Evidence map›Paper›PMID 37654039›Full record

ArticleCroatian medical journal2023

The burden of bacterial antimicrobial resistance in Croatia in 2019: a country-level systematic analysis.

Tomislav Meštrović, Kevin Shunji Ikuta, Lucien Swetschinski, Authia Gray, Gisela Robles Aguilar, Chieh Han, Eve Wool, Anna Gershberg Hayoon, Christopher Jl Murray, Mohsen Naghavi

Open access · diamondAbstract read
In one paragraph

Article in Croatian medical journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.7field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Tomislav MeštrovićTomislav Meštrović, Department of Nursing, University Centre Varaždin, University North, Ul. 104. brigade 3, 42 000 Varaždin, Croatia, tmestrovic@unin.hr.
Kevin Shunji Ikuta
Lucien Swetschinski
Authia Gray
Gisela Robles Aguilar
Chieh Han
Eve Wool
Anna Gershberg Hayoon
Christopher Jl Murray
Mohsen Naghavi
University of Washington · USInstitute for Health Metrics and Evaluation · USUniversity North · HR

Funding

Wellcome Trust
6 · The paper itself

Abstract

aimTo deliver the most wide-ranging set of antimicrobial resistance (AMR) burden estimates for Croatia to date.

methodsA complex modeling approach with five broad modeling components was used to estimate the disease burden for 12 main infectious syndromes and one residual group, 23 pathogenic bacteria, and 88 bug-drug combinations. This was represented by two relevant counterfactual scenarios: deaths/disability-adjusted life years (DALYs) that are attributable to AMR considering a situation where drug-resistant infections are substituted with sensitive ones, and deaths/DALYs associated with AMR considering a scenario where people with drug-resistant infections would instead present without any infection. The 95% uncertainty intervals (UI) were based on 1000 posterior draws in each modeling step, reported at the 2.5% and 97.5% of the draws' distribution, while out-of-sample predictive validation was pursued for all the models.

resultsThe total burden associated with AMR in Croatia was 2546 (95% UI 1558-3803) deaths and 46958 (28,033-71,628) DALYs, while the attributable burden was 614 (365-943) deaths and 11321 (6,544-17,809) DALYs. The highest number of deaths was established for bloodstream infections, followed by peritoneal and intra-abdominal infections and infections of the urinary tract. Five leading pathogenic bacterial agents were responsible for 1808 deaths associated with resistance: Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa (ordered by the number of deaths). Trimethoprim/sulfamethoxazole-resistant E coli and methicillin-resistant S. aureus were dominant pathogen-drug combinations in regard to mortality associated with and attributable to AMR, respectively.

conclusionWe showed that AMR represented a substantial public health concern in Croatia, which reflects global trends; hence, our detailed country-level findings may fast-track the implementation of multipronged strategies tailored in accordance with leading pathogens and pathogen-drug combinations.

Indexed as

Anti-Infective AgentsMethicillin-Resistant Staphylococcus aureusAnti-Bacterial AgentsBacteriaCroatiaDrug Resistance, BacterialEscherichia coliHumansAnti-Bacterial AgentsAnti-Infective Agents

Identifiers

PMID37654039
PMCPMC10509683
OpenAlexW4386347274

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.