全球细菌感染负担分析——33种细菌病原体相关的全球死亡率(2019年)报告解读

Analysis of global burden of bacterial infections:an interpretation of Global mortality associated with 33 bacte-rial pathogens in 2019

全球细菌感染负担报告显示,2019年全球因细菌感染相关死亡者约有1370万人[95%(uncertainty intervals,UI)为1090万~1710万],占同期全球死亡人数的13.6%(10.1%-18.1%),为全球第二大死亡原因,仅次于缺血性心脏病。11种感染性综合征中,33种细菌病原体与全球770万人(570万~1020万)的死亡相关。下呼吸道感染导致全球约400万人(333万~489万)死亡,其中肺炎链球菌导致了最多死亡,为65.3万(55.3万~77.7万);血流感染导致了291万人(174万~453万),其中金黄色葡萄球菌导致了最多死亡,为29.9万人(16.6万~48.5万);腹膜和腹腔内感染导致128万人(82.6万~186.0万)死亡,其中大肠埃希菌导致死亡最多,为29万人(18.8万~42.3万)。全球细菌感染负担报告还显示,2019年,金黄色葡萄球菌与超过100万人死亡相关(导致110.5万人死亡);大肠埃希菌导致全球45万(32.9万~60.2万)女性和50万(35.5万~68.4万)男性死亡,肺炎链球菌导致全球超过75万人死亡;肺炎克雷伯菌导致全球超过75万人死亡;铜绿假单胞菌导致全球超过50万人死亡。全球细菌感染负担报告数据表明,在全球范围内,与死亡人数最多相关的病原体因年龄而异。金黄色葡萄球菌是15岁以上人群中死亡最多的病原体,该年龄组有94万人(68.2万~127.6万)死亡;伤寒沙门氏菌与5~14岁儿童死亡最多相关,死亡人数达4.9万人(2.3万~8.6万);肺炎链球菌与新生儿至4岁幼儿死亡最多相关,死亡人数达22.5万人(18.0万~28.1万)。全球细菌感染负担报告通过估计各种病原体和感染性综合征的死亡率,这些细菌感染负担有些是之前未知的,有些是被严重低估的,特别是在中低收入国家中不成比例的高负担,而中国地区缺乏相应的数据及研究,有必要开展相应的调查研究,从而制定创新策略。

The Global Burden of Bacterial Infections report showed that in 2019,there were approximately 13.7 million deaths worldwide due to infection(95%UI ranging from 10.9 million to 17.1 million),and bacterial infection related deaths accounted for 13.6%(10.1%-18.1%)of global deaths,making it the second leading cause of death globally,second only to ischemic heart disease.Eleven infectious syndromes involve 33 bacterial pathogens and are associated with 7.7 million deaths worldwide(5.7 million to 10.2 million).Lower respiratory tract infections have caused approximately 4 million deaths worldwide(3.33 million to 4.89 million),with Streptococcus pneumoniae causing the most deaths at 653000(553000 to 777000);Blood flow infections have caused 2.91 million people(1.74 million to 4.53 million),with Staphylococcus aureus causing the most deaths,at 299000 people(166000 to 485000);Peritoneal and intra-abdominal infections have caused 1.28 million deaths(826000 to 1.86 million),with Escherichia coli causing the most deaths,reaching 290000(188000 to 423000).The Global Burden of Bacterial Infections report also shows that in 2019,Staphylococcus aureus was associated with over 1 million deaths(resulting in 1.105 million deaths);Escherichia coli causes 450000(329000 to 602000)female and 500000(355000 to 684000)male deaths worldwide,while Streptococcus pneumoniae causes over 750000 deaths worldwide;Klebsiella pneumoniae causes over 750000 deaths worldwide;Pseudomonas aeruginosa has caused over 500000 deaths worldwide.The Global Burden of Bacterial Infections report data shows that the pathogens most associated with mortality worldwide vary by age.Staphylococcus aureus is the deadliest pathogen among people aged 15 and above,with 940000 deaths(682000 to 1276000)in this age group;Salmonella typhi is most associated with mortality in children aged 5-14,with a death toll of 49000(23000-86000);Streptococcus pneumoniae is most associated with the death of newborns to 4-year-old children,with a death toll of 225000(180000 to 281000).The Global Burden of Bacterial Infections report estimates the mortality rates of various pathogens and infectious syndromes,some of which were previously unknown and some were severely underestimated,especially in low-and middle-income countries where the burden is disproportionately high.However,there is a lack of corresponding data and research in China,and it is necessary to conduct corresponding surveys and research to develop innovative strategies.