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Cited by 2,235Antibiotic Use and ResistanceGlobal Health and EpidemiologyPneumonia and Respiratory Infections

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Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019

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Ikuta, Kevin S, Swetschinski, Lucien R, Robles Aguilar, Gisela, Sharara, Fablina, Mestrovic, Tomislav, Gray, Authia P, Davis Weaver, Nicole, Wool, Eve E, Han, Chieh, Gershberg Hayoon, Anna, Aali, Amirali, Abate, Semagn Mekonnen, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abd-Elsalam, Sherief, Abebe, Getachew, Abedi, Aidin, Abhari, Amir Parsa, Abidi, Hassan, Aboagye, Richard Gyan, Absalan, Abdorrahim, Abubaker Ali, Hiwa, Acuna, Juan Manuel, Adane, Tigist Demssew, Addo, Isaac Yeboah, Adegboye, Oyelola A, Adnan, Mohammad, Adnani, Qorinah Estiningtyas Sakilah, Afzal, Muhammad Sohail, Afzal, Saira, Aghdam, Zahra Babaei, Ahinkorah, Bright Opoku, Ahmad, Aqeel, Ahmad, Araz Ramazan, Ahmad, Rizwan, Ahmad, Sajjad, Ahmad, Sohail, Ahmadi, Sepideh, Ahmed, Ali, Ahmed, Haroon, Ahmed, Jivan Qasim, Ahmed Rashid, Tarik, Ajami, Marjan, Aji, Budi, Akbarzadeh-Khiavi, Mostafa, Akunna, Chisom Joyqueenet, Al Hamad, Hanadi, Alahdab, Fares, Al-Aly, Ziyad, Aldeyab, Mamoon A, Aleman, Alicia V, Alhalaiqa, Fadwa Alhalaiqa Naji, Alhassan, Robert Kaba, Ali, Beriwan Abdulqadir, Ali, Liaqat, Ali, Syed Shujait, Alimohamadi, Yousef, Alipour, Vahid, Alizadeh, Atiyeh, Aljunid, Syed Mohamed, Allel, Kasim, Almustanyir, Sami, Ameyaw, Edward Kwabena, Amit, Arianna Maever L, Anandavelane, Nivedita, Ancuceanu, Robert, Andrei, Catalina Liliana, Andrei, Tudorel, Anggraini, Dewi, Ansar, Adnan, Anyasodor, Anayochukwu Edward, Arabloo, Jalal, Aravkin, Aleksandr Y, Areda, Demelash, Aripov, Timur, Artamonov, Anton A, Arulappan, Judie, Aruleba, Raphael Taiwo, Asaduzzaman, Muhammad, Ashraf, Tahira, Athari, Seyyed Shamsadin, Atlaw, Daniel, Attia, Sameh, Ausloos, Marcel, Awoke, Tewachew, Ayala Quintanilla, Beatriz Paulina, Ayana, Tegegn Mulatu, Azadnajafabad, Sina, Azari Jafari, Amirhossein, B, Darshan B, Badar, Muhammad, Badiye, Ashish D, Baghcheghi, Nayereh, Bagherieh, Sara, Baig, Atif Amin, Banerjee, Indrajit, Barac, Aleksandra, Bardhan, Mainak, Barone-Adesi, Francesco, Barqawi, Hiba Jawdat, Barrow, Amadou, Baskaran, Pritish, Basu, Saurav, Batiha, Abdul-Monim Mohammad, Bedi, Neeraj, Belete, Melaku Ashagrie, Belgaumi, Uzma Iqbal, Bender, Rose G, Bhandari, Bharti, Bhandari, Dinesh, Bhardwaj, Pankaj, Bhaskar, Sonu, Bhattacharyya, Krittika, Bhattarai, Suraj, Bitaraf, Saeid, Buonsenso, Danilo, Butt, Zahid A, Caetano dos Santos, Florentino Luciano, Cai, Jiao, Calina, Daniela, Camargos, Paulo, Cámera, Luis Alberto, Cárdenas, Rosario, Cevik, Muge, Chadwick, Joshua, Charan, Jaykaran, Chaurasia, Akhilanand, Ching, Patrick R, Choudhari, Sonali Gajanan, Chowdhury, Enayet Karim, Chowdhury, Fazle Rabbi, Chu, Dinh-Toi, Chukwu, Isaac Sunday, Dadras, Omid, Dagnaw, Fentaw Teshome, Dai, Xiaochen, Das, Saswati, Dastiridou, Anna, Debela, Sisay Abebe, Demisse, Fitsum Wolde, Demissie, Solomon, Dereje, Diriba, Derese, Msganaw, Desai, Hardik Dineshbhai, Dessalegn, Fikadu Nugusu, Dessalegni, Samuel Abebe A, Desye, Belay, Dhaduk, Kartik, Dhimal, Meghnath, Dhingra, Sameer, Diao, Nancy, Diaz, Daniel, Djalalinia, Shirin, Dodangeh, Milad, Dongarwar, Deepa, Dora, Bezabih Terefe, Dorostkar, Fariba, Dsouza, Haneil Larson, Dubljanin, Eleonora, Dunachie, Susanna J, Durojaiye, Oyewole Christopher, Edinur, Hisham Atan, Ejigu, Habtamu Bekele, Ekholuenetale, Michael, Ekundayo, Temitope Cyrus, El-Abid, Hassan, Elhadi, Muhammed, Elmonem, Mohamed A, Emami, Amir, Engelbert Bain, Luchuo, Enyew, Daniel Berhanie, Erkhembayar, Ryenchindorj, Eshrati, Babak, Etaee, Farshid, Fagbamigbe, Adeniyi Francis, Falahi, Shahab, Fallahzadeh, Aida, Faraon, Emerito Jose A, Fatehizadeh, Ali, Fekadu, Ginenus, Fernandes, João C, Ferrari, Allegra, Fetensa, Getahun, Filip, Irina, Fischer, Florian, Foroutan, Masoud, Gaal, Peter Andras, Gadanya, Muktar A, Gaidhane, Abhay Motiramji, Ganesan, Balasankar, Gebrehiwot, Mesfin, Ghanbari, Reza, Ghasemi Nour, Mohammad, Ghashghaee, Ahmad, Gholamrezanezhad, Ali, Gholizadeh, Abdolmajid, Golechha, Mahaveer, Goleij, Pouya, Golinelli, Davide, Goodridge, Amador, Gunawardane, Damitha Asanga, Guo, Yuming, Gupta, Rajat Das, Gupta, Sapna, Gupta, Veer Bala, Gupta, Vivek Kumar, Guta, Alemu, Habibzadeh, Parham, Haddadi Avval, Atlas, Halwani, Rabih, Hanif, Asif, Hannan, Md. 