1990-2021年中国多重耐药菌感染疾病负担变化趋势

Changing trends of burden of diseases due to multidrug-resistantorganisms infections in China from 1990 to 2021

  • 摘要: 目的 分析1990-2021年中国多重耐药菌(MDRO)感染疾病负担变化趋势,为防控政策制定提供支持。方法 选取全球疾病负担研究(GBD)数据库中1990-2010年中国(除台湾地区)的MDRO感染相关疾病负担数据,用死亡人数、病死率、伤残调整生命年(DALYs)和DALYs率作为疾病负担评价指标,分析不同MDRO及不同年龄组的变化趋势。结果 1990-2021年,我国MDRO感染相关死亡例数占比呈上升趋势(P<0.001);耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯类鲍曼不动杆菌(CRAB)和耐碳青霉烯类铜绿假单胞菌(CRPA)感染的疾病负担处于前三位;MRSA在1990年后快速上升,至2016年后略有下降,CRAB在2010年后略有下降,CRPA在2010年后趋于平稳;耐碳青霉烯类大肠埃希菌(CRECO)2010年后开始缓慢上升,耐万古霉素肠球菌(VRE)始终较低;耐碳青霉烯类肺炎克雷伯菌(CRKP)在2010年后增幅明显;MDRO感染在不同年龄组中的疾病负担,新生儿和<5岁儿童呈下降趋势,≥70岁老人则呈上升趋势。结论 1990-2021年中国MDRO感染疾病负担中,MRSA、CRAB和CRPA一直处于前三位,但其在2010年后基本处于下降或增幅很小的趋势,VRE一直处于低位,CRECO缓慢增长,CRKP则呈快速增长趋势,需进一步关注和加强CRKP感染及老年人群的防控。

     

    Abstract: OBJECTIVE To analyze the changing trends of disease of burden due to multidrug-resistant organisms (MDROs) infections in China from 1990 to 2021 so as to provide bases for development of prevention and control policies. METHODS The data regarding to the burden of disease associated with MDROs infections in China (except Taiwan) from 1990 to 2010 were collected from the GBD database; the number of deaths, mortality rate, DALYs and the rate of DALYs were taken as the indexes for evaluation of the burden of diseases. The changing trends were observed and compared among the different MDROs infections and the different age groups. RESULTS The proportion of death cases related to MDROs infections showed an upward trend in China from 1990 to 2021 (P<0.001). The disease burdens of methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) ranked the top 3; MRSA rose rapidly after 1990 and showed a slight decline after 2016, CRAB declined slightly after 2010, and CRPA remained relatively stable after 2010; carbapenem-resistant Escherichia coli (CRECO) began to increase slowly after 2010, while vancomycin-resistant Enterococcus (VRE) remained consistently low; carbapenem-resistant Klebsiella pneumoniae (CRKP) increased markedly after 2010; regarding the disease burden of MDROs infections across the age groups, neonates and children aged less than 5 years old showed a downward trend, whereas adults aged no less than 70 years old showed an upward trend. CONCLUSION In the burden of disease of MDROs infection in China from 1990 to 2021, MRSA, CRAB and CRPA have been in the top three, but they are basically in the trend of decreasing or very small increase after 2010, VRE has been at a low level, CRECO is slowly increasing, and CRKP is rapidly increasing, which needs to be further paid attention to and strengthened in the prevention and control of CRKP infections among the elderly population.

     

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