Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Issue 10369 (17th December 2022)

• Record Type: Journal Article
• Authors: 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, Fares; 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 Cyrus; El-Abid, Hassan; Elhadi, Muhammed; Elmonem, Mohamed A; Emami, Amir; Engelbert Bain, Luchuo; Enyew, Daniel Berhanie; Erkhembayar, Ryenchindorj; Eshrati, Babak; Etaee, Farshid; Fagbamigbe, Adeniyi Francis; Falahi, Shahab; Fallahzadeh, Aida; Faraon, Emerito Jose A; Fatehizadeh, Ali; Fekadu, Ginenus; Fernandes, João C; Ferrari, Allegra; Fetensa, Getahun; Filip, Irina; Fischer, Florian; Foroutan, Masoud; Gaal, Peter Andras; 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 Das; Gupta, Sapna; Gupta, Veer Bala; Gupta, Vivek Kumar; Guta, Alemu; Habibzadeh, Parham; Haddadi Avval, Atlas; 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, Tamas; 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, Abbas; 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 Douglas; 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 Abbas; 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, Tamás; 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, Marcos; Peres, Mario F P; Perico, Norberto; Petcu, Ionela-Roxana; Piracha, Zahra Zahid; Podder, Indrashis; 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 Rodrigues; 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, Miklós; 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-Ioannis; 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; Naghavi, Mohsen;
• Is Part Of: Lancet. Volume 400:Issue 10369(2022)
• Page Start: 2221
• Page End: 2248
• Publication Date: 2022-12-17
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(22)02185-7
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: 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.