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Kandel, Himal, Kapoor, Neeti, Karkhah, Samad, Kassa, Bekalu Getnet, Kassebaum, Nicholas J, Katoto, Patrick DMC, Keykhaei, Mohammad, Khajuria, Himanshu, Khan, Abbas, Khan, Imteyaz A, Khan, Maseer, Khan, Md Nuruzzaman, Khan, Moien AB, Khatatbeh, Moawiah Mohammad, Khater, Mona M, Khayat Kashani, Hamid Reza, Khubchandani, Jagdish, Kim, Hanna, Kim, Min Seo, Kimokoti, Ruth W, Kissoon, Niranjan, Kochhar, Sonali, Kompani, Farzad, Kosen, Soewarta, Koul, Parvaiz A, Koulmane Laxminarayana, Sindhura Lakshmi, Krapp Lopez, Fiorella, Krishan, Kewal, Krishnamoorthy, Vijay, Kulkarni, Vishnutheertha, Kumar, Naveen, Kurmi, Om P, Kuttikkattu, Ambily, Kyu, Hmwe Hmwe, Lal, Dharmesh Kumar, Lám, Judit, Landires, Iván, Lasrado, Savita, Lee, Sang-woong, Lenzi, Jacopo, Lewycka, Sonia, Li, Shanshan, Lim, Stephen S, Liu, Wei, Lodha, Rakesh, Loftus, Michael J, Lohiya, Ayush, Lorenzovici, László, Lotfi, Mojgan, Mahmoodpoor, Ata, Mahmoud, Mansour Adam, Mahmoudi, Razzagh, Majeed, Azeem, Majidpoor, Jamal, Makki, Alaa, Mamo, Galana Ayana, Manla, Yosef, Martorell, Miquel, Matei, Clara N, McManigal, Barney, Mehrabi Nasab, Entezar, Mehrotra, Ravi, Melese, Addisu, Mendoza-Cano, Oliver, Menezes, Ritesh G, Mentis, Alexios-Fotios A, Micha, Georgia, Michalek, Irmina Maria, Micheletti Gomide Nogueira de Sá, Ana Carolina, Milevska Kostova, Neda, Mir, Shabir Ahmad, Mirghafourvand, Mojgan, Mirmoeeni, Seyyedmohammadsadeq, Mirrakhimov, Erkin M, Mirza-Aghazadeh-Attari, Mohammad, Misganaw, Abay Sisay, Misganaw, Awoke, Misra, Sanjeev, Mohammadi, Esmaeil, Mohammadi, Mokhtar, Mohammadian-Hafshejani, Abdollah, Mohammed, Shafiu, Mohan, Syam, Mohseni, Mohammad, Mokdad, Ali H, Momtazmanesh, Sara, Monasta, Lorenzo, Moore, Catrin E, Moradi, Maryam, Moradi Sarabi, Mostafa, Morrison, Shane Douglas, Motaghinejad, Majid, Mousavi Isfahani, Haleh, Mousavi Khaneghah, Amin, Mousavi-Aghdas, Seyed Ali, Mubarik, Sumaira, Mulita, Francesk, Mulu, Getaneh Baye B, Munro, Sandra B, Muthupandian, Saravanan, Nair, Tapas Sadasivan, Naqvi, Atta 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Hossein, Samy, Abdallah M, Sanadgol, Nima, Sankararaman, Senthilkumar, Sanmarchi, Francesco, Sathian, Brijesh, Sawhney, Monika, Saya, Ganesh Kumar, Senthilkumaran, Subramanian, Seylani, Allen, Shah, Pritik A, Shaikh, Masood Ali, Shaker, Elaheh, Shakhmardanov, Murad Ziyaudinovich, Sharew, Mequannent Melaku, Sharifi-Razavi, Athena, Sharma, Purva, Sheikhi, Rahim Ali, Sheikhy, Ali, Shetty, Pavanchand H, Shigematsu, Mika, Shin, Jae Il, Shirzad-Aski, Hesamaddin, Shivakumar, K M, Shobeiri, Parnian, Shorofi, Seyed Afshin, Shrestha, Sunil, Sibhat, Migbar Mekonnen, Sidemo, Negussie Boti, Sikder, Mustafa Kamal, Silva, Luís Manuel Lopes Rodrigues, Singh, Jasvinder A, Singh, Paramdeep, Singh, Surjit, Siraj, Md Shahjahan, Siwal, Samarjeet Singh, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Socea, Bogdan, Solomon, Damtew Damtew, Song, Yimeng, Sreeramareddy, Chandrashekhar T, Suleman, Muhammad, Suliankatchi Abdulkader, Rizwan, Sultana, Saima, Szócska, Miklós, Tabatabaeizadeh, Seyed-Amir, Tabish, Mohammad, Taheri, Majid, Taki, Elahe, Tan, Ker-Kan, Tandukar, Sarmila, Tat, Nathan Y, Tat, Vivian Y, Tefera, Belay Negash, Tefera, Yibekal Manaye, Temesgen, Gebremaryam, Temsah, Mohamad-Hani, Tharwat, Samar, Thiyagarajan, Arulmani, Tleyjeh, Imad I, Troeger, Christopher E, Umapathi, Krishna Kishore, Upadhyay, Era, Valadan Tahbaz, Sahel, Valdez, Pascual R, Van den Eynde, Jef, van Doorn, H. Rogier, Vaziri, Siavash, Verras, Georgios-Ioannis, Viswanathan, Harimadhav, Vo, Bay, Waris, Abdul, Wassie, Gizachew Tadesse, Wickramasinghe, Nuwan Darshana, Yaghoubi, Sajad, Yahya, Gahin Abdulraheem Tayib Yahya, Yahyazadeh Jabbari, Seyed Hossein, Yigit, Arzu, Yiğit, Vahit, Yon, Dong Keon, Yonemoto, Naohiro, Zahir, Mazyar, Zaman, Burhan Abdullah, Zaman, Sojib Bin, Zangiabadian, Moein, Zare, Iman, Zastrozhin, Mikhail Sergeevich, Zhang, Zhi-Jiang, Zheng, Peng, Zhong, Chenwen, Zoladl, Mohammad, Zumla, Alimuddin, Hay, Simon I, Dolecek, Christiane, Sartorius, Benn, Murray, Christopher J L, Naghavi, Mohsen·2022·The Lancet
