5 research outputs found
Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis
Background: Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs).
Methods: We estimated the incidence of infections with 16 antibiotic resistance–bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011–12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature.
Findings: From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148–763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480–38 430) attributable deaths and 874 541 (768 837–989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece.
Interpretation: Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases
Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study
The members of the European Survey on Carbapenemase-Producing
Enterobacteriaceae, (EuSCAPE) Working Group are: Portugal—Manuela Caniça and Vera ManageiroBACKGROUND: Gaps in the diagnostic capacity and heterogeneity of national surveillance and reporting standards in Europe make it difficult to contain carbapenemase-producing Enterobacteriaceae. We report the development of a consistent sampling framework and the results of the first structured survey on the occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in European hospitals.
METHODS: National expert laboratories recruited hospitals with diagnostic capacities, who collected the first ten carbapenem non-susceptible clinical isolates of K pneumoniae or E coli and ten susceptible same-species comparator isolates and pertinent patient and hospital information. Isolates and data were relayed back to national expert laboratories, which made laboratory-substantiated information available for central analysis.
FINDINGS: Between Nov 1, 2013, and April 30, 2014, 455 sentinel hospitals in 36 countries submitted 2703 clinical isolates (2301 [85%] K pneumoniae and 402 (15%) E coli). 850 (37%) of 2301 K pneumoniae samples and 77 (19%) of 402 E coli samples were carbapenemase (KPC, NDM, OXA-48-like, or VIM) producers. The ratio of K pneumoniae to E coli was 11:1. 1·3 patients per 10 000 hospital admissions had positive clinical specimens. Prevalence differed greatly, with the highest rates in Mediterranean and Balkan countries. Carbapenemase-producing K pneumoniae isolates showed high resistance to last-line antibiotics.
INTERPRETATION: This initiative shows an encouraging commitment by all participants, and suggests that challenges in the establishment of a continent-wide enhanced sentinel surveillance for carbapenemase-producing Enterobacteriaeceae can be overcome. Strengthening infection control efforts in hospitals is crucial for controlling spread through local and national health care networks.European Centre for Disease Prevention and Controlinfo:eu-repo/semantics/publishedVersio
Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis
Background Infections due to antibiotic-resistant bacteria are
threatening modern health care. However, estimating their incidence,
complications, and attributable mortality is challenging. We aimed to
estimate the burden of infections caused by antibiotic-resistant
bacteria of public health concern in countries of the EU and European
Economic Area (EEA) in 2015, measured in number of cases, attributable
deaths, and disability-adjusted life-years (DALYs).
Methods We estimated the incidence of infections with 16 antibiotic
resistance-bacterium combinations from European Antimicrobial Resistance
Surveillance Network (EARS-Net) 2015 data that was country-corrected for
population coverage. We multiplied the number of bloodstream infections
(BSIs) by a conversion factor derived from the European Centre for
Disease Prevention and Control point prevalence survey of
health-care-associated infections in European acute care hospitals in
2011-12 to estimate the number of non-BSIs. We developed disease outcome
models for five types of infection on the basis of systematic reviews of
the literature.
Findings From EARS-Net data collected between Jan 1, 2015, and Dec 31,
2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148-763
966) infections with antibiotic-resistant bacteria, of which 63.5% (426
277 of 671 689) were associated with health care. These infections
accounted for an estimated 33 110 (28 480-38 430) attributable deaths
and 874 541 (768 837-989 068) DALYs. The burden for the EU and EEA was
highest in infants (aged <1 year) and people aged 65 years or older, had
increased since 2007, and was highest in Italy and Greece.
Interpretation Our results present the health burden of five types of
infection with antibiotic-resistant bacteria expressed, for the first
time, in DALYs. The estimated burden of infections with
antibiotic-resistant bacteria in the EU and EEA is substantial compared
with that of other infectious diseases, and has increased since 2007.
Our burden estimates provide useful information for public health
decision-makers prioritising interventions for infectious diseases.
Copyright (c) 2018 The Author(s). Published by Elsevier Ltd. This is an
Open Access article under the CC BY 4.0 license