Abstract：
In Germany, there is an increasing amount of vancomycin-resistant Enterococcus faecium (VREfm) isolates in bloodstream infections (BSIs); however, estimates on recent incidences and disease burden are missing. We aim to estimate the incidence and calculate the annual disease burden in disease-adjusted life years (DALYs) for BSIs due to VREfm in Germany between 2015 and 2020 to support informed decision-making in the field of antimicrobial resistance (AMR). We used the Antibiotic Resistance Surveillance (ARS) system data to obtain incidence estimates. The estimated incidences were used in the Burden of Communicable Disease in Europe (BCoDE) toolkit to calculate the attributable DALYs. A total of 3417 VREfm blood culture-positive isolates were observed within ARS. The estimated incidence of VREfm-BSIs per 100,000 inhabitants increased from 1.4 (95% Uncertainty Interval [UI]: 0.8−1.9) in 2015 to 2.9 (95% UI: 2.4−3.3) in 2020. The estimated burden, expressed in DALYs per 100,000 inhabitants, increased from 8.5 (95% UI: 7.3−9.7; YLD = 0.9, YLL = 7.6) in 2015 to 15.6 (95% UI: 14.6−16.6; YLD = 1.6, YLL = 14) in 2020. The most affected groups within the observed period are the 65−69-year-old males with 262.9 DALYs per 100,000 inhabitants, and in the younger age groups (<30 years), the under-one-year-old with 43.1 DALYs per 100,000 inhabitants and 34.5 DALYs for male and female, respectively. The increasing DALYs of BSIs due to VREfm require targeted prevention and control measures to address their unequal distribution across gender and age, especially for older hospitalized patients, neonates, and infants in Germany.
摘要：
在德国,在血流感染（BSIs）中，耐万古霉素的屎肠球菌（VREfm）分离株的数量越来越多；然而，对近期发病率和疾病负担的估计缺失。我们的目标是估计发病率，并计算2015年至2020年间德国因VREfm导致的BSI的疾病调整寿命年（DALYs）的年度疾病负担，以支持抗菌素耐药性（AMR）领域的知情决策。我们使用抗生素耐药性监测（ARS）系统数据来获得发病率估计值。估计的发病率用于欧洲传染病负担（BCoDE）工具包中，以计算可归因的DALY。在ARS中观察到总共3417株VREfm血液培养阳性分离株。每10万居民VREfm-BSI的估计发生率从2015年的1.4（95％不确定性区间[UI]：0.8-1.9）增加到2020年的2.9（95％UI：2.4-3.3）。估计的负担，以每10万居民的DALYs表示，从2015年的8.5（95％UI：7.3-9.7；YLD=0.9，YLL=7.6）增加到2020年的15.6（95％UI：14.6-16.6；YLD=1.6，YLL=14）。观察期内受影响最大的群体是65-69岁的男性，每10万居民有262.9个DALYs，在较年轻的年龄组(<30岁)中，1岁以下人口，每100,000名居民有43.1个DALYs，男性和女性有34.5个DALYs，分别。由于VREfm而增加的BSIDALYs需要有针对性的预防和控制措施，以解决其在性别和年龄之间的不平等分布，尤其是老年住院患者，新生儿,德国的婴儿