DOI 10.1016/s0140-6736(22)02185-7PMC PMC9763654
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Abstract

BACKGROUND: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. METHODS: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. FINDINGS: From an estimated 13·7 million (95% UI 10·9-17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7-10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2-18·1) of all global deaths and 56·2% (52·1-60·1) of all sepsis-related deaths in 2019. Five leading pathogens-Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa-were responsible for 54·9% (52·9-56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185-285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4-71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. INTERPRETATION: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. FUNDING: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund.

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Figure 1 Global number of deaths (A) and YLLs (B), by pathogen and infectious syndrome, 2019 Columns show total number of deaths for each pathogen, with error bars showing 95% uncertainty intervals, with the bars split into infectious syndromes. LRI=lower respiratory infection. iNTS=invasive non-typhoidal Salmonella. Salmonella Typhi=Salmonella enterica serotype Typhi. Salmonella Paratyphi=Salmonella enterica serotype Paratyphi. UTI=urinary tract infection. YLLs=years of life lost.
Figure 1 Global number of deaths (A) and YLLs (B), by pathogen and infectious syndrome, 2019 Columns show total number of deaths for each pathogen, with error bars showing 95% uncertainty intervals, with the bars split into infectious syndromes. LRI=lower respiratory infection. iNTS=invasive non-typhoidal Salmonella. Salmonella Typhi=Salmonella enterica serotype Typhi. Salmonella Paratyphi=Salmonella enterica serotype Paratyphi. UTI=urinary tract infection. YLLs=years of life lost.CC BY · PubMed Central
Figure 2 Overall age-standardised mortality rate per 100 000 population for 33 pathogens investigated, 2019
Figure 2 Overall age-standardised mortality rate per 100 000 population for 33 pathogens investigated, 2019CC BY · PubMed Central
Figure 3 Pathogen responsible for the highest age-standardised mortality rate per 100 000 population (A) and for the highest age-standardised YLL rate per 100 000 population (B), for each country or territory, 2019 A baumannii=Acinetobacter baumannii. E coli=Escherichia coli. K pneumoniae=Klebsiella pneumoniae. S aureus=Staphylococcus aureus. S pneumoniae=Streptococcus pneumoniae. YLLs=years of life lost.
Figure 3 Pathogen responsible for the highest age-standardised mortality rate per 100 000 population (A) and for the highest age-standardised YLL rate per 100 000 population (B), for each country or territory, 2019 A baumannii=Acinetobacter baumannii. E coli=Escherichia coli. K pneumoniae=Klebsiella pneumoniae. S aureus=Staphylococcus aureus. S pneumoniae=Streptococcus pneumoniae. YLLs=years of life lost.CC BY · PubMed Central
Figure 4 Global number of deaths (A) and YLLs (B), by pathogen and GBD super-region, 2019 Data are presented for the 14 pathogens with the largest number of global deaths; the Other group comprises the additional 19 bacteria estimated in this study. GBD=Global Burden of Diseases, Injuries, and Risk Factors. Salmonella Typhi=Salmonella enterica serotype Typhi. YLLs=years of life lost.
