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Autor:innen: 
Naghavi, Mohsen
Vollset, Stein Emil
Ikuta, Kevin S
Swetschinski, Lucien R
Gray, Authia P
Wool, Eve E
Robles Aguilar, Gisela
Mestrovic, Tomislav
Smith, Georgia
Han, Chieh
Hsu, Rebecca L
Azzam, Ahmed Y.
Babaei, Mahsa
Babin, Francois-Xavier
Badar, Muhammad
Baig, Atif Amin
Bajcetic, Milica
Baker, Stephen
Bardhan, Mainak
Barqawi, Hiba Jawdat
Basharat, Zarrin
Chalek, Julian
Basiru, Afisu
Bastard, Mathieu
Basu, Saurav
Bayleyegn, Nebiyou Simegnew
Belete, Melaku Ashagrie
Bello, Olorunjuwon Omolaja
Beloukas, Apostolos
Berkley, James A
Bhagavathula, Akshaya Srikanth
Bhaskar, Sonu
Araki, Daniel T
Bhuyan, Soumitra S
Bielicki, Julia A
Briko, Nikolay Ivanovich
Brown, Colin Stewart
Browne, Annie J
Buonsenso, Danilo
Bustanji, Yasser
Carvalheiro, Cristina G
Castañeda-Orjuela, Carlos A
Cenderadewi, Muthia
Chung, Erin
Chadwick, Joshua
Chakraborty, Sandip
Chandika, Rama Mohan
Chandy, Sara
Chansamouth, Vilada
Chattu, Vijay Kumar
Chaudhary, Anis Ahmad
Ching, Patrick R
Chopra, Hitesh
Chowdhury, Fazle Rabbi
Raggi, Catalina
Chu, Dinh-Toi
Chutiyami, Muhammad
Cruz-Martins, Natalia
da Silva, Alanna Gomes
Dadras, Omid
Dai, Xiaochen
Darcho, Samuel D
Das, Saswati
De la Hoz, Fernando Pio
Dekker, Denise Myriam
Gershberg Hayoon, Anna
Dhama, Kuldeep
Diaz, Daniel
Dickson, Benjamin Felix Rothschild
Djorie, Serge Ghislain
Dodangeh, Milad
Dohare, Sushil
Dokova, Klara Georgieva
Doshi, Ojas Prakashbhai
Dowou, Robert Kokou
Dsouza, Haneil Larson
Davis Weaver, Nicole
Dunachie, Susanna J
Dziedzic, Arkadiusz Marian
Eckmanns, Tim
Ed-Dra, Abdelaziz
Eftekharimehrabad, Aziz
Ekundayo, Temitope Cyrus
El Sayed, Iman
Elhadi, Muhammed
El-Huneidi, Waseem
Elias, Christelle
Lindstedt, Paulina A
Ellis, Sally J
Elsheikh, Randa
Elsohaby, Ibrahim
Eltaha, Chadi
Eshrati, Babak
Eslami, Majid
Eyre, David William
Fadaka, Adewale Oluwaseun
Fagbamigbe, Adeniyi Francis
Fahim, Ayesha
Smith, Amanda E
Fakhri-Demeshghieh, Aliasghar
Fasina, Folorunso Oludayo
Fasina, Modupe Margaret
Fatehizadeh, Ali
Feasey, Nicholas A
Feizkhah, Alireza
Fekadu, Ginenus
Fischer, Florian
Fitriana, Ida
Forrest, Karen M
Altay, Umut
Fortuna Rodrigues, Celia
Fuller, John E
Gadanya, Muktar A
Gajdács, Márió
Gandhi, Aravind P
Garcia-Gallo, Esteban E
Garrett, Denise O
Gautam, Rupesh K
Gebregergis, Miglas Welay
Gebrehiwot, Mesfin
Bhattacharjee, Natalia V
Gebremeskel, Teferi Gebru
Geffers, Christine
Georgalis, Leonidas
Ghazy, Ramy Mohamed
Golechha, Mahaveer
Golinelli, Davide
Gordon, Melita
Gulati, Snigdha
Gupta, Rajat Das
Gupta, Sapna
Giannakis, Konstantinos
Gupta, Vijai Kumar
Habteyohannes, Awoke Derbie
Haller, Sebastian
Harapan, Harapan
Harrison, Michelle L
Hasaballah, Ahmed I
Hasan, Ikramul
Hasan, Rumina Syeda
Hasani, Hamidreza
Haselbeck, Andrea Haekyung
Fell, Frederick
Hasnain, Md Saquib
Hassan, Ikrama Ibrahim
Hassan, Shoaib
Hassan Zadeh Tabatabaei, Mahgol Sadat
Hayat, Khezar
He, Jiawei
Hegazi, Omar E
Heidari, Mohammad
Hezam, Kamal
Holla, Ramesh
McManigal, Barney
Holm, Marianne
Hopkins, Heidi
Hossain, Md Mahbub
Hosseinzadeh, Mehdi
Hostiuc, Sorin
Hussein, Nawfal R
Huy, Le Duc
Ibáñez-Prada, Elsa D
Ikiroma, Adalia
Ilic, Irena M
Ekapirat, Nattwut
Islam, Sheikh Mohammed Shariful
Ismail, Faisal
Ismail, Nahlah Elkudssiah
Iwu, Chidozie Declan
Iwu-Jaja, Chinwe Juliana
Jafarzadeh, Abdollah
Jaiteh, Fatoumatta
Jalilzadeh Yengejeh, Reza
Jamora, Roland Dominic G
Javidnia, Javad
Mendes, Jessica Andretta
Jawaid, Talha
Jenney, Adam W J
Jeon, Hyon Jin
Jokar, Mohammad
Jomehzadeh, Nabi
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Joseph, Nitin
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Kanmodi, Kehinde Kazeem
Kantar, Rami S
Runghien, Tilleye
Kapisi, James Apollo
Karaye, Ibraheem M
Khader, Yousef Saleh
Khajuria, Himanshu
Khalid, Nauman
Khamesipour, Faham
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Khan, Mohammad Jobair
Khan, Muhammad Tariq
Khanal, Vishnu
Srimokla, Oraya
Khidri, Feriha Fatima
Khubchandani, Jagdish
Khusuwan, Suwimon
Kim, Min Seo
Kisa, Adnan
Korshunov, Vladimir Andreevich
Krapp, Fiorella
