Author/Editor		Cassini, Alessandro; Diaz Högberg, Diamantis; Quattrocchi, Annalisa; Kolman, Jana; Klavs, Irena; Korošec, Aleš
Title		Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015
Type		članek
Vol. and No.		Letnik 19, št. 1
Publication year		2019
Volume		str. 56-66
ISSN		1473-3099 - The Lancet Infectious Diseases
Language		eng
Abstract		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.
Keywords		antibiotic-resistant bacteria i deaths EU