The Global Burden of Klebsiella pneumoniae-Associated Lower Respiratory Infection in 204 Countries and Territories, 1990–2021: Findings From the Global Burden of Disease Study 2021

This study investigates the global epidemiological burden of lower respiratory infections (LRI) attributable to Klebsiella pneumoniae from 1990 to 2021, using data from the Global Burden of Disease Study (GBD) 2021. The findings reveal that globally, disability-adjusted life years (DALYs) from Klebsiella pneumoniae-associated LRI decreased from 16,701,044 (95% UI: 14,220,055 to 19,183,469) in 1990 to 6,935,440 (95% UI: 5,953,328 to 8,007,786) in 2021, while deaths declined from 239,367 (95% UI: 212,553 to 268,072) to 175,783 (95% UI: 158,749 to 193,924). The age-standardized DALYs rate dropped from 313.1 (95% UI: 266.6 to 359.7) to 87.9 (95% UI: 75.4 to 101.5), and the death rate decreased from 4.5 (95% UI: 4.0 to 5.0) to 2.2 (95% UI: 2.0 to 2.5). In 2021, the highest rates were observed in Oceania and Sub-Saharan Africa, particularly in Central African Republic, Niger, and Zimbabwe, while the lowest rates were found in Australasia, High-income North America, Eastern Europe, and East Asia, especially in the UAE, Australia, and Qatar. Higher rates were noted among both males and females under 10 and over 65 years old. Although most regions experienced decreases in age-standardized rates from 1990 to 2021, Southern Latin America exhibited an increase. Additionally, age-standardized DALYs and death rates generally declined with increasing socio-demographic index (SDI). The global burden of LRI due to Klebsiella pneumoniae significantly decreased over the study period, but lower SDI regions, children, and the elderly remain vulnerable and require targeted interventions to further reduce this burden.

本研究依托2021年全球疾病负担研究（Global Burden of Disease Study, GBD）数据，针对1990至2021年间由肺炎克雷伯菌（Klebsiella pneumoniae）所致下呼吸道感染（lower respiratory infections, LRI）的全球流行病学负担展开分析。研究结果显示，全球范围内，与肺炎克雷伯菌相关的下呼吸道感染所致伤残调整寿命年（disability-adjusted life years, DALYs）从1990年的16701044（95%不确定区间：14220055至19183469）降至2021年的6935440（95%不确定区间：5953328至8007786）；同期死亡数从239367（95%不确定区间：212553至268072）下降至175783（95%不确定区间：158749至193924）。年龄标化伤残调整寿命年率（age-standardized DALYs rate）从313.1（95%不确定区间：266.6至359.7）降至87.9（95%不确定区间：75.4至101.5），死亡率（death rate）则从4.5（95%不确定区间：4.0至5.0）下降至2.2（95%不确定区间：2.0至2.5）。2021年，大洋洲与撒哈拉以南非洲的相关率水平最高，其中尤以中非共和国、尼日尔及津巴布韦为甚；而澳大拉西亚、高收入北美、东欧及东亚的相关率水平最低，尤其是阿拉伯联合酋长国、澳大利亚与卡塔尔。10岁以下及65岁以上的男性与女性群体中，相关率均处于较高水平。尽管1990至2021年间多数地区的年龄标化率呈下降趋势，但拉丁美洲南部地区的年龄标化率却出现上升。此外，年龄标化伤残调整寿命年率与死亡率普遍随社会人口指数（socio-demographic index, SDI）的升高而降低。本研究周期内，肺炎克雷伯菌所致下呼吸道感染的全球负担显著下降，但社会人口指数较低的地区、儿童与老年群体仍属于脆弱人群，需采取针对性干预措施以进一步降低此类疾病负担。