Abstract：
OBJECTIVE: Bone and joint infections, complicated by the burgeoning challenge of antimicrobial resistance (AMR), pose significant public health threats by amplifying the disease burden globally. We leveraged results from the 2019 Global Burden of Disease Study (GBD) to explore the impact of AMR attributed to bone and joint infections in terms of disability-adjusted life years (DALYs), elucidating the contemporary status and temporal trends.
METHODS: Utilizing GBD 2019 data, we summarized the burden of bone and joint infections attributed to AMR across 195 countries and territories in the 30 years from 1990 to 2019. We review the epidemiology of AMR in terms of age-standardized rates, the estimated DALYs, comprising years of life lost (YLLs) and years lived with disability (YLDs), as well as associations between DALYs and socio-demographic indices.
RESULTS: The GBD revealed that DALYs attributed to bone and joint infections associated with AMR have risen discernibly between 1990 and 2019 globally. Significant geographical disparities and a positive correlation with socio-demographic indicators were observed. Staphylococcus aureus infections, Group A Streptococcus, Group B Streptococcus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterobacter-related bone and joint infections were associated with the highest DALYs because of a high proportion of antimicrobial resistance. Countries with limited access to healthcare, suboptimal sanitary conditions, and inconsistent antibiotic stewardship were markedly impacted.
CONCLUSIONS: The GBD underscores the escalating burden of bone and joint infections exacerbated by AMR, necessitating urgent, multi-faceted interventions. Strategies to mitigate the progression and impact of AMR should emphasize prudent antimicrobial usage and robust infection prevention and control measures, coupled with advancements in diagnostic and therapeutic modalities.
METHODS: Utilizing GBD 2019 data, we summarized the burden of bone and joint infections attributed to AMR across 195 countries and territories in the 30 years from 1990 to 2019. We review the epidemiology of AMR in terms of age-standardized rates, the estimated DALYs, comprising years of life lost (YLLs) and years lived with disability (YLDs), as well as associations between DALYs and socio-demographic indices.
RESULTS: The GBD revealed that DALYs attributed to bone and joint infections associated with AMR have risen discernibly between 1990 and 2019 globally. Significant geographical disparities and a positive correlation with socio-demographic indicators were observed. Staphylococcus aureus infections, Group A Streptococcus, Group B Streptococcus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterobacter-related bone and joint infections were associated with the highest DALYs because of a high proportion of antimicrobial resistance. Countries with limited access to healthcare, suboptimal sanitary conditions, and inconsistent antibiotic stewardship were markedly impacted.
CONCLUSIONS: The GBD underscores the escalating burden of bone and joint infections exacerbated by AMR, necessitating urgent, multi-faceted interventions. Strategies to mitigate the progression and impact of AMR should emphasize prudent antimicrobial usage and robust infection prevention and control measures, coupled with advancements in diagnostic and therapeutic modalities.
摘要：
目标：骨和关节感染，随着抗菌素耐药性(AMR)的日益严峻的挑战，通过扩大全球疾病负担，构成重大的公共卫生威胁。我们利用2019年全球疾病负担研究（GBD）的结果，探讨了骨和关节感染对残疾调整寿命年（DALYs）的影响。阐明当代地位和时间趋势。
方法：利用GBD2019数据，我们总结了自1990年至2019年30年间,来自195个国家和地区的由AMR引起的骨和关节感染负担.我们根据年龄标准化率审查了AMR的流行病学，估计的DALYs，包括生命损失年数(YLL)和残疾生活年数(YLD)，以及DALY和社会人口指数之间的关联。
结果：GBD显示，与AMR相关的骨和关节感染的DALY在1990年至2019年期间在全球范围内明显上升。观察到显著的地理差异和与社会人口指标的正相关。金黄色葡萄球菌感染，A组链球菌,B组链球菌,大肠杆菌,铜绿假单胞菌,肺炎克雷伯菌,肠杆菌相关的骨和关节感染与最高的DALYs相关,因为抗菌药物耐药比例很高。获得医疗保健机会有限的国家，次优卫生条件，不一致的抗生素管理受到明显影响。
结论：GBD强调了AMR加剧的骨和关节感染的不断增加的负担，迫切需要，多方面的干预。缓解AMR进展和影响的策略应强调谨慎使用抗菌药物和强有力的感染预防和控制措施。再加上诊断和治疗方式的进步。
方法：利用GBD2019数据，我们总结了自1990年至2019年30年间,来自195个国家和地区的由AMR引起的骨和关节感染负担.我们根据年龄标准化率审查了AMR的流行病学，估计的DALYs，包括生命损失年数(YLL)和残疾生活年数(YLD)，以及DALY和社会人口指数之间的关联。
结果：GBD显示，与AMR相关的骨和关节感染的DALY在1990年至2019年期间在全球范围内明显上升。观察到显著的地理差异和与社会人口指标的正相关。金黄色葡萄球菌感染，A组链球菌,B组链球菌,大肠杆菌,铜绿假单胞菌,肺炎克雷伯菌,肠杆菌相关的骨和关节感染与最高的DALYs相关,因为抗菌药物耐药比例很高。获得医疗保健机会有限的国家，次优卫生条件，不一致的抗生素管理受到明显影响。
结论：GBD强调了AMR加剧的骨和关节感染的不断增加的负担，迫切需要，多方面的干预。缓解AMR进展和影响的策略应强调谨慎使用抗菌药物和强有力的感染预防和控制措施。再加上诊断和治疗方式的进步。