Figure 4 Global number of deaths (A) and YLLs (B), by pathogen and GBD super-region, 2019 Data are presented for the 14 pathogens with the largest number of global deaths; the Other group comprises the additional 19 bacteria estimated in this study. GBD=Global Burden of Diseases, Injuries, and Risk Factors. Salmonella Typhi=Salmonella enterica serotype Typhi. YLLs=years of life lost.CC BY · PubMed Central
Figure 5 Global number of deaths, by pathogen, age, and sex groups, 2019 Data are presented for the 14 pathogens with the largest number of global deaths; the Other group comprises the additional 19 bacteria estimated in this study. Neonatal=0 days to 27 days old. Post-neonatal=28 days to <1 year old. Salmonella Typhi=Salmonella enterica serotype Typhi.
Figure 5 Global number of deaths, by pathogen, age, and sex groups, 2019 Data are presented for the 14 pathogens with the largest number of global deaths; the Other group comprises the additional 19 bacteria estimated in this study. Neonatal=0 days to 27 days old. Post-neonatal=28 days to <1 year old. Salmonella Typhi=Salmonella enterica serotype Typhi.CC BY · PubMed Central

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Ikuta, K. S., Swetschinski, L. R., Robles Aguilar, G., Sharara, F., Mestrovic, T., Gray, A. P., Davis Weaver, N., Wool, E. E., Han, C., Gershberg Hayoon, A., Aali, A., Abate, S. M., Abbasi-Kangevari, M., Abbasi-Kangevari, Z., Abd-Elsalam, S., Abebe, G., Abedi, A., Abhari, A. P., Abidi, H., Aboagye, R. G., Absalan, A., Abubaker Ali, H., Acuna, J. M., Adane, T. D., Addo, I. Y., Adegboye, O. A., Adnan, M., Adnani, Q. E. S., Afzal, M. S., Afzal, S., Aghdam, Z. B., Ahinkorah, B. O., Ahmad, A., Ahmad, A. R., Ahmad, R., Ahmad, S., Ahmad, S., Ahmadi, S., Ahmed, A., Ahmed, H., Ahmed, J. Q., Ahmed Rashid, T., Ajami, M., Aji, B., Akbarzadeh-Khiavi, M., Akunna, C. J., Al Hamad, H., Alahdab, F., Al-Aly, Z., Aldeyab, M. A., Aleman, A. V., Alhalaiqa, F. A. N., Alhassan, R. K., Ali, B. A., Ali, L., Ali, S. S., Alimohamadi, Y., Alipour, V., Alizadeh, A., Aljunid, S. M., Allel, K., Almustanyir, S., Ameyaw, E. K., Amit, A. M. L., Anandavelane, N., Ancuceanu, R., Andrei, C. L., Andrei, T., Anggraini, D., Ansar, A., Anyasodor, A. E., Arabloo, J., Aravkin, A. Y., Areda, D., Aripov, T., Artamonov, A. A., Arulappan, J., Aruleba, R. T., Asaduzzaman, M., Ashraf, T., Athari, S. S., Atlaw, D., Attia, S., Ausloos, M., Awoke, T., Ayala Quintanilla, B. P., Ayana, T. M., Azadnajafabad, S., Azari Jafari, A., B, D. B., Badar, M., Badiye, A. D., Baghcheghi, N., Bagherieh, S., Baig, A. A., Banerjee, I., Barac, A., Bardhan, M., Barone-Adesi, F., Barqawi, H. J., Barrow, A., Baskaran, P., Basu, S., Batiha, A.-M. M., Bedi, N., Belete, M. A., Belgaumi, U. I., Bender, R. G., Bhandari, B., Bhandari, D., Bhardwaj, P., Bhaskar, S., Bhattacharyya, K., Bhattarai, S., Bitaraf, S., Buonsenso, D., Butt, Z. A., Caetano dos Santos, F. L., Cai, J., Calina, D., Camargos, P., Cámera, L. A., Cárdenas, R., Cevik, M., Chadwick, J., Charan, J., Chaurasia, A., Ching, P. R., Choudhari, S. G., Chowdhury, E. K., Chowdhury, F. R., Chu, D.-T., Chukwu, I. S., Dadras, O., Dagnaw, F. T., Dai, X., Das, S., Dastiridou, A., Debela, S. A., Demisse, F. W., Demissie, S., Dereje, D., Derese, M., Desai, H. D., Dessalegn, F. N., Dessalegni, S. A. A., Desye, B., Dhaduk, K., Dhimal, M., Dhingra, S., Diao, N., Diaz, D., Djalalinia, S., Dodangeh, M., Dongarwar, D., Dora, B. T., Dorostkar, F., Dsouza, H. L., Dubljanin, E., Dunachie, S. J., Durojaiye, O. C., Edinur, H. A., Ejigu, H. B., Ekholuenetale, M., Ekundayo, T. C., El-Abid, H., Elhadi, M., Elmonem, M. A., Emami, A., Engelbert Bain, L., Enyew, D. B., Erkhembayar, R., Eshrati, B., Etaee, F., Fagbamigbe, A. F., Falahi, S., Fallahzadeh, A., Faraon, E. J. A., Fatehizadeh, A., Fekadu, G., Fernandes, J. C., Ferrari, A., Fetensa, G., Filip, I., Fischer, F., Foroutan, M., Gaal, P. A., Gadanya, M. A., Gaidhane, A. M., Ganesan, B., Gebrehiwot, M., Ghanbari, R., Ghasemi Nour, M., Ghashghaee, A., Gholamrezanezhad, A., Gholizadeh, A., Golechha, M., Goleij, P., Golinelli, D., Goodridge, A., Gunawardane, D. A., Guo, Y., Gupta, R. D., Gupta, S., Gupta, V. B., Gupta, V. K., Guta, A., Habibzadeh, P., Haddadi