136 million such infections globally; China, Pakistan and India bear highest burden
Drug-resistant bacterial pathogens frequently cause hospital-associated resistant infections, which are resistant to one or more antimicrobials. Photo: iStock_ India is among the countries bearing the highest burden of hospital-associated resistant infections (HARI) globally, according to a recent study. These infections are an important cause of morbidity and mortality in patients receiving treatment.
Hospital-associated infections occur in individuals while they are receiving medical treatment in a healthcare facility, such as hospitals, clinics, or other healthcare facilities.
The article was published in the journal PLOS Medicine on June 13, 2023.
The paper estimated the trend in prevalence of HARIs caused by high-priority pathogens such as Escherichia coli, Acinetobacter spp, Klebsiella spp, Staphylococcus aureus, Enterobacter spp and Pseudomonas spp in 195 countries.
Drug-resistant bacterial pathogens frequently cause these infections, which are resistant to one or more antimicrobials, thus exhibiting antimicrobial resistance (AMR).
The global number of HARIs is 136 million per year, according to the study, with China (52 million), Pakistan (10 million) and India (9 million) bearing the heaviest burden.
With nearly 119 million cases, middle-income countries had the highest annual burden of hospital-associated resistant infections. Among the high-income countries, the United States had the highest number of HARIs per year.
Overall, middle-income countries (119 million to 215 million) had more HARIs per year than low-income (2 million to 5 million) and high-income (15 million to 25 million).
Here is a description of the pathogens responsible for these infections in these settings:
HARIs significantly impact low- and middle-income settings due to their poor antimicrobial stewardship and limited microbiology diagnostic capacities.
A similar study published in the journal Lancet in 2022 attempted to estimate deaths and disability-adjusted life-years attributable to and associated with bacterial AMR for 23 pathogens and 88 pathogen-drug combinations in 204 countries and territories in 2019.
There were an estimated 4.95 million deaths associated with bacterial AMR in 2019 according to predictive statistical models, including 1.27 million deaths attributable to bacterial AMR.
However, while the aforementioned study provides a comprehensive overview of the global burden of AMR, it makes no distinction between hospital and community-associated settings.
Furthermore, the authors acknowledged that, in the absence of systematic surveillance systems for HARIs, the paper’s findings can be viewed as a baseline overview of rates.
The authors also emphasised that AMR is not currently recognized as a threat on par with HIV, tuberculosis and malaria, but the findings show that the burden of HARIs is substantial and thus deserves attention from world leaders.
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