Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
Issued Date
2022-12-17
Resource Type
ISSN
01406736
eISSN
1474547X
Scopus ID
2-s2.0-85143975205
Pubmed ID
36423648
Journal Title
The Lancet
Volume
400
Issue
10369
Start Page
2221
End Page
2248
Rights Holder(s)
SCOPUS
Bibliographic Citation
The Lancet Vol.400 No.10369 (2022) , 2221-2248
Suggested Citation
Ikuta K.S., Swetschinski L.R., Aguilar G.R., Sharara F., Mestrovic T., Gray A.P., Weaver N.D., Wool E.E., Han C., Hayoon A.G., Aali A., Abate S.M., Abbasi-Kangevari M., Abbasi-Kangevari Z., Abd-Elsalam S., Abebe G., Abedi A., Abhari A.P., Abidi H., Aboagye R.G., Absalan A., Ali H.A., Acuna J.M., Adane T.D., Addo I.Y., Adegboye O.A., Adnan M., Adnani Q.E.S., Afzal M.S., Afzal S., Aghdam Z.B., Ahinkorah B.O., Ahmad A., Ahmad A.R., Ahmad R., Ahmad S., Ahmad S., Ahmadi S., Ahmed A., Ahmed H., Ahmed J.Q., Rashid T.A., Ajami M., Aji B., Akbarzadeh-Khiavi M., Akunna C.J., Hamad H.A., Alahdab F., Al-Aly Z., Aldeyab M.A., Aleman A.V., Alhalaiqa F.A.N., Alhassan R.K., Ali B.A., Ali L., Ali S.S., Alimohamadi Y., Alipour V., Alizadeh A., Aljunid S.M., Allel K., Almustanyir S., Ameyaw E.K., Amit A.M.L., Anandavelane N., Ancuceanu R., Andrei C.L., Andrei T., Anggraini D., Ansar A., Anyasodor A.E., Arabloo J., Aravkin A.Y., Areda D., Aripov T., Artamonov A.A., Arulappan J., Aruleba R.T., Asaduzzaman M., Ashraf T., Athari S.S., Atlaw D., Attia S., Ausloos M., Awoke T., Quintanilla B.P.A., Ayana T.M., Azadnajafabad S., Jafari A.A., Darshan B., Badar M., Badiye A.D., Baghcheghi N., Bagherieh S., Baig A.A., Banerjee I., Barac A., Bardhan M., Barone-Adesi F., Barqawi H.J. Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Vol.400 No.10369 (2022) , 2221-2248. 2248. doi:10.1016/S0140-6736(22)02185-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/90245
Title
Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
Author(s)
Ikuta K.S.
Swetschinski L.R.
Aguilar G.R.
Sharara F.
Mestrovic T.
Gray A.P.
Weaver N.D.
Wool E.E.
Han C.
Hayoon A.G.
Aali A.
Abate S.M.
Abbasi-Kangevari M.
Abbasi-Kangevari Z.
Abd-Elsalam S.
Abebe G.
Abedi A.
Abhari A.P.
Abidi H.
Aboagye R.G.
Absalan A.
Ali H.A.
Acuna J.M.
Adane T.D.
Addo I.Y.
Adegboye O.A.
Adnan M.
Adnani Q.E.S.
Afzal M.S.
Afzal S.
Aghdam Z.B.
Ahinkorah B.O.
Ahmad A.
Ahmad A.R.
Ahmad R.
Ahmad S.
Ahmad S.
Ahmadi S.
Ahmed A.
Ahmed H.
Ahmed J.Q.
Rashid T.A.
Ajami M.
Aji B.
Akbarzadeh-Khiavi M.
Akunna C.J.
Hamad H.A.
Alahdab F.
Al-Aly Z.
Aldeyab M.A.
Aleman A.V.
Alhalaiqa F.A.N.
Alhassan R.K.
Ali B.A.
Ali L.
Ali S.S.
Alimohamadi Y.
Alipour V.
Alizadeh A.
Aljunid S.M.
Allel K.
Almustanyir S.
Ameyaw E.K.
Amit A.M.L.
Anandavelane N.
Ancuceanu R.
Andrei C.L.
Andrei T.
Anggraini D.
Ansar A.
Anyasodor A.E.
Arabloo J.
Aravkin A.Y.
Areda D.
Aripov T.
Artamonov A.A.
Arulappan J.
Aruleba R.T.
Asaduzzaman M.
Ashraf T.
Athari S.S.
Atlaw D.
Attia S.
Ausloos M.
Awoke T.
Quintanilla B.P.A.
Ayana T.M.
Azadnajafabad S.
Jafari A.A.
Darshan B.
Badar M.
Badiye A.D.
Baghcheghi N.
Bagherieh S.
Baig A.A.
Banerjee I.
Barac A.