Avval, A., Halwani, R., Hanif, A., Hannan, M. A., Harapan, H., Hassan, S., Hassankhani, H., Hayat, K., Heibati, B., Heidari, G., Heidari, M., Heidari-Soureshjani, R., Herteliu, C., Heyi, D. Z., Hezam, K., Hoogar, P., Horita, N., Hossain, M. M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Hoveidamanesh, S., Huang, J., Hussain, S., Hussein, N. R., Ibitoye, S. E., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Imam, M. T., Immurana, M., Inbaraj, L. R., Iradukunda, A., Ismail, N. E., Iwu, C. C. D., Iwu, C. J., J, L. M., Jakovljevic, M., Jamshidi, E., Javaheri, T., Javanmardi, F., Javidnia, J., Jayapal, S. K., Jayarajah, U., Jebai, R., Jha, R. P., Joo, T., Joseph, N., Joukar, F., Jozwiak, J. J., Kacimi, S. E. O., Kadashetti, V., Kalankesh, L. R., Kalhor, R., Kamal, V. K., Kandel, H., Kapoor, N., Karkhah, S., Kassa, B. G., Kassebaum, N. J., Katoto, P. D., Keykhaei, M., Khajuria, H., Khan, A., Khan, I. A., Khan, M., Khan, M. N., Khan, M. A., Khatatbeh, M. M., Khater, M. M., Khayat Kashani, H. R., Khubchandani, J., Kim, H., Kim, M. S., Kimokoti, R. W., Kissoon, N., Kochhar, S., Kompani, F., Kosen, S., Koul, P. A., Koulmane Laxminarayana, S. L., Krapp Lopez, F., Krishan, K., Krishnamoorthy, V., Kulkarni, V., Kumar, N., Kurmi, O. P., Kuttikkattu, A., Kyu, H. H., Lal, D. K., Lám, J., Landires, I., Lasrado, S., Lee, S.-W., Lenzi, J., Lewycka, S., Li, S., Lim, S. S., Liu, W., Lodha, R., Loftus, M. J., Lohiya, A., Lorenzovici, L., Lotfi, M., Mahmoodpoor, A., Mahmoud, M. A., Mahmoudi, R., Majeed, A., Majidpoor, J., Makki, A., Mamo, G. A., Manla, Y., Martorell, M., Matei, C. N., McManigal, B., Mehrabi Nasab, E., Mehrotra, R., Melese, A., Mendoza-Cano, O., Menezes, R. G., Mentis, A.-F. A., Micha, G., Michalek, I. M., Micheletti Gomide Nogueira de Sá, A. C., Milevska Kostova, N., Mir, S. A., Mirghafourvand, M., Mirmoeeni, S., Mirrakhimov, E. M., Mirza-Aghazadeh-Attari, M., Misganaw, A. S., Misganaw, A., Misra, S., Mohammadi, E., Mohammadi, M., Mohammadian-Hafshejani, A., Mohammed, S., Mohan, S., Mohseni, M., Mokdad, A. H., Momtazmanesh, S., Monasta, L., Moore, C. E., Moradi, M., Moradi Sarabi, M., Morrison, S. D., Motaghinejad, M., Mousavi Isfahani, H., Mousavi Khaneghah, A., Mousavi-Aghdas, S. A., Mubarik, S., Mulita, F., Mulu, G. B. B., Munro, S. B., Muthupandian, S., Nair, T. S., Naqvi, A. A., Narang, H., Natto, Z. S., Naveed, M., Nayak, B. P., Naz, S., Negoi, I., Nejadghaderi, S. A., Neupane Kandel, S., Ngwa, C. H., Niazi, R. K., Nogueira de Sá, A. T., Noroozi, N., Nouraei, H., Nowroozi, A., Nuñez-Samudio, V., Nutor, J. J., Nzoputam, C. I., Nzoputam, O. J., Oancea, B., Obaidur, R. M., Ojha, V. A., Okekunle, A. P., Okonji, O. C., Olagunju, A. T., Olusanya, B. O., Omar Bali, A., Omer, E., Otstavnov, N., Oumer, B., P A, M., Padubidri, J. R., Pakshir, K., Palicz, T., Pana, A., Pardhan, S., Paredes, J. L., Parekh, U., Park, E.-C., Park, S., Pathak, A., Paudel, R., Paudel, U., Pawar, S., Pazoki Toroudi, H., Peng, M., Pensato, U., Pepito, V. C. F., Pereira, M., Peres, M. F. P., Perico, N., Petcu, I.-R., Piracha, Z. Z., Podder, I., Pokhrel, N., Poluru, R., Postma, M. J., Pourtaheri, N., Prashant, A., Qattea, I., Rabiee, M., Rabiee, N., Radfar, A., Raeghi, S., Rafiei, S., Raghav, P. R., Rahbarnia, L., Rahimi-Movaghar, V., Rahman, M., Rahman, M. A., Rahmani, A. M., Rahmanian, V., Ram, P., Ranjha, M. M. A. N., Rao, S. J., Rashidi, M.-M., Rasul, A., Ratan, Z. A., Rawaf, S., Rawassizadeh, R., Razeghinia, M. S., Redwan, E. M. M., Regasa, M. T., Remuzzi, G., Reta, M. A., Rezaei, N., Rezapour, A., Riad, A., Ripon, R. K., Rudd, K. E., Saddik, B., Sadeghian, S., Saeed, U., Safaei, M., Safary, A., Safi, S. Z., Sahebazzamani, M., Sahebkar, A., Sahoo, H., Salahi, S., Salahi, S., Salari, H., Salehi, S., Samadi Kafil, H., Samy, A. M., Sanadgol, N., Sankararaman, S., Sanmarchi, F., Sathian, B., Sawhney, M., Saya, G. K., Senthilkumaran, S., Seylani, A., Shah, P. A., Shaikh, M. A., Shaker, E., Shakhmardanov, M. Z., Sharew, M. M., Sharifi-Razavi, A., Sharma, P., Sheikhi, R. A., Sheikhy, A., Shetty, P. H., Shigematsu, M., Shin, J. I., Shirzad-Aski, H., Shivakumar, K. M., Shobeiri, P., Shorofi, S. A., Shrestha, S., Sibhat, M. M., Sidemo, N. B., Sikder, M. K., Silva, L. M. L. R., Singh, J. A., Singh, P., Singh, S., Siraj, M. S., Siwal, S. S., Skryabin, V. Y., Skryabina, A. A., Socea, B., Solomon, D. D., Song, Y., Sreeramareddy, C. T., Suleman, M., Suliankatchi Abdulkader, R., Sultana, S., Szócska, M., Tabatabaeizadeh, S.-A., Tabish, M., Taheri, M., Taki, E., Tan, K.-K., Tandukar, S., Tat, N. Y., Tat, V. Y., Tefera, B. N., Tefera, Y. M., Temesgen, G., Temsah, M.-H., Tharwat, S., Thiyagarajan, A., Tleyjeh, I. I., Troeger, C. E., Umapathi, K. K., Upadhyay, E., Valadan Tahbaz, S., Valdez, P. R., Van den Eynde, J., van Doorn, H. R., Vaziri, S., Verras, G.-I., Viswanathan, H., Vo, B., Waris, A., Wassie, G. T., Wickramasinghe, N. D., Yaghoubi, S., Yahya, G. A. T. Y., Yahyazadeh Jabbari, S. H., Yigit, A., Yiğit, V., Yon, D. K., Yonemoto, N., Zahir, M., Zaman, B. A., Zaman, S. B., Zangiabadian, M., Zare, I., Zastrozhin, M. S., Zhang, Z.-J., Zheng, P., Zhong, C., Zoladl, M., Zumla, A., Hay, S. I., Dolecek, C., Sartorius, B., Murray, C. J. L., & Naghavi, M.
