Disability-adjusted life years from bone and joint infections associated with antimicrobial resistance: an insight from the 2019 Global Burden of Disease Study

Kai-Uwe Lewandrowski; Roberto Carlos Lyra da Silva; John C Elfar; Abduljabbar Alhammoud; Isam Sami Moghamis; Bendenikt W Burkhardt; Joachim M Oertel; Stefan Landgraeber; Rossano Kepler Alvim Fiorelli; Paulo Sérgio Teixeira de Carvalho; Ivo Abraham; Jorge Felipe Ramírez León; Ernesto Martinez; Morgan P Lorio

doi:10.1007/s00264-024-06143-2

Disability-adjusted life years from bone and joint infections associated with antimicrobial resistance: an insight from the 2019 Global Burden of Disease Study

Int Orthop. 2024 Mar 19. doi: 10.1007/s00264-024-06143-2. Online ahead of print.

Authors

Affiliations

¹ Orthopedics Surgery Department, Center for Advanced Spine Care of Southern Arizona, Tucson, AZ, USA.
² Basic Nursing Department, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil.
³ Orthopedics Surgery Department, University of Arizona College of Medicine, Tucson, AZ, USA.
⁴ Orthopedics Surgery Department, University of Arizona College of Medicine, Tucson, AZ, USA. aghammoud85@hotmail.com.
⁵ Orthopedics Surgery Department, Hamad Medical Corporation, Doha, Qatar.
⁶ Wirbelsäulenzentrum Spine Center - WSC_Hirslanden klinik Zurich, Zurich, Switzerland.
⁷ Department of Neurosurgery, Saarland University Hospital, Hamburg, Germany.
⁸ Department of General & Specialized Surgery, Gaffrée e Guinle University Hospital, Rio de Janeiro, Brazil.
⁹ Pain and Spine Minimally Invasive Surgery Service, Gaffre e Guinle University Hospital, Rio de Janeiro, Brazil.
¹⁰ Clinical Translational Science, University of Arizona, Tucson, AZ, USA.
¹¹ Orthopedics Surgery Department, Minimally Invasive Spine Center, Bogotá, Colombia.
¹² Orthopedics Surgery Department, Reina Sofia Clinic, Bogotá, Colombia.
¹³ Advanced Orthopedics, Punta Gorda, Florida, USA.

PMID: 38502335
DOI: 10.1007/s00264-024-06143-2

Abstract

Purpose: 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.

Keywords: Antimicrobial resistance; Bone and joint infections; Disability-adjusted life years.