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Global Mortality Associated With 33 Bacterial Pathogens in 2019: A Systematic Analysis for the Global Burden of Disease Study 2019 Publisher Pubmed



Ikuta KS1, 2 ; Swetschinski LR2 ; Aguilar GR8 ; Sharara F11 ; Mestrovic T2, 12 ; Gray AP2 ; Weaver ND2 ; Wool EE2 ; Han C2 ; Hayoon AG2 ; Aali A13 ; Abate SM18 ; Abbasikangevari M19, 31 ; Abbasikangevari Z19, 31 Show All Authors
Authors
  1. Ikuta KS1, 2
  2. Swetschinski LR2
  3. Aguilar GR8
  4. Sharara F11
  5. Mestrovic T2, 12
  6. Gray AP2
  7. Weaver ND2
  8. Wool EE2
  9. Han C2
  10. Hayoon AG2
  11. Aali A13
  12. Abate SM18
  13. Abbasikangevari M19, 31
  14. Abbasikangevari Z19, 31
  15. Abdelsalam S39
  16. Abebe G40
  17. Abedi A44, 45
  18. Abhari AP48
  19. Abidi H51
  20. Aboagye RG53
  21. Absalan A54, 55
  22. Ali HA56, 57
  23. Acuna JM58, 59
  24. Adane TD61
  25. Addo IY64, 65
  26. Adegboye OA66
  27. Adnan M67
  28. Adnani QES68
  29. Afzal MS69
  30. Afzal S70, 71
  31. Aghdam ZB72
  32. Ahinkorah BO83
  33. Ahmad A84
  34. Ahmad AR26, 85
  35. Ahmad R86
  36. Ahmad S87
  37. Ahmad S87
  38. Ahmadi S32
  39. Ahmed A92, 93
  40. Ahmed H94, 95
  41. Ahmed JQ91, 94
  42. Rashid TA97
  43. Ajami M98, 99
  44. Aji B100
  45. Akbarzadehkhiavi M73, 178
  46. Akunna CJ101, 102
  47. Hamad HA103, 104
  48. Alahdab F105
  49. Alaly Z106, 108
  50. Aldeyab MA109, 202
  51. Aleman AV110
  52. Alhalaiqa FAN111, 112
  53. Alhassan RK113
  54. Ali BA114
  55. Ali L115
  56. Ali SS116
  57. Alimohamadi Y20, 118
  58. Alipour V119, 120
  59. Alizadeh A29
  60. Aljunid SM129, 130
  61. Allel K131, 133
  62. Almustanyir S135, 136
  63. Ameyaw EK137
  64. Amit AML138
  65. Anandavelane N140
  66. Ancuceanu R145
  67. Andrei CL146
  68. Andrei T151, 240
  69. Anggraini D152, 153
  70. Ansar A154, 156
  71. Anyasodor AE157, 285
  72. Arabloo J119
  73. Aravkin AY2, 3
  74. Areda D158, 159
  75. Aripov T160, 161
  76. Artamonov AA162, 342
  77. Arulappan J163
  78. Aruleba RT164
  79. Asaduzzaman M165
  80. Ashraf T166
  81. Athari SS168
  82. Atlaw D169
  83. Attia S171
  84. Ausloos M151, 172
  85. Awoke T173, 355
  86. Quintanilla BPA155, 175
  87. Ayana TM41
  88. Azadnajafabad S19
  89. Jafari AA176
  90. Darshan B177
  91. Badar M181
  92. Badiye AD182
  93. Baghcheghi N183
  94. Bagherieh S48
  95. Baig AA184
  96. Banerjee I185
  97. Barac A186, 187
  98. Bardhan M189, 190
  99. Baroneadesi F193, 376, 377
  100. Barqawi HJ194, 379, 381
  101. Barrow A198, 199
  102. Baskaran P141, 408
  103. Basu S200, 409
  104. Batiha AMM111
  105. Bedi N201, 203
  106. Belete MA204
  107. Belgaumi UI206
  108. Bender RG2
  109. Bhandari B208
  110. Bhandari D209, 210
  111. Bhardwaj P141, 142
  112. Bhaskar S213, 214
  113. Bhattacharyya K215, 216
  114. Bhattarai S132, 217
  115. Bitaraf S218, 410
  116. Buonsenso D219, 220
  117. Butt ZA221, 222
  118. Dos Santos FLC223, 411
  119. Cai J224
  120. Calina D225
  121. Camargos P225, 230
  122. Camera LA226, 229
  123. Cardenas R227, 228
  124. Cevik M231, 233
  125. Chadwick J234, 417
  126. Charan J143
  127. Chaurasia A236
  128. Ching PR107
  129. Choudhari SG237
  130. Chowdhury EK238, 239