Affiliations
University of Washington (US)
Corresponding author
Naghavi, Mohsen
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2022-12
Volume
400
Issue
10369
Pages
2221-2248
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(22)02185-7
PMC
PMC9763654
OpenAlex
W4309503005
Cited by
2,235
References
37
Citations by year
2026: 517 · 2025: 730 · 2024: 654 · 2023: 325 · 2022: 8
FWCI
278.44
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion, cc-by)
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  • CentAUR (University of Reading) (acceptedVersion)
  • St George's Online Research Archive (St George's University of London) (acceptedVersion)
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  • ResearchOnline - JCU (James Cook University) (submittedVersion)
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  • YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
  • Lirias (KU Leuven) (submittedVersion, cc-by)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
  • Charles Sturt University Research Output (CRO) (submittedVersion, cc-by)
  • Research Online (University of Wollongong) (submittedVersion)
  • FedUni ResearchOnline (Federation University Australia) (submittedVersion, cc-by)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
  • Research Repository Portal (Ilam University of Medical Sciences) (submittedVersion, cc-by)
  • UCL Discovery (University College London) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
  • Figshare (submittedVersion, cc-by)
  • Figshare (submittedVersion)
  • PubliCatt (Università Cattolica del Sacro Cuore) (submittedVersion, other-oa)
  • Huddersfield Research Portal (University of Huddersfield) (submittedVersion, cc-by)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by)
  • Spiral (Imperial College London) (submittedVersion, cc-by)
  • Use Siena air (University of Siena) (submittedVersion, cc-by)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
Funders
  • U.S. Department of Veterans Affairs
  • Bill and Melinda Gates Foundation (OPP1176062, A126042)
  • Social Science Research Council (COVID-19)
  • Amgen
  • Pfizer
  • Sanofi
  • Alexander von Humboldt-Stiftung
  • Yale University
  • University of Southern California
  • Kaiser Permanente
  • Teva Pharmaceutical Industries
  • Emory University
  • Harvard University
  • Washington University in St. Louis
  • Cleveland Clinic
  • Arizona State University
  • City University of Hong Kong
  • Florida International University
  • Universidade da Beira Interior
  • University of Washington
  • Hamad Medical Corporation
  • Rice University
  • Johns Hopkins University (COVID-19)
  • University of Central Florida
  • University of Pittsburgh
  • Case Western Reserve University
  • Bournemouth University
  • Rush University
  • University of South Carolina
  • Jazan University
  • Prince Sattam bin Abdulaziz University
  • COMSATS Institute of Information Technology
  • New Mexico State University
  • McMaster University
  • Queensland Health
  • Wellcome Trust
  • Anglia Ruskin University
  • Indiana University Health
  • Iran University of Medical Sciences
  • UK Research and Innovation (MR/W02067X/1)
  • Amarin Corporation
  • Institute for Health Metrics and Evaluation
  • South Eastern Sydney Local Health District
  • Australian Government
  • National Authority for Scientific Research and Innovation
  • Istituto di Ricerche Farmacologiche Mario Negri - IRCCS
  • University of Central Punjab
  • University of Engineering and Technology, Lahore
  • Ahmadu Bello University
  • Høgskulen på Vestlandet
  • Universitas Riau
  • Rafsanjan University of Medical Sciences
  • Wollega University
  • Tribhuvan University
  • Instituut voor Tropische Geneeskunde
  • Mongolian National University of Medical Sciences
