{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:00:52Z","timestamp":1793638852018,"version":"4.5.1"},"reference-count":30,"publisher":