Krumkamp, Ralf
Kuddus, Mohammed
Kulimbet, Mukhtar
Abdelkader, Atef
Kumar, Dewesh
Kumaran, Emmanuelle A P
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Le, Thao Thi Thu
Lederer, Ingeborg Maria
Lee, Munjae
Lee, Seung Won
Abd-Elsalam, Sherief
Lepape, Alain
Lerango, Temesgen Leka
Ligade, Virendra S
Lim, Cherry
Lim, Stephen S
Limenh, Liknaw Workie
Liu, Chaojie
Liu, Xiaofeng
Liu, Xuefeng
Loftus, Michael J
Aboagye, Richard Gyan
M Amin, Hawraz Ibrahim
Maass, Kelsey Lynn
Maharaj, Sandeep B
Mahmoud, Mansour Adam
Maikanti-Charalampous, Panagiota
Makram, Omar M
Malhotra, Kashish
Malik, Ahmad Azam
Mandilara, Georgia D
Marks, Florian
Abolhassani, Hassan
Martinez-Guerra, Bernardo Alfonso
Martorell, Miquel
Masoumi-Asl, Hossein
Mathioudakis, Alexander G
May, Juergen
McHugh, Theresa A
Meiring, James
Meles, Hadush Negash
Melese, Addisu
Melese, Endalkachew Belayneh
Abualruz, Hasan
Minervini, Giuseppe
Mohamed, Nouh Saad
Mohammed, Shafiu
Mohan, Syam
Mokdad, Ali H
Monasta, Lorenzo
Moodi Ghalibaf, AmirAli
Moore, Catrin E
Moradi, Yousef
Mossialos, Elias
Abubakar, Usman
Mougin, Vincent
Mukoro, George Duke
Mulita, Francesk
Muller-Pebody, Berit
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Musa, Sani
Musicha, Patrick
Musila, Lillian A
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Nagarajan, Ahamarshan Jayaraman
Abukhadijah, Hana J
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Nair, Tapas Sadasivan
Najmuldeen, Hastyar Hama Rashid
Natto, Zuhair S
Nauman, Javaid
Nayak, Biswa Prakash
Nchanji, G Takop
Ndishimye, Pacifique
Negoi, Ionut
Aburuz, Salahdein
Negoi, Ruxandra Irina
Nejadghaderi, Seyed Aria
Nguyen, QuynhAnh P
Noman, Efaq Ali
Nwakanma, Davis C
O'Brien, Seamus
Ochoa, Theresa J
Odetokun, Ismail A
Ogundijo, Oluwaseun Adeolu
Ojo-Akosile, Tolulope R
Abu-Zaid, Ahmed
Okeke, Sylvester Reuben
Okonji, Osaretin Christabel
Olagunju, Andrew T
Olivas-Martinez, Antonio
Olorukooba, Abdulhakeem Abayomi
Olwoch, Peter
Onyedibe, Kenneth Ikenna
Ortiz-Brizuela, Edgar
Osuolale, Olayinka
Ounchanum, Pradthana
Achalapong, Sureerak
Oyeyemi, Oyetunde T
P A, Mahesh Padukudru
Paredes, Jose L
Parikh, Romil R
Patel, Jay
Patil, Shankargouda
Pawar, Shrikant
Peleg, Anton Y
Peprah, Prince
Perdigão, João
Addo, Isaac Yeboah
Perrone, Carlo
Petcu, Ionela-Roxana
Phommasone, Koukeo
Piracha, Zahra Zahid
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Poluru, Ramesh
Ponce-De-Leon, Alfredo
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Qamar, Farah Naz
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Qasim, Nameer Hashim
Rafai, Clotaire Donatien
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Rahimi-Movaghar, Vafa
Rahman, Mosiur
Rahman, Muhammad Aziz
Ramadan, Hazem
Ramasamy, Shakthi Kumaran
Adeyeoluwa, Temitayo Esther
Ramesh, Pushkal Sinduvadi
Ramteke, Pramod W
Rana, Rishabh Kumar
Rani, Usha
Rashidi, Mohammad-Mahdi
Rathish, Devarajan
Rattanavong, Sayaphet
Rawaf, Salman
Redwan, Elrashdy Moustafa Mohamed
Reyes, Luis Felipe
Adnani, Qorinah Estiningtyas Sakilah
Roberts, Tamalee
Robotham, Julie V
Rosenthal, Victor Daniel
Ross, Allen Guy
Roy, Nitai
Rudd, Kristina E
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Saddik, Basema Ahmad
Saeb, Mohammad Reza
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Adzigbli, Leticia Akua
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Saheb Sharif-Askari, Narjes
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Afzal, Muhammad Sohail
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Samy, Abdallah M
Saravanan, Aswini
Satpathy, Maheswar
Schumacher, Austin E
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Ahlstrom, Austin J
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Tovani-Palone, Marcos Roberto
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Vaithinathan, Asokan Govindaraj
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Walker, Ann Sarah
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Williams, Phoebe C M
Wolde, Asrat Arja
Wozniak, Teresa M
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Wu, Felicia
