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- Ikuta, K. S., et al.
(författare)
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Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
- 2022
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Ingår i: Lancet. - : Elsevier BV. - 0140-6736. ; 400:10369, s. 2221-2248
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Tidskriftsartikel (refereegranskat)abstract
- Background Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2.5th and 97.5th percentiles across 1000 posterior draws for each quantity of interest. Findings From an estimated 13.7 million (95% UI 10.9-17.1) infection-related deaths in 2019, there were 7.7 million deaths (5.7-10.2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13.6% (10.2-18.1) of all global deaths and 56.2% (52.1-60.1) of all sepsis-related deaths in 2019. Five leading pathogens-Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa-were responsible for 54.9% (52.9-56.9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185-285) per 100 000 population, and lowest in the high-income super-region, with 52.2 deaths (37.4-71.5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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- Jiang, M., et al.
(författare)
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The mitochondrial single-stranded DNA binding protein is essential for initiation of mtDNA replication
- 2021
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Ingår i: Science Advances. - : American Association for the Advancement of Science (AAAS). - 2375-2548. ; 7:27
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Tidskriftsartikel (refereegranskat)abstract
- We report a role for the mitochondrial single-stranded DNA binding protein (mtSSB) in regulating mitochondrial DNA (mtDNA) replication initiation in mammalian mitochondria. Transcription from the light-strand promoter (LSP) is required both for gene expression and for generating the RNA primers needed for initiation of mtDNA synthesis. In the absence of mtSSB, transcription from LSP is strongly up-regulated, but no replication primers are formed. Using deep sequencing in a mouse knockout model and biochemical reconstitution experiments with pure proteins, we find that mtSSB is necessary to restrict transcription initiation to optimize RNA primer formation at both origins of mtDNA replication. Last, we show that human pathological versions of mtSSB causing severe mitochondrial disease cannot efficiently support primer formation and initiation of mtDNA replication. © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science.
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- Bhattacharya, Prosun, et al.
(författare)
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Geogenic arsenic in groundwaters from Terai Alluvial Plain of Nepal
- 2003
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Ingår i: Journal de Physique IV. - : EDP Sciences. - 1155-4339 .- 1764-7177. ; 107, s. 173-176
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Tidskriftsartikel (refereegranskat)abstract
- The origin and mobility of arsenic (As) in the groundwater environment has received serious attention in recent years. Recent studies have reported naturally occurring As in groundwaters of the Terai Alluvial Plains (TAP) in southern Nepal, where groundwater exploitation has increased since the 1960s. The source of As in TAP is geogenic and leached primarily due to weathering of As bearing rocks and sediments in the Himalayas. In our present study, we have investigated the groundwater chemistry in the central part of the TAP in Nawalparasi district. TAP groundwaters are near-neutral to alkaline, with predominantly reducing character and high HCO3-, low SO4- and NO3- concentrations. Elevated HCO3 levels possibly result due to the oxidation of organic matter, low SO42- levels reflect sulfate reduction. Elevated NH4+ concentrations in these groundwaters suggest dissimilatory nitrate reduction in the aquifers. Total arsenic (As,.,) levels in groundwater varied from 1.7 mug/L to as high as 404 mug/L with dominance of As(III) species and elevated levels of dissolved Fe and Mn. Arsenic is mobilized in groundwaters as a result of desorption of As-oxyanions adsorbed onto Fe- and Mn-oxides as well as reductive dissolution of these surface reactive phases from the sediments along with release of As in anoxic groundwaters.
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- Tandukar, N., et al.
(författare)
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Naturally occurring arsenic in groundwater of Terai region in Nepal and mitigation options
- 2005
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Ingår i: Natural Arsenic in Groundwater. - London : Taylor & Francis Group. - 041536700X ; , s. 41-48
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Konferensbidrag (refereegranskat)abstract
- Natural arsenic (As) was detected in groundwaters in the Terai Alluvial Plain (TAP) in southern Nepal in the year 1999. By the end of March 2004, about 245,000 wells have been tested for As, out of which about 3% samples are found to have exceeded Interim Nepalese Standard of 50 mu g/L. From the detail study conducted in hotspot district Nawalparasi, natural rocks are thought to be the sources of As that are leached mainly due to the weathering of As bearing minerals from the Himalayas towards the northern Nepal. In this paper, the chemistry of groundwater from highly arsenic affected Nawalparasi district in the central part of the TAP in southern Nepal has been presented. TA-P groundwaters are found to be predominantly of reducing character with low SO42- and NO3-, but high HCO3- concentrations. Total arsenic (As-tot) concentration in groundwater varied from 1.7 mu g/L to as high as 404 mu g/L. As(III) species is found to be predominant along with elevated levels of dissolved Fe and Mn. The correlation between DOC, HCO3-, Fe-tot and As-tot strongly supports the hypothesis of reductive dissolution of Fe-oxyhydroxides as the main mechanism of mobilization of As in groundwater in TAP. Blanket testing by As-field test kits is the easiest way to find out As free sources nearby for tubewell switching. In the absence of As-free source, the only available option is the treatment of water either at the point of entry or at the point of use to meet the drinking water standard. DWSS in collaboration with UNICEF and WHO is conducting blanket testing of As in 10 Terai districts. Based on the blanket test result, As treatment methods such as 3-gagri filter, arsenic biosand filter etc., which are simple, effective, affordable and socially acceptable will be provided as a short-term option to the affected communities in hotspot areas.
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