What is the burden of disease for AMR by geographic region?

AMR caused 4.71M associated deaths globally in 2021, with regional distribution showing approximately 541,000 deaths in Europe, 569,000 in the Americas, and varying country-specific impacts.

Abstract

Antimicrobial resistance (AMR) exacts a heavy toll that varies by region. Global cross‐country studies report that in 2021 AMR was linked with 4.71 million deaths (range: 4.23–5.19 million) and 1.14 million deaths were directly attributable to resistance (range: 1.00–1.28 million); projections for 2050 reach 8.22 million associated and 1.91 million attributable deaths, with an estimated 46.5 million disability‐adjusted life years lost. In the WHO European region, estimates include 541,000 associated and 133,000 attributable deaths, while in the Americas figures of 569,000 associated and 141,000 attributable deaths have been documented. Country-specific data further detail the burden; for example, one study from Japan notes 14,300 deaths linked to MRSA and a study from China reports 711,852 associated deaths.

Key pathogens driving these outcomes include Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Acinetobacter baumannii. Findings further indicate that gram-negative resistance is often shaped by carbapenem-resistant pathogens, whereas MRSA predominates the gram-positive burden. Economic and healthcare impacts have been quantified in several settings—for instance, incremental costs of US$2 billion for MRSA in Japan, increases in hospital stays ranging from 1.6 to over 8 additional days, and societal economic burdens reaching billions in local currencies. These studies collectively underscore a substantial and regionally variable disease burden due to AMR.

Methods

We analyzed 25 sources from an initial pool of 496, using 7 screening criteria. Each paper was reviewed for 5 key aspects that mattered most to the research question. More on methods

Papers identified with Elicit search
n = 496
Papers screened using: Burden Metrics, Study Population, Geographic Context, Study Design, Pathogen Focus, Outcome Specificity, Sample Size
n = 496
Papers screened out
n = 471
Papers included for extraction
n = 25

Paper search

Using your research question “What is the burden of disease for AMR by geographic region?”, we searched across over 126 million academic papers from the Semantic Scholar corpus. We retrieved the 496 papers most relevant to the query.

Screening

We screened in sources based on their abstracts that met these criteria:

• Burden Metrics: Does the study report at least one AMR burden metric (mortality, morbidity, healthcare costs, length of hospital stay, or disability-adjusted life years)?
• Study Population: Does the study examine human populations in any healthcare setting (community, hospital, or long-term care)?
• Geographic Context: Does the study specify a clear geographic region or country where the research was conducted?
• Study Design: Is the study a primary research study, systematic review, or meta-analysis containing empirical data?
• Pathogen Focus: Does the study report on bacterial pathogen(s) with antimicrobial resistance?
• Outcome Specificity: Does the study report specific burden outcomes beyond just prevalence or resistance mechanisms?
• Sample Size: Does the study include 10 or more cases/participants?

Results

Characteristics of Included Studies

Global and Regional Disease Burden

Mortality Burden

Economic and Healthcare Impact