Infections by multi-resistant bacteria in Spanish hospitals could cause more than 20000 deaths a year

A study published in The Lancet Regional Health – Europe estimates that in 2023 there were 173 infections due to multi-resistant microorganisms in hospitals in Spain, with 653 associated deaths. The research reveals that the burden of this type of infections is significantly higher than expected.

Antimicrobial resistance continues to be one of the greatest threats to public health in Spain, with a significant increase in infections caused by multi-resistant microorganisms in hospitalized patients. Now, several teams from the Infectious Diseases area of ​​CIBER (CIBERINFEC) have analyzed the impact of hospital infections and associated deaths, noting that the health burden caused by multi-resistant bacterial infections in Spain is much greater than previously described. The results have been published in The Lancet Regional Health – Europe. 

This study analyzed more than 4.800 hospitalized patients from three prospective studies carried out in 2018, 2019 and 2023, comparing diagnoses of multidrug-resistant bacterial infections in the three periods, with the participation of 82, 133 and 130 Spanish hospitals, respectively.

The study has been coordinated by CIBERINFEC researchers Jose Miguel Cisneros, researcher at the Institute of Biomedicine of Seville (IBiS) and director of the Infectious Diseases and Microbiology Unit of the Virgen del Rocío University Hospital, and Jose Ramon Cloth-Pardo, researcher at the Aragon Health Research Institute (IIS Aragón) and head of the Infectious Diseases service at the University Clinical Hospital of Zaragoza and has had the collaboration of many CIBER groups in different institutions. The research adds a new and efficient approach to measure the health burden of multi-resistant bacterial infections in a country and has been carried out jointly by microbiologists and infectious disease specialists.

Dr. Cisneros notes that “this study provides the most comprehensive analysis to date of the annual health impact of bacterial resistance to antimicrobials in Spain and contains methodological advances with respect to previous related works. Thus, we have observed that The health burden caused by infections caused by multi-resistant bacteria in Spain is much greater than described above."

The implications of the study, according to Dr. Cisneros, are: “that the methodology can be used in other countries for comparative purposes; the data can be useful to raise awareness about this serious problem of bacterial resistance to antimicrobials; and, finally, the results can help health authorities to prioritize resources based on the magnitude of the problem, and health professionals to better understand the main epidemiological, microbiological and clinical characteristics of multi-resistant bacteria in hospitalized patients and, therefore, to design the best interventions to improve outcomes.”

As Dr. Paño-Pardo explains, “the cumulative impact of antimicrobial resistance observed in the study is very high. In 2023, around 170 people would have been diagnosed with infections caused by multi-resistant organisms, of whom 000 would have died within 24 days of diagnosis.”

“The impact of these infections, as indicated by the study, is greater than expected,” the authors explain, which is why “It is necessary to intensify actions at the national level to combat antimicrobial resistance. Our results should help raise awareness among professionals, the media, citizens and health authorities about the real threat posed by these resistances.”

The study analyzed data from more than 4 hospitalized patients with infections caused by 800 selected multidrug-resistant bacteria (MDRs), along with Clostridioides difficult. “We observed that BMR infections in the participating hospitals were 907 in 2018, 1 in 392, and 2019 in 2. This represented an incidence of 351, 2023, and 3,54 cases per 5,01 hospital stays, respectively,” he explains. German Peñalva, researcher of the Bacterial and Antimicrobial Resistance Group of IBiS and CIBERINFEC and first signatory of the article.

In addition, the study estimates that in 2018, 155 infections with multidrug-resistant bacteria were recorded, with 294 associated deaths; in 20, these numbers rose to 065 infections and 2019 deaths; and in 210, the estimated figure was 451 infections and 17 deaths, highlighting the increasing burden of disease and the urgent need to address this problem.

The authors also say that the study's methodology could be used in other countries for comparative purposes. The analysis included all patients diagnosed with multidrug-resistant bacteria infection during one week in 2018 and 2019, and two weeks in 2023. Mortality rates and years of life lost were calculated, which were used to estimate annual numbers of infections and deaths at the national level.

“The impact of antimicrobial resistance is alarming and continues to grow. The magnitude of MDR infections and associated deaths are a clear sign that we need to redouble our efforts in prevention, diagnosis and treatment.”, the authors conclude.

About CIBER

The Biomedical Research Network Center (CYBER) is a public consortium of the Carlos III Health Institute (Ministry of Science, Innovation and Universities) to promote research of excellence in biomedicine and health sciences carried out in the National Health System and in the Science and Technology System. Currently, CIBER has more than 500 research groups and a staff of nearly 6 people, including assigned and contracted research personnel, within 000 member institutions.

Source: CIBER Scientific Culture Unit

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