  • Krishna Institute Of Medical Sciences Deemed To Be University
  • Torbat Heydariyeh University of Medical Sciences
  • Ministerul Cercetării, Inovării şi Digitalizării (ID-585-CTR-42-PFE-2021, PN-III-P4-ID-PCCF-2016-0084)
  • Maragheh University of Medical Sciences
  • Universidad de Colima
  • Universidad Peruana Cayetano Heredia
  • Kasturba Medical College, Manipal
  • Moderna
  • Seres Therapeutics
  • Saveetha Dental College
  • BGI Group
  • Invitae
  • National Institute for Health and Care Research (NF-SI-0616-10016, COVID-19, NIHR300791, NIHR203795)
  • Department of Health and Social Care (MR/W02067X/1, NIHR300791)
  • University of Leicester
  • University of St Andrews
  • University of Warwick
  • Imperial College London
  • University College London
  • University of Oxford
  • University of Reading
  • Cancer Institute NSW
  • La Trobe University
  • Macquarie University
  • London South Bank University
  • Coventry University
  • South African Medical Research Council
  • University of Pretoria
  • National University of Singapore
  • Department of Science and Technology, Ministry of Science and Technology, India
  • Indian Council of Medical Research (COVID-19)
  • Public Health Foundation of India
  • Amity University
  • Rijksuniversiteit Groningen
  • Charles Sturt University
  • University of New South Wales
  • University of Technology Sydney
  • University of Wollongong
  • Deakin University
  • Monash University
  • Flinders University
  • James Cook University
  • Curtin University of Technology
  • Public Health England
  • Semmelweis Egyetem
  • Bundesministerium für Bildung und Forschung
  • Ain Shams University
  • Chongqing University
  • King Saud University
  • Cairo University
  • Taibah University
  • Dongguk University
  • Pohang University of Science and Technology
  • Seoul National University
  • Yonsei University
  • Kyung Hee University
  • Ewha Womans University
  • Gachon University
  • Islamic Azad University
  • Amirkabir University of Technology
  • Banaras Hindu University
  • Bushehr University of Medical Sciences
  • University of Calcutta
  • Bundesministerium für Gesundheit
  • Ministero della Salute (34/2017)
  • University of the Western Cape
  • Ilam University of Medical Sciences
  • Ministry of Health and Medical Education
  • Isfahan University of Medical Sciences
  • KU Leuven
  • Karolinska Institutet
  • King Abdulaziz University
  • Khalifa University of Science, Technology and Research
  • Mahidol University
  • Mazandaran University of Medical Sciences
  • Universidad Autónoma Metropolitana
  • Shahroud University of Medical Sciences
  • Shiraz University of Medical Sciences
  • Sultan Qaboos University
  • Tabriz University of Medical Sciences
  • Universiteit Stellenbosch
  • Kuwait University
  • Tehran University of Medical Sciences and Health Services
  • University of Waterloo
  • Universiti Kebangsaan Malaysia
  • Universiti Sains Malaysia
  • Kerman University of Medical Sciences
  • Università degli Studi di Genova
  • Haramaya University
  • Chinese University of Hong Kong
  • Shahrekord University
  • Shanghai Jiao Tong University
  • Süleyman Demirel Üniversitesi
  • Nankai University
  • Ahvaz Jundishapur University of Medical Sciences
  • Universitetet i Bergen
  • Jimma University
  • Shiraz University
  • Universitair Medisch Centrum Groningen
  • Kermanshah University of Medical Sciences
  • Universitetet i Oslo
  • Tehran Heart Center
  • Guilan University of Medical Sciences
  • Universidade de São Paulo
  • Università degli Studi del Piemonte Orientale
  • Universidad Nacional Autónoma de México
  • Università Cattolica del Sacro Cuore
  • Shahrekord University of Medical Sciences
  • Göteborgs Universitet
  • Autoritatea Natională pentru Cercetare Stiintifică
  • Shahid Beheshti University of Medical Sciences
  • Bahir Dar University
  • Università di Bologna
  • Ateneo de Manila University
  • United Arab Emirates University
  • Universidad de la República Uruguay
  • Ministério da Ciência, Tecnologia e Ensino Superior (UID/Multi/50016/2019)
  • Oulun Yliopisto
  • Centre Hospitalier Universitaire Vaudois
  • Qazvin University of Medical Sciences
  • Yarmouk University (34/2017)
  • Aristotle University of Thessaloniki
  • Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii (34/2017, PN-III-P4-ID, PN-III-P4-ID-PCCF-2016-0084, PN-III-P4-ID-PCCF-2016)