Bardhan M.
Barone-Adesi F.
Barqawi H.J.
Swetschinski L.R.
Aguilar G.R.
Sharara F.
Mestrovic T.
Gray A.P.
Weaver N.D.
Wool E.E.
Han C.
Hayoon A.G.
Aali A.
Abate S.M.
Abbasi-Kangevari M.
Abbasi-Kangevari Z.
Abd-Elsalam S.
Abebe G.
Abedi A.
Abhari A.P.
Abidi H.
Aboagye R.G.
Absalan A.
Ali H.A.
Acuna J.M.
Adane T.D.
Addo I.Y.
Adegboye O.A.
Adnan M.
Adnani Q.E.S.
Afzal M.S.
Afzal S.
Aghdam Z.B.
Ahinkorah B.O.
Ahmad A.
Ahmad A.R.
Ahmad R.
Ahmad S.
Ahmad S.
Ahmadi S.
Ahmed A.
Ahmed H.
Ahmed J.Q.
Rashid T.A.
Ajami M.
Aji B.
Akbarzadeh-Khiavi M.
Akunna C.J.
Hamad H.A.
Alahdab F.
Al-Aly Z.
Aldeyab M.A.
Aleman A.V.
Alhalaiqa F.A.N.
Alhassan R.K.
Ali B.A.
Ali L.
Ali S.S.
Alimohamadi Y.
Alipour V.
Alizadeh A.
Aljunid S.M.
Allel K.
Almustanyir S.
Ameyaw E.K.
Amit A.M.L.
Anandavelane N.
Ancuceanu R.
Andrei C.L.
Andrei T.
Anggraini D.
Ansar A.
Anyasodor A.E.
Arabloo J.
Aravkin A.Y.
Areda D.
Aripov T.
Artamonov A.A.
Arulappan J.
Aruleba R.T.
Asaduzzaman M.
Ashraf T.
Athari S.S.
Atlaw D.
Attia S.
Ausloos M.
Awoke T.
Quintanilla B.P.A.
Ayana T.M.
Azadnajafabad S.
Jafari A.A.
Darshan B.
Badar M.
Badiye A.D.
Baghcheghi N.
Bagherieh S.
Baig A.A.
Banerjee I.
Barac A.
Bardhan M.
Barone-Adesi F.
Barqawi H.J.
Author's Affiliation
University of Raparin
Tishk International University
University of Kurdistan Hewlêr
National University of Medical Sciences
College of Medicine Alfaisal University
University North
College of Medicine, University of Ibadan
School of Medicine
University of Leicester School of Business
Liver and Gastrointestinal Diseases Research Center
IUMS Health Management and Economics Research Center
University of Human Development
Non-Communicable Diseases Research Center
University of Health and Allied Sciences, Ghana
Erbil Polytechnic University
Institute of Forensic Science, Nagpur
Shaqra University
Khomein University of Medical Sciences
Madda Walabu University
Dilla University
Arba Minch University
All India Institute of Medical Sciences, Jodhpur
Bucharest University of Economic Studies
Saveh University of Medical Sciences
Jazan University
Dr. D. Y. Patil Vidyapeeth, Pune
Universidad de San Martín de Porres
Imam Abdulrahman Bin Faisal University
Khalifa University of Science and Technology
Universiti Sultan Zainal Abidin
Institute for Health Metrics and Evaluation
COMSATS University Islamabad
Cancer Institute NSW
University of Duhok
Rumailah Hospital
Hamad Medical Corporation
Sultan Qaboos University
Universidad de la Republica
Ateneo de Manila University
Bahir Dar University
University of Sharjah
University of Management and Technology Lahore
University of Lahore
Universitas Jenderal Soedirman
Universitas Riau
Universitas Padjadjaran
Belgrade University School of Medicine
Quaid-i-Azam University
Philadelphia University
Gomal University
Kuwait University
Yasuj University of Medical Sciences
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Ministry of Health Saudi Arabia
University of Huddersfield
London School of Hygiene & Tropical Medicine
Tabriz University of Medical Sciences
Boston Children's Hospital
University of Southern California
South African Medical Research Council
UNSW Sydney
Tehran University of Medical Sciences
Indian Council of Medical Research
Iran University of Medical Sciences
School of Medicine, Isfahan UMS
University of Technology Sydney
U.S. Department of Veterans Affairs
University College London
University of Pretoria
Russian Academy of Sciences
James Cook University
Shahid Beheshti University of Medical Sciences
Monash University Malaysia
Justus-Liebig-Universität Gießen
Manipal Academy of Higher Education
Kasturba Medical College, Manipal
University of Washington
National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences
Florida International University
Keck School of Medicine of USC
VA Medical Center
Faculty of Medicine, Nursing and Health Sciences
Zanjan University of Medical Sciences (ZUMS)
Tanta University
Lingnan University, Hong Kong
Universitetet i Oslo
Washington University in St. Louis
Rijksuniversiteit Groningen
Nuffield Department of Medicine
Sina Trauma and Surgery Research Center
National Institute of Cholera and Enteric Diseases India
Ball Memorial Hospital
La Trobe University
Mayo Clinic
Arizona State University
Università degli Studi del Piemonte Orientale "Amedeo Avogadro"
Universiti Kebangsaan Malaysia
Mashhad University of Medical Sciences, School of Medicine
Charles Sturt University