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Yadav, Mukesh Kumar Kumar
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Yismaw, Yazachew Engida
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Ahmed, Ayman
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Zhang, Zhi-Jiang
Zielińska, Magdalena
Zumla, Alimuddin
Zyoud, Sa'ed H. H
Zyoud, Samer H
Hay, Simon I
Ahmed, Haroon
Stergachis, Andy
Sartorius, Benn
Cooper, Ben S
Dolecek, Christiane
Murray, Christopher J L
Ahmed, Ibrar
Ahmed, Mohammed
Ahmed, Saeed
Ahmed, Syed Anees
Akkaif, Mohammed Ahmed
Al Awaidy, Salah
Al Thaher, Yazan
Alalalmeh, Samer O
AlBataineh, Mohammad T
Aldhaleei, Wafa A
Al-Gheethi, Adel Ali Saeed
Alhaji, Nma Bida
Ali, Abid
Ali, Liaqat
Ali, Syed Shujait
Ali, Waad
Allel, Kasim
Al-Marwani, Sabah
Alrawashdeh, Ahmad
Altaf, Awais
Al-Tammemi, Alaa B.
Al-Tawfiq, Jaffar A
Alzoubi, Karem H
Al-Zyoud, Walid Adnan
Amos, Ben
Amuasi, John H
Ancuceanu, Robert
Andrews, Jason R
Anil, Abhishek
Anuoluwa, Iyadunni Adesola
Anvari, Saeid
Anyasodor, Anayochukwu Edward
Apostol, Geminn Louis Carace
Arabloo, Jalal
Arafat, Mosab
Aravkin, Aleksandr Y
Areda, Demelash
Aremu, Abdulfatai
Artamonov, Anton A
Ashley, Elizabeth A
Asika, Marvellous O
Athari, Seyyed Shamsadin
Atout, Maha Moh'd Wahbi
Awoke, Tewachew
Azadnajafabad, Sina
Azam, James Mba
Aziz, Shahkaar
Erscheinungsjahr: 
2024
Quellenangabe: 
[Journal:] The Lancet [ISSN:] 0140-6736 [Volume:] 404 [Issue:] 10459 [Publisher:] Elsevier [Place:] Amsterdam [Year:] 2024 [Pages:] 1199-1226
Verlag: 
Elsevier, Amsterdam
Zusammenfassung: 
Background: Antimicrobial (AMR) poses an important global health challenge in the 21st century. A previous study has quantified the global and regional burden of AMR for 2019, followed with additional publications that provided more detailed estimates for several WHO regions by country. To date, there have been no studies that produce comprehensive estimates of AMR burden across locations that encompass historical trends and future forecasts. Methods: We estimated all-age and age-specific deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 22 pathogens, 84 pathogen–drug combinations, and 11 infectious syndromes in 204 countries and territories from 1990 to 2021. We collected and used multiple cause of death data, hospital discharge data, microbiology data, literature studies, single drug resistance profiles, pharmaceutical sales, antibiotic use surveys, mortality surveillance, linkage data, outpatient and inpatient insurance claims data, and previously published data, covering 520 million individual records or isolates and 19 513 study-location-years. We used statistical modelling to produce estimates of AMR burden for all locations, including those with no data. Our approach leverages the estimation of five broad component quantities: the number of deaths involving sepsis; the proportion of infectious deaths attributable to a given infectious syndrome; the proportion of infectious syndrome deaths attributable to a given pathogen; the percentage of a given pathogen resistant to an antibiotic of interest; and the excess risk of death or duration of an infection associated with this resistance. Using these components, we estimated disease burden attributable to and associated with AMR, which we define based on two counterfactuals; respectively, an alternative scenario in which all drug-resistant infections are replaced by drug-susceptible infections, and an alternative scenario in which all drug-resistant infections were replaced by no infection. Additionally, we produced global and regional forecasts of AMR burden until 2050 for three scenarios: a reference scenario that is a probabilistic forecast of the most likely future; a Gram-negative drug scenario that assumes future drug development that targets Gram-negative pathogens; and a better care scenario that assumes future improvements in health-care quality and access to appropriate antimicrobials. We present final estimates aggregated to the global, super-regional, and regional