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Disease burden of bloodstream infections caused by antimicrobial-resistant bacteria: A population-level study, Japan,
Shinya Tsuzuki1, Nobuaki Matsunaga2, Koji Yahara3
1AMR 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.
Background:
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).
Methods:
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.
Results:
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.
Conclusion:
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.
Insights
Antimicrobial resistance (AMR) causes significant disease burden in Japan, with bloodstream infections (BSIs) from resistant bacteria like MRSA, FQREC, and 3GREC not decreasing. The burden is highest in older adults and requires urgent policy intervention.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Antimicrobial resistance (AMR) poses a significant global health challenge.
- Quantifying the disease burden of AMR, particularly bloodstream infections (BSIs), remains difficult.
- This study focuses on estimating the disease burden of BSIs caused by major antimicrobial-resistant bacteria in Japan.
Purpose of the Study:
- To estimate the disease burden of BSIs caused by nine major antimicrobial-resistant bacteria in Japan from 2015 to 2018.
- To quantify this burden in terms of disability-adjusted life-years (DALYs).
- To provide data for healthcare policy and AMR intervention prioritization.
Main Methods:
- Utilized comprehensive national surveillance data from over 1400 hospitals (2015-2018).
- Estimated DALYs for BSIs caused by nine key antimicrobial-resistant bacteria.
- Adapted Cassini et al.'s methodology for international comparison.
Main Results:
- In 2018, an estimated 137.9 DALYs per 100,000 population were attributed to BSIs from these nine bacteria.
- Methicillin-resistant Staphylococcus aureus (MRSA), fluoroquinolone-resistant E. coli (FQREC), and 3rd-gen cephalosporin-resistant E. coli (3GREC) accounted for 87.2% of the burden.
- The disease burden did not decrease during the study period and was highest in individuals aged 65 and older.
Conclusions:
- This study provides the first comprehensive estimate of the disease burden of BSIs from nine major antimicrobial-resistant bacteria in Japan.
- The overall AMR disease burden in Japan is substantial and shows no sign of decreasing.
- FQREC and 3GREC burdens have increased, MRSA burden exceeds that in the EU/EEA, highlighting the need for targeted interventions.
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