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Background Bone and joint infections (BJIs) are disabling conditions whose global burden is evolving. This study aimed to systematically analyze the disease burden, temporal trends, pathogen spectrum, and resistance profiles of BJIs at the global, regional, and national levels from 1990 to 2021. Methods Based on the Global Research on Antimicrobial Resistance Project, this study extracted data on deaths and disability-adjusted life years (DALYs) attributable to BJIs from 1990 to 2021, stratified by sex, age, region, pathogen, and antimicrobial resistance. Trends and inequalities were analyzed using estimated annual percentage change, the Bayesian age-period-cohort model and health inequality analysis. Results Between 1990 and 2021, the global number of deaths due to BJIs increased by 228% (from 7,475 to 24,505), and DALYs increased by 291% (from 1,549,957 to 6,054,611), with age-standardized rates showing a consistent upward trend. The disease burden exhibited significant geographical inequality, with East Asia bearing the heaviest and fastest-growing burden. Staphylococcus aureus was the leading pathogen responsible for both mortality and DALYs. Regarding antimicrobial resistance-associated burden, the death toll attributable to antimicrobial resistance increased markedly, with Staphylococcus aureus , Escherichia coli , Pseudomonas aeruginosa , and Klebsiella pneumoniae being the most prominent contributors. Conclusions The global burden of BJIs continues to increase, exhibits significant regional inequalities, and antimicrobial resistance serves as a critical driver of health loss. These findings necessitate strengthened infection prevention and control, prudent antimicrobial use, and the development of novel therapeutic strategies.
Xu et al. (Tue,) studied this question.
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