Will 10 Million People Die a Year due to Antimicrobial Resistance by 2050?

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Abstract

Marlieke de Kraker and colleagues reflect on the need for better global estimates for the burden of antimicrobial resistance.

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Benchmarking the incidence and mortality of severe sepsis in the United States.

David F Gaieski, J. Edwards, Michael Kallan … (2013)

In 1992, the first consensus definition of severe sepsis was published. Subsequent epidemiologic estimates were collected using administrative data, but ongoing discrepancies in the definition of severe sepsis produced large differences in estimates. We seek to describe the variations in incidence and mortality of severe sepsis in the United States using four methods of database abstraction. We hypothesized that different methodologies of capturing cases of severe sepsis would result in disparate estimates of incidence and mortality. Using a nationally representative sample, four previously published methods (Angus et al, Martin et al, Dombrovskiy et al, and Wang et al) were used to gather cases of severe sepsis over a 6-year period (2004-2009). In addition, the use of new International Statistical Classification of Diseases, 9th Edition (ICD-9), sepsis codes was compared with previous methods. Annual national incidence and in-hospital mortality of severe sepsis. The average annual incidence varied by as much as 3.5-fold depending on method used and ranged from 894,013 (300/100,000 population) to 3,110,630 (1,031/100,000) using the methods of Dombrovskiy et al and Wang et al, respectively. Average annual increase in the incidence of severe sepsis was similar (13.0% to 13.3%) across all methods. In-hospital mortality ranged from 14.7% to 29.9% using abstraction methods of Wang et al and Dombrovskiy et al. Using all methods, there was a decrease in in-hospital mortality across the 6-year period (35.2% to 25.6% [Dombrovskiy et al] and 17.8% to 12.1% [Wang et al]). Use of ICD-9 sepsis codes more than doubled over the 6-year period (158,722 - 489,632 [995.92 severe sepsis], 131,719 - 303,615 [785.52 septic shock]). There is substantial variability in incidence and mortality of severe sepsis depending on the method of database abstraction used. A uniform, consistent method is needed for use in national registries to facilitate accurate assessment of clinical interventions and outcome comparisons between hospitals and regions.

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Hospital-acquired infections--appropriate statistical treatment is urgently needed!

Arthur Allignol, Martin Wolkewitz, Nadine Binder … (2013)

Research on hospital-acquired infections (HAIs) requires the highest methodological standards to minimize the risk of bias and to avoid misleading interpretation. There are two major issues related specifically to studies in this area, namely the timing of infection and the occurrence of so-called competing risks, which deserve special attention. Just as a patient who acquires a serious infection during hospital admission needs appropriate antibiotic treatment, data being collected in studies on hospital-acquired infections need appropriate statistical analysis. We illustrate the urgent need for appropriate statistical treatment of hospital-acquired infections with some examples from recently conducted studies.The considerations presented are relevant for investigations on risk factors for HAIs as well as for outcome studies.

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Comparative cost of selective screening to prevent transmission of methicillin-resistant Staphylococcus aureus (MRSA), compared with the attributable costs of MRSA infection.

Laura Gavaldá, Cristina Masuet-Aumatell, Juan Alfonso Beltrán … (2006)

The annual cost of a screening program to detect methicillin-resistant Staphylococcus aureus (MRSA) in a teaching hospital in Spain was 10,261 Euro. The average cost per MRSA infection was 2,730 Euro; therefore, the cost of the program would be covered if it only prevented 4 infections per year (11% of the total number of MRSA infections at our hospital).

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Author and article information

Journal

Journal ID (nlm-ta): PLoS Med

Journal ID (iso-abbrev): PLoS Med

Journal ID (publisher-id): plos

Journal ID (pmc): plosmed

Title: PLoS Medicine

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Print): 1549-1277

ISSN (Electronic): 1549-1676

Publication date (Electronic): 29 November 2016

Publication date Collection: November 2016

Volume: 13

Issue: 11

Electronic Location Identifier: e1002184

Affiliations

[1 ]Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland

[2 ]Infectious Diseases Department, Austin Health, Heidelberg, Australia

Author notes

I have read the journal's policy and have the following conflicts to report: SH and AJS participated in an investigator-initiated study on the burden of antimicrobial resistance (TIMBER) supported by an unrestricted research grant provided by Pfizer Europe and bioMérieux. SH is also a member of the Editorial Board of PLOS Medicine. AJS is an employee of Hand Hygiene Australia, a national quality improvement program, and is a member of the Healthcare Associated Infection Advisory Committee of the Australian Commission for Safety and Quality in Healthcare.

* E-mail: marlieke.dekraker@ 123456hcuge.ch

Author information

Marlieke E. A. de Kraker http://orcid.org/0000-0003-0903-8614

Andrew J. Stewardson http://orcid.org/0000-0001-6805-1224

Article

Publisher ID: PMEDICINE-D-16-02737

DOI: 10.1371/journal.pmed.1002184

PMC ID: 5127510

PubMed ID: 27898664

SO-VID: 6e059a44-a140-492b-ba8a-264aeb6f81a6

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This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Figures: 1, Tables: 1, Pages: 6

Funding

For MdK and SH, the research leading to this viewpoint has received support from the Innovative Medicines Initiative Joint Undertaking under grant agreements nos. 115523, 115620, and 115737 (Combatting Bacterial Resistance in Europe projects [COMBACTE]), resources of which are composed of financial contribution from the European Union's 7th Framework Programme (FP7/2007–2013) and the European Federation of Pharmaceutical Industries and Associations (EFPIA) companies’ in kind contribution. The funders had no role in data collection and analysis, decision to publish, or preparation of the manuscript.

Will 10 Million People Die a Year due to Antimicrobial Resistance by 2050?

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Most cited references 3

Benchmarking the incidence and mortality of severe sepsis in the United States.

Hospital-acquired infections--appropriate statistical treatment is urgently needed!

Comparative cost of selective screening to prevent transmission of methicillin-resistant Staphylococcus aureus (MRSA), compared with the attributable costs of MRSA infection.

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