University of Cape Town
Ottawa University
Satras Biotechnology Company
International Relations & Diplomacy
Sir Seewoosagur Ramgoolam Medical College
MAHSA University
MAHSA University
Federal Ministry of Health
Psychological Sciences Association
Abasyn University
Dire Dawa University
Public Health Association of Australia
Arifin Achmad Hospital
Tashkent Institute of Postgraduate Medical Education
Clinic for Infectious and Tropical Diseases
King Edward Memorial Hospital
Independent Consultant
The Intercountry Centre for Oral Health (ICOH) for Africa
Institute of Public Health
Tishk International University
University of Kurdistan Hewlêr
National University of Medical Sciences
College of Medicine Alfaisal University
University North
College of Medicine, University of Ibadan
School of Medicine
University of Leicester School of Business
Liver and Gastrointestinal Diseases Research Center
IUMS Health Management and Economics Research Center
University of Human Development
Non-Communicable Diseases Research Center
University of Health and Allied Sciences, Ghana
Erbil Polytechnic University
Institute of Forensic Science, Nagpur
Shaqra University
Khomein University of Medical Sciences
Madda Walabu University
Dilla University
Arba Minch University
All India Institute of Medical Sciences, Jodhpur
Bucharest University of Economic Studies
Saveh University of Medical Sciences
Jazan University
Dr. D. Y. Patil Vidyapeeth, Pune
Universidad de San Martín de Porres
Imam Abdulrahman Bin Faisal University
Khalifa University of Science and Technology
Universiti Sultan Zainal Abidin
Institute for Health Metrics and Evaluation
COMSATS University Islamabad
Cancer Institute NSW
University of Duhok
Rumailah Hospital
Hamad Medical Corporation
Sultan Qaboos University
Universidad de la Republica
Ateneo de Manila University
Bahir Dar University
University of Sharjah
University of Management and Technology Lahore
University of Lahore
Universitas Jenderal Soedirman
Universitas Riau
Universitas Padjadjaran
Belgrade University School of Medicine
Quaid-i-Azam University
Philadelphia University
Gomal University
Kuwait University
Yasuj University of Medical Sciences
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Ministry of Health Saudi Arabia
University of Huddersfield
London School of Hygiene & Tropical Medicine
Tabriz University of Medical Sciences
Boston Children's Hospital
University of Southern California
South African Medical Research Council
UNSW Sydney
Tehran University of Medical Sciences
Indian Council of Medical Research
Iran University of Medical Sciences
School of Medicine, Isfahan UMS
University of Technology Sydney
U.S. Department of Veterans Affairs
University College London
University of Pretoria
Russian Academy of Sciences
James Cook University
Shahid Beheshti University of Medical Sciences
Monash University Malaysia
Justus-Liebig-Universität Gießen
Manipal Academy of Higher Education
Kasturba Medical College, Manipal
University of Washington
National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences
Florida International University
Keck School of Medicine of USC
VA Medical Center
Faculty of Medicine, Nursing and Health Sciences
Zanjan University of Medical Sciences (ZUMS)
Tanta University
Lingnan University, Hong Kong
Universitetet i Oslo
Washington University in St. Louis
Rijksuniversiteit Groningen
Nuffield Department of Medicine
Sina Trauma and Surgery Research Center
National Institute of Cholera and Enteric Diseases India
Ball Memorial Hospital
La Trobe University
Mayo Clinic
Arizona State University
Università degli Studi del Piemonte Orientale "Amedeo Avogadro"
Universiti Kebangsaan Malaysia
Mashhad University of Medical Sciences, School of Medicine
Charles Sturt University
University of Cape Town
Ottawa University
Satras Biotechnology Company
International Relations & Diplomacy
Sir Seewoosagur Ramgoolam Medical College
MAHSA University
MAHSA University
Federal Ministry of Health
Psychological Sciences Association
Abasyn University
Dire Dawa University
Public Health Association of Australia
Arifin Achmad Hospital
Tashkent Institute of Postgraduate Medical Education
Clinic for Infectious and Tropical Diseases
King Edward Memorial Hospital
Independent Consultant
The Intercountry Centre for Oral Health (ICOH) for Africa
Institute of Public Health
Other Contributor(s)
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.