AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, Japan; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan.
AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, Japan.
Int J Infect Dis. 2021 Jul;108:119-124. doi: 10.1016/j.ijid.2021.05.018. Epub 2021 May 13.
Antimicrobial resistance (AMR) is a global health problem. However, quantitative evaluation of its disease burden is challenging. This study aimed to estimate the disease burden of bloodstream infections (BSIs) caused by major antimicrobial-resistant bacteria in Japan between 2015 and 2018 in terms of disability-adjusted life-years (DALYs).
DALYs of BSIs caused by nine major antimicrobial-resistant bacteria in Japan were estimated using comprehensive national surveillance data of all routine bacteriological test results from more than 1400 hospitals between 2015 and 2018. The methodology of Cassini et al. was modified to enable comparison of the present results with those in other countries.
It was estimated that 137.9 [95% uncertainty interval (UI) 130.7-145.2] DALYs per 100,000 population were attributable to BSIs caused by nine antimicrobial-resistant bacteria in 2018. Methicillin-resistant Staphylococcus aureus (MRSA), fluoroquinolone-resistant Escherichia coli (FQREC) and third-generation cephalosporin-resistant E. coli (3GREC) accounted for 87.2% overall. The burden did not decrease during the study period and was highest in people aged ≥65 years.
The results revealed, for the first time, the disease burden of BSIs caused by nine major antimicrobial-resistant bacteria in Japan. The estimated disease burden associated with AMR in Japan is substantial and has not begun to decrease. Notably, the burden from FQREC and 3GREC has increased steadily, and that from MRSA is larger in Japan than in the European Union/European Economic Area, whereas the burden from other bacteria is comparatively small. These results are expected to provide useful information for healthcare policy makers for prioritizing interventions for AMR.
抗菌药物耐药性（AMR）是一个全球性的健康问题。然而，对其疾病负担进行定量评估具有挑战性。本研究旨在根据伤残调整生命年（DALYs）来估计 2015 年至 2018 年日本由主要抗菌药物耐药菌引起的血流感染（BSI）的疾病负担。
使用 2015 年至 2018 年来自 1400 多家医院的所有常规细菌学检测结果的综合国家监测数据，估计日本由 9 种主要抗菌药物耐药菌引起的 BSI 的 DALYs。对 Cassini 等人的方法进行了修改，以实现与其他国家的结果进行比较。
据估计，2018 年，每 10 万人中有 137.9（95%不确定区间[UI]为 130.7-145.2）个 DALYs 归因于 9 种抗菌药物耐药菌引起的 BSI。耐甲氧西林金黄色葡萄球菌（MRSA）、氟喹诺酮类耐药大肠埃希菌（FQREC）和第三代头孢菌素耐药大肠埃希菌（3GREC）占总体的 87.2%。在研究期间，该负担没有下降，并且在≥65 岁人群中最高。
这些结果首次揭示了日本由 9 种主要抗菌药物耐药菌引起的 BSI 的疾病负担。日本与 AMR 相关的估计疾病负担相当大，且尚未开始下降。值得注意的是，FQREC 和 3GREC 的负担稳步增加，而 MRSA 的负担在日本大于欧盟/欧洲经济区，而其他细菌的负担相对较小。这些结果有望为医疗保健政策制定者提供有用的信息，以确定 AMR 干预措施的优先级。