  • Federation University Australia
  • Technische Universität Berlin
  • Wuhan University
  • Secretaría Nacional de Ciencia, Tecnología e Innovación
  • University of Cape Town
  • Yasuj University of Medical Sciences
  • Urmia University
  • Binzhou Medical University
  • Universitatea din București
  • Universidade Federal de Minas Gerais
  • University of the Philippines
  • Shaqra University
  • Majmaah University
  • Universitatea de Medicină şi Farmacie "Carol Davila" Bucureşti
  • University of Tabriz
  • Ilam University
  • University of Gondar
  • Addis Ababa University
  • Tanta University
  • National Nutrition and Food Technology Research Institute
  • Golestan University of Medical Sciences
  • Zanjan University of Medical Sciences
  • Dire Dawa University
  • Khulna University
  • University of Zanjan
  • Xiamen University
  • University of Peradeniya
  • International Centre for Diarrhoeal Disease Research, Bangladesh
  • Mansoura University
  • International Medical University
  • Mekelle University
  • National Center of Neurology and Psychiatry
  • Jawaharlal Institute Of Postgraduate Medical Education and Research
  • University of Colombo
  • University of Thessaly
  • Masarykova Univerzita (MUNI/IGA/1104/2021, LX22NPO5101)
  • Monash University Malaysia
  • Rajarata University of Sri Lanka
  • King Fahad Medical City
  • Gonabad University of Medical Sciences
  • Lorestan University of Medical Sciences
  • Hellenic Foundation for Research and Innovation (MIMS-860)
  • Hubei University of Medicine
  • Lingnan University
  • Imam Abdulrahman Bin Faisal University
  • Universiti Sultan Zainal Abidin
  • Jenderal Soedirman University
  • Jahrom University of Medical Sciences
  • University of Tlemcen
  • Universitas Padjadjaran
  • Universitas Syiah Kuala
  • Rajshahi University
  • Universitatea Sapientia
  • Universidad Autónoma de Sinaloa
  • Moscow Institute of Physics and Technology
  • Alfaisal University
  • Pirogov Russian National Research Medical University
  • Ajman University
  • Humanitas Research Hospital
  • National Institute of Pharmaceutical Education and Research, Raebareli
  • Madda Walabu University
  • Dilla University
  • Adigrat University
  • University of Health and Allied Sciences
  • Debre Tabor University
  • University of Veterinary and Animal Sciences
  • Uniwersytet Opolski
  • National Institutes of Health (COVID-19)
  • Directorate for Biological Sciences
  • Defense Threat Reduction Agency
  • Samsung
  • Horizon 2020 Framework Programme (LX22NPO5101)
  • Medical Research Council (MR/W020653/1, MR/W02067X/1, COVID-19)
  • National Health and Medical Research Council
  • Leibniz-Gemeinschaft
  • Japan Society for the Promotion of Science (21K04541)
  • Fundação para a Ciência e a Tecnologia (CEN-TRO-04-3559-FSE-000162, UID/Multi/50016/2019, /2017)
  • Russian Academy of Sciences
  • Gastrointestinal and Liver Diseases Research Center
  • Yonsei University College of Medicine
  • European Regional Development Fund (CENTRO-04-3559-FSE-000162)
  • Center for International Health
  • Zabol University of Medical Sciences
  • National Research, Development and Innovation Office (RRF-2.3.1-21, RRF-2.3.1-21-2022-00006)
  • NIHR Sheffield Biomedical Research Centre
  • National Heart, Lung, and Blood Institute
  • National Human Genome Research Institute
  • National Institute of General Medical Sciences (K23GM141463)
  • National Institute of Allergy and Infectious Diseases (T32AI007044)
  • Fogarty International Center (D43TW009763)
  • NIH Clinical Center
  • Division of Human Resource Development
  • Janssen Pharmaceuticals
  • European and Developing Countries Clinical Trials Partnership (CANTAM-3)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Epidemiology
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Keywords
pathogenic bacteria, infectious disease mortality, antimicrobial resistance, sepsis, infectious syndromes, attributable fraction, mortality estimates, Global Burden of Disease Study 2019, sex differences in mortality, age differences in mortality, uncertainty intervals
MeSH terms
Global Burden of Disease, Bacteria, Bacterial Infections, Child, Female, Humans, Male, Risk Factors, Syndrome, Global Health, Africa South of the Sahara, Sepsis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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