level. Findings: In 2021, we estimated 4·71 million (95% UI 4·23–5·19) deaths were associated with bacterial AMR, including 1·14 million (1·00–1·28) deaths attributable to bacterial AMR. Trends in AMR mortality over the past 31 years varied substantially by age and location. From 1990 to 2021, deaths from AMR decreased by more than 50% among children younger than 5 years yet increased by over 80% for adults 70 years and older. AMR mortality decreased for children younger than 5 years in all super-regions, whereas AMR mortality in people 5 years and older increased in all super regions. For both deaths associated with and deaths attributable to AMR, meticillin-resistant Staphylococcus aureus increased the most globally (from 261000 associated deaths [95% UI 150000–372 000] and 57200 attributable deaths [34100–80 300] in 1990, to 550 000 associated deaths [500000–600000] and 130000 attributable deaths [113000–146 000] in 2021). Among Gram-negative bacteria, resistance to carbapenems increased more than any other antibiotic class, rising from 619000 associated deaths (405 000–834000) in 1990, to 1·03 million associated deaths (909000–1·16 million) in 2021, and from 127 000 attributable deaths (82 100–171000) in 1990, to 216 000 (168 000–264000) attributable deaths in 2021. There was a notable decrease in non-COVID-related infectious disease in 2020 and 2021. Our forecasts show that an estimated 1·91 million (1·56–2·26) deaths attributable to AMR and 8·22 million (6·85–9·65) deaths associated with AMR could occur globally in 2050. Super-regions with the highest all-age AMR mortality rate in 2050 are forecasted to be south Asia and Latin America and the Caribbean. Increases in deaths attributable to AMR will be largest among those 70 years and older (65·9% [61·2–69·8] of all-age deaths attributable to AMR in 2050). In stark contrast to the strong increase in number of deaths due to AMR of 69·6% (51·5–89·2) from 2022 to 2050, the number of DALYs showed a much smaller increase of 9·4% (–6·9 to 29·0) to 46·5 million (37·7 to 57·3) in 2050. Under the better care scenario, across all age groups, 92·0 million deaths (82·8–102·0) could be cumulatively averted between 2025 and 2050, through better care of severe infections and improved access to antibiotics, and under the Gram negative drug scenario, 11·1 million AMR deaths (9·08–13·2) could be averted through the development of a Gram negative drug pipeline to prevent AMR deaths. Interpretation: This study presents the first comprehensive assessment of the global burden of AMR from 1990 to 2021, with results forecasted until 2050. Evaluating changing trends in AMR mortality across time and location is necessary Lancet 2024; 404: 1199–226 Published Online September 16, 2024 https://doi.org/10.1016/ S0140-6736(24)01867-1 See Comment page 1172 *Collaborators listed at the end of the Article Correspondence to: Christopher J L Murray, Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington School of Medicine, Seattle, WA 98195, USA cjlm@uw.edu Articles 1200 www.thelancet.com Vol 404 September 28, 2024 to understand how this important global health threat is developing and prepares us to make informed decisions regarding interventions. Our findings show the importance of infection prevention, as shown by the reduction of AMR deaths in those younger than 5 years. Simultaneously, our results underscore the concerning trend of AMR burden among those older than 70 years, alongside a rapidly ageing global community. The opposing trends in the burden of AMR deaths between younger and older individuals explains the moderate future increase in global number of DALYs versus number of deaths. Given the high variability of AMR burden by location and age, it is important that interventions combine infection prevention, vaccination, minimisation of inappropriate antibiotic use in farming and humans, and research into new antibiotics to mitigate the number of AMR deaths that are forecasted for 2050.
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