  131. Chowdhury FR243
  132. Chu DT244
  133. Chukwu IS245
  134. Dadras O246, 247
  135. Dagnaw FT250
  136. Dai X251
  137. Das S252, 443
  138. Dastiridou A253, 254
  139. Debela SA256
  140. Demisse FW42
  141. Demissie S43
  142. Dereje D257
  143. Derese M258
  144. Desai HD259
  145. Dessalegn FN42, 260
  146. Dessalegni SAA42
  147. Desye B261, 510
  148. Dhaduk K262
  149. Dhimal M263
  150. Dhingra S266
  151. Diao N267
  152. Diaz D269, 270
  153. Djalalinia S271
  154. Dodangeh M121, 577
  155. Dongarwar D272
  156. Dora BT42
  157. Dorostkar F122
  158. Dsouza HL177, 273
  159. Dubljanin E188
  160. Dunachie SJ9, 275
  161. Durojaiye OC276, 595
  162. Edinur HA277
  163. Ejigu HB278
  164. Ekholuenetale M282, 283
  165. Ekundayo TC286
  166. Elabid H287
  167. Elhadi M288
  168. Elmonem MA289
  169. Emami A290
  170. Bain LE293
  171. Enyew DB279
  172. Erkhembayar R294
  173. Eshrati B123
  174. Etaee F295
  175. Fagbamigbe AF232, 282
  176. Falahi S298
  177. Fallahzadeh A21, 299
  178. Faraon EJA303
  179. Fatehizadeh A49
  180. Fekadu G304, 306
  181. Fernandes JC309
  182. Ferrari A310
  183. Fetensa G307
  184. Filip I311, 312
  185. Fischer F313
  186. Foroutan M314, 315
  187. Gaal PA316, 318
  188. Gadanya MA319, 320
  189. Gaidhane AM237
  190. Ganesan B321, 322
  191. Gebrehiwot M205
  192. Ghanbari R323
  193. Nour MG14
  194. Ghashghaee A324
  195. Gholamrezanezhad A46
  196. Gholizadeh A329
  197. Golechha M330
  198. Goleij P331
  199. Golinelli D332
  200. Goodridge A333
  201. Gunawardane DA334
  202. Guo Y335
  203. Gupta RD336, 337
  204. Gupta S338
  205. Gupta VB339
  206. Gupta VK340
  207. Guta A341
  208. Habibzadeh P291
  209. Avval AH15
  210. Halwani R194, 195
  211. Hanif A167
  212. Hannan MA343, 344
  213. Harapan H345
  214. Hassan S248, 249
  215. Hassankhani H74, 346
  216. Hayat K347, 348
  217. Heibati B349
  218. Heidari G30, 350, 351
  219. Heidari M352
  220. Heidarisoureshjani R30
  221. Herteliu C151, 354
  222. Heyi DZ353
  223. Hezam K356, 357
  224. Hoogar P179
  225. Horita N358, 359
  226. Hossain MM360, 361
  227. Hosseinzadeh M362
  228. Hostiuc M147
  229. Hostiuc S148, 363
  230. Hoveidamanesh S364
  231. Huang J305
  232. Hussain S365, 366
  233. Hussein NR369
  234. Ibitoye SE283
  235. Ilesanmi OS284, 370
  236. Ilic IM187
  237. Ilic MD371
  238. Imam MT372
  239. Immurana M113
  240. Inbaraj LR373
  241. Iradukunda A374, 375
  242. Ismail NE181, 386
  243. Iwu CCD387
  244. Iwu CJ388
  245. Linda MJ388
  246. Jakovljevic M382, 383
  247. Jamshidi E33, 384
  248. Javaheri T385
  249. Javanmardi F290
  250. Javidnia J387
  251. Jayapal SK390
  252. Jayarajah U391, 392
  253. Jebai R60
  254. Jha RP393, 394
  255. Joo T316, 395
  256. Joseph N274
  257. Joukar F396, 397
  258. Jozwiak JJ399
  259. Kacimi SEO400
  260. Kadashetti V206
  261. Kalankesh LR401
  262. Kalhor R325, 326
  263. Kamal VK191, 235
  264. Kandel H403, 404
  265. Kapoor N182
  266. Karkhah S398
  267. Kassa BG251
  268. Kassebaum NJ2, 4, 5
  269. Katoto PDMC380, 405
  270. Keykhaei M19, 22
  271. Khajuria H406
  272. Khan A2
  273. Khan IA34
  274. Khan M19
  275. Khan MN22
  276. Khan MAB404
  277. Khatatbeh MM407
