Full toll of bacterial infection mapped for first time

The authors behind of a new study in The Lancet believe bacterial infection could be the second leading cause of death around the world.
 
Their analysis estimates there were 7.7 million deaths in 2019 linked to 33 pathogens, the equivalent of around 13.6% of all the world’s mortalities that year.
 
Only ischaemic heart disease accounted for more deaths.
 
The authors say detail on the disease burden of bacterial pathogens has historically been limited, and make the case for a much higher level of investment into prevention and treatment.
 
‘These new data for the first time reveal the full extent of the global public health challenge posed by bacterial infections,’ Dr Christopher Murray, study co-author and Director of the Institute for Health Metrics and Evaluation at the University of Washington’s School of Medicine, said.
 
‘It is of utmost importance to put these results on the radar of global health initiatives so that a deeper dive into these deadly pathogens can be conducted and proper investments are made to slash the number of deaths and infections.’
 
The common bacterial pathogens were considered along with 11 infection types.
 
Five pathogens – Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa – accounted for more than half (an estimated 54.9%) of the deaths linked to bacterial infection, according to researchers.
 
The study included analysis of funding levels for infectious disease research, finding that investment into tackling bacterial infections lagged.
 
Researchers stated that there was US$42 billion (AU$62.19 b) in funding for HIV research between 2000 and 2017 compared to $1.4 billion (AU$2.07 b) for Staphylococcus aureus and $800 million (AU$1.18 b) for Escherichia coli research – although the bacterial infections caused significantly more deaths.
 
In 2019, there were 864,000 global deaths linked to HIV/AIDS – equivalent to around 11% of those linked to bacterial infection over the same period.
 
‘The investments in HIV research are certainly warranted and, although bacterial infections could be tackled with different overlapping strategies, this disparity in funding might have been driven, in part, by the shortage of global burden numbers for these bacterial pathogens,’ the authors wrote.
 
The article indicates the age-standardised mortality rate linked to the 33 pathogens is significantly lower in the wealthiest parts of the world.
 
Australia’s mortality rate per 100,000 residents is placed between 35 and 50, compared to 200–394 deaths per 100,000 in much of Sub-Saharan Africa.
 
The researchers included mortality estimates for 204 countries and territories using data from the Global Burden of Disease 2019 and Global Research on Antimicrobial Resistance.
 
Around 343 million individual records were used to estimate the impact of each pathogen.
 
For Australia, the analysis cited Staphylococcus aureus as the pathogen causing the highest mortality (10.1 deaths per 100,000 people), followed by Escherichia coli (6) and Pseudomonas aeruginosa (3.5).
 
The authors say that many treatable infections occur in young age groups, a situation they describe as ‘a sobering reality’.
 
‘Building stronger health systems with more robust diagnostic infrastructure, improved diagnostic imaging and microbiological capacity, and standardised workflows are crucial steps to address this substantial burden, together with implementing appropriate infection control and antimicrobial stewardship measures,’ the study reads.
 
The research used funding from the Bill & Melinda Gates Foundation, as well as from the UK’s Wellcome Trust.
 
An article published in The Lancet earlier this year estimated there were more deaths due to antimicrobial resistance in 2019 – a total put at 1.7 million – than malaria and HIV combined.
 
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