeva, Chandra Datta Sumi, Arulmani Thiyagarajan, Marcos Roberto Tovani-Palone, Metin Yesiltepe, Sojib Bin Zaman, Mohsen Naghavi, University of St Andrews. School of Medicine, University of St Andrews. Population and Behavioural Science Division, and Collaborators, European Antimicrobial Resistance

Subjects
MCC, Methicillin-Resistant Staphylococcus aureus, RM, Public Health, Environmental and Occupational Health, 3rd-DAS, World Health Organization, RM Therapeutics. Pharmacology, Anti-Bacterial Agents, SDG 3 - Good Health and Well-being, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Drug Resistance, Bacterial, Escherichia coli, Humans
Abstract

Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund. Background Antimicrobial resistance (AMR) represents one of the most crucial threats to public health and modern health care. Previous studies have identified challenges with estimating the magnitude of the problem and its downstream effect on human health and mortality. To our knowledge, this study presents the most comprehensive set of regional and country-level estimates of AMR burden in the WHO European region to date. Methods We estimated deaths and disability-adjusted life-years attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen–drug combinations for the WHO European region and its countries in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). Data were solicited from a wide array of international stakeholders; these included research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. Findings We estimated 541 000 deaths (95% UI 370 000–763 000) associated with bacterial AMR and 133 000 deaths (90 100–188 000) attributable to bacterial AMR in the whole WHO European region in 2019. The largest fatal burden of AMR in the region came from bloodstream infections, with 195 000 deaths (104 000–333 000) associated with resistance, followed by intra-abdominal infections (127 000 deaths [81 900–185 000]) and respiratory infections (120 000 deaths [94 500–154 000]). Seven leading pathogens were responsible for about 457 000 deaths associated with resistance in 53 countries of this region; these pathogens were, in descending order of mortality, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae, and Acinetobacter baumannii. Methicillin-resistant S aureus was shown to be the leading pathogen–drug combination in 27 countries for deaths attributable to AMR, while aminopenicillin-resistant E coli predominated in 47 countries for deaths associated with AMR. Interpretation The high levels of resistance for several important bacterial pathogens and pathogen–drug combinations, together with the high mortality rates associated with these pathogens, show that AMR is a serious threat to public health in the WHO European region. Our regional and cross-country analyses open the door for strategies that can be tailored to leading pathogen–drug combinations and the available resources in a specific location. These results underscore that the most effective way to tackle AMR in this region will require targeted efforts and investments in conjunction with continuous outcome-based research endeavours. Publisher PDF

Published
2022

5. Health Toll From Open Flame and Cigarette-Started Fires on Flame-Retardant Furniture in Massachusetts, 2003-2016.

Author

Rodgers KM, Swetschinski LR, Dodson RE, Alpert HR, Fleming JM, and Rudel RA

Subjects
Burns etiology, Burns mortality, Humans, Massachusetts epidemiology, Risk Assessment, Tobacco Products, Fires statistics & numerical data, Flame Retardants, Interior Design and Furnishings statistics & numerical data
Abstract

Objectives. To evaluate the risk of death and injury in residential fires started on upholstered furniture, with a focus on open flame and cigarette-related heat sources. Methods. We used civilian death and injury data from 34 081 residential fires in the Massachusetts Fire Incident Reporting System from 2003 to 2016. We compared outcomes associated with fires that started on upholstered furniture ignited by smoking materials versus open flames. Results. Although fires starting on upholstered furniture were not common (2.2% of total fires), odds of death and injury were significantly higher in these fires than in fires started on other substrates. Among furniture fires, odds of death were 3 times greater when those fires were ignited by smoking materials than when ignited by open flames (odds ratio = 3.4; 95% confidence interval = 1.3, 10.9). Conclusions. Furniture fires started by smoking materials were associated with more deaths than were furniture fires started by open flames. Public Health Implications. Historically, furniture flammability regulations have focused on open flame heat sources, resulting in the addition of toxic flame retardants to furniture. Interventions to reduce deaths should instead focus on smoking materials.

Published
2019
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