  278. Khater MM413
  279. Kashani HRK43, 412
  280. Khubchandani J414
  281. Kim H415
  282. Kim MS416
  283. Kimokoti RW418
  284. Kissoon N419
  285. Kochhar S6, 420
  286. Kompani F23
  287. Kosen S421
  288. Koul PA422
  289. Laxminarayana SLK423
  290. Lopez FK424, 426
  291. Krishan K427
  292. Krishnamoorthy V5, 428
  293. Kulkarni V429
  294. Kumar N430
  295. Kurmi OP431, 432
  296. Kuttikkattu A434
  297. Kyu HH435
  298. Lal DK435
  299. Lam J436
  300. Landires I437, 439
  301. Lasrado S440
  302. Lee SW441
  303. Lenzi J332
  304. Lewycka S9, 441
  305. Li S442
  306. Lim SS2, 4
  307. Liu W2, 4
  308. Lodha R442
  309. Loftus MJ241, 243
  310. Lohiya A444
  311. Lorenzovici L445, 446
  312. Lotfi M75, 76
  313. Mahmoodpoor A77
  314. Mahmoud MA327, 447
  315. Mahmoudi R327
  316. Majeed A448
  317. Majidpoor J402
  318. Makki A196
  319. Mamo GA280
  320. Manla Y449
  321. Martorell M450, 451
  322. Matei CN149, 452
  323. Mcmanigal B9
  324. Nasab EM23
  325. Mehrotra R192
  326. Melese A173
  327. Mendozacano O453
  328. Menezes RG89
  329. Mentis AFA454
  330. Micha G455
  331. Michalek IM456, 457
  332. Des ACMGN226, 227
  333. Kostova NM458, 459
  334. Mir SA460
  335. Mirghafourvand M78
  336. Mirmoeeni S176
  337. Mirrakhimov EM461, 462
  338. Mirzaaghazadehattari M79, 463
  339. Misganaw AS464, 465, 466
  340. Misganaw A4
  341. Misra S144
  342. Mohammadi E24, 302
  343. Mohammadi M467
  344. Mohammadianhafshejani A352
  345. Mohammed S468, 469
  346. Mohan S203, 470
  347. Mohseni M50, 471
  348. Mokdad AH2, 4
  349. Momtazmanesh S19, 21
  350. Monasta L472
  351. Moore CE473
  352. Moradi M128, 474, 475
  353. Sarabi MM474, 475
  354. Morrison SD7
  355. Motaghinejad M35
  356. Isfahani HM124
  357. Khaneghah AM476
  358. Mousaviaghdas SA80
  359. Mubarik S477
  360. Mulita F255, 479
  361. Mulu GBB480
  362. Munro SB481
  363. Muthupandian S482, 483
  364. Nair TS484
  365. Naqvi AA485
  366. Narang H486, 487
  367. Natto ZS268, 488
  368. Naveed M489
  369. Nayak BP406
  370. Naz S116
  371. Negoi I150, 490
  372. Nejadghaderi SA36, 300
  373. Kandel SN403, 404, 491
  374. Ngwa CH492
  375. Niazi RK493
  376. Des ATN494
  377. Noroozi N25
  378. Nouraei H292
  379. Nowroozi A21
  380. Nunezsamudio V438, 439
  381. Nutor JJ494
  382. Nzoputam CI496
  383. Nzoputam OJ497, 498
  384. Oancea B499
  385. Obaidur RM500, 501
  386. Ojha VA502, 503
  387. Okekunle AP284, 504
  388. Okonji OC505
  389. Olagunju AT433, 506
  390. Olusanya BO507
  391. Bali AO57
  392. Omer E508
  393. Otstavnov N509
  394. Oumer B42
  395. Padubidri JR177
  396. Pakshir K292
  397. Palicz T316, 395
  398. Pana A511, 512
  399. Pardhan S513
  400. Paredes JL425
  401. Parekh U514
  402. Park EC515, 516
  403. Park S517
  404. Pathak A519, 520
  405. Paudel R211
  406. Paudel U212, 264
  407. Pawar S296
  408. Toroudi HP125, 126
  409. Peng M521, 522
  410. Pensato U523
  411. Pepito VCF139
  412. Pereira M524
  413. Peres MFP525, 526
  414. Perico N527
  415. Petcu IR151
  416. Piracha ZZ528
  417. Podder I529
  418. Pokhrel N265
  419. Poluru R530
  420. Postma MJ62, 63
  421. Pourtaheri N531
  422. Prashant A503
  423. Qattea I532
  424. Rabiee M534
  425. Rabiee N341, 535
  426. Radfar A536
  427. Raeghi S537
  428. Rafiei S328
  429. Raghav PR141
  430. Rahbarnia L538
  431. Rahimimovaghar V25
  432. Rahman M154, 539, 540
  433. Rahman MA540
  434. Rahmani AM541
  435. Rahmanian V542
  436. Ram P543
  437. Ranjha MMAN544
  438. Rao SJ545
  439. Rashidi MM19, 31
  440. Rasul A546
  441. Ratan ZA547, 548
  442. Rawaf S448, 549
  443. Rawassizadeh R386
  444. Razeghinia MS550, 552
  445. Redwan EMM553, 554
  446. Regasa MT308
  447. Remuzzi G527
  448. Reta MA378, 555
  449. Rezaei N19
  450. Rezapour A119
  451. Riad A367, 368
  452. Ripon RK556
  453. Rudd KE557
  454. Saddik B197
  455. Sadeghian S218
  456. Saeed U528, 558
  457. Safaei M559
  458. Safary A81
  459. Safi SZ561, 562
  460. Sahebazzamani M551, 563
  461. Sahebkar A16, 17
  462. Sahoo H564
  463. Salahi S127
  464. Salahi S127
  465. Salari H567
  466. Salehi S47
  467. Kafil HS82
  468. Samy AM568
  469. Sanadgol N569
  470. Sankararaman S533, 570
  471. Sanmarchi F332
  472. Sathian B103, 571
  473. Sawhney M572
  474. Saya GK573
  475. Senthilkumaran S574
  476. Seylani A575
  477. Shah PA576
  478. Shaikh MA578
  479. Shaker E24, 300
  480. Shakhmardanov MZ579
  481. Sharew MM580
  482. Sharifirazavi A388
  483. Sharma P581
  484. Sheikhi RA353
  485. Sheikhy A27, 299
  486. Shetty PH273
  487. Shigematsu M500
  488. Shin JI518
  489. Shirzadaski H582
  490. Shivakumar KM207
  491. Shobeiri P24, 301
  492. Shorofi SA389, 583
  493. Shrestha S584
  494. Sibhat MM585
  495. Sidemo NB43
  496. Sikder MK586
  497. Silva LMLR587, 588
  498. Singh JA143
  499. Singh P589
  500. Singh S590, 591
  501. Siraj MS592
  502. Siwal SS593
  503. Skryabin VY579, 594
  504. Skryabina AA579
  505. Socea B150, 597
  506. Solomon DD170, 598
  507. Song Y297
  508. Sreeramareddy CT599
  509. Suleman M117, 600
  510. Abdulkader RS601
  511. Sultana S602
  512. Szocska M317
  513. Tabatabaeizadeh SA603
  514. Tabish M85
  515. Taheri M37, 128
  516. Taki E28
  517. Tan KK604
  518. Tandukar S605
  519. Tat NY606
  520. Tat VY607, 608
  521. Tefera BN281
  522. Tefera YM609
  523. Temesgen G42
  524. Temsah MH610
  525. Tharwat S611
  526. Thiyagarajan A612
  527. Tleyjeh II613, 614
  528. Troeger CE32
  529. Umapathi KK615
  530. Upadhyay E430
  531. Tahbaz SV616, 617
  532. Valdez PR229, 618
  533. Van Den Eynde J619
  534. Van Doorn HR8, 620
  535. Vaziri S560
  536. Verras GI479, 621
  537. Viswanathan H141
  538. Vo B622
  539. Waris A623
  540. Wassie GT174
  541. Wickramasinghe ND624
  542. Yaghoubi S625
  543. Yahya GATY95
  544. Jabbari SHY616
  545. Yigit A626
  546. Yigit V626
  547. Yon DK627
  548. Yonemoto N628, 629
  549. Zahir M38
  550. Zaman BA96
  551. Zaman SB242, 592
  552. Zangiabadian M36
  553. Zare I630
  554. Zastrozhin MS495, 596
  555. Zhang ZJ478
  556. Zheng P2, 4
  557. Zhong C305
  558. Zoladl M52
  559. Zumla A134, 631
  560. Hay SI2, 4
  561. Dolecek C10, 632
  562. Sartorius B4, 8, 9
  563. Murray CJL2, 4
  564. Naghavi M2, 4

Source: The Lancet Published:2022


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. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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