1808. Burden of infectious diseases and bacterial antimicrobial resistance in China, 2019: a systematic analysis

Abstract

Abstract Background Whether on a global scale or within China, the issue of bacterial antimicrobial resistance (AMR) has become a pressing concern. This study aimed to comprehensively investigate the disease burden of infectious diseases and AMR in China. Methods Data on infectious diseases and AMR were collected by the Global Antimicrobial Resistance Burden study 2019 database. Our analysis steps consisted of 5 broad components: estimating the disease burdens of the total and 12 infectious syndromes by age and sex; describing the burden caused by 43 pathogens; calculating the burden caused by bacterial AMR in two scenarios (AMR associated deaths, AMR attributable deaths), respectively; estimating the AMR burden of 22 bacteria; calculating the burden of AMR by 22 bacteria and 19 antibiotics combinations. Results In 2019, there were an estimated 1.3 million (95% UI 0.8-1.9) infection-related deaths in China, accounting for 12.1% of the total deaths for that year. Males were 1.5 times more affected than females. Bloodstream infections was the largest fatal burden syndrome, associating with 521392 deaths (286307-870583), followed by lower respiratory infections (373175 deaths), and peritoneal and intra-abdominal infections (152087 deaths). These five leading pathogens were S aureus, A baumannii, E coli, S pneumoniae, and E spp., which were associated with 41.2% (502658/1218693) of all infection-related deaths. The pathogens of different infectious syndromes exhibit significant heterogeneity. In 2019, 602561 deaths were associated with bacterial AMR, including 145465 deaths attributable to bacterial AMR. Six leading pathogen-drug combinations were responsible for more than 0.5 million deaths in 2019: macrolides resistance S aureus, fourth-generation cephalosporins resistance A baumannii, carbapenems resistance A baumannii, third-generation cephalosporins resistance A baumannii, aminopenicillin resistance E coli, macrolides resistance S pneumoniae.Figure 1:Number and rate of deaths by pathogens in China, 2019. (A) Number; (B) Rate per 100000 populationFigure 2:Number of deaths associated with bacterial antimicrobial resistance by pathogen-drug combination in China, 2019 Conclusion This study provides the comprehensive assessment of the burden of infectious diseases and bacterial AMR in China. The annual death toll of 1.3 million infection-related deaths, including 600000 deaths related to antibiotic resistance, requires sufficient attention. Disclosures All Authors: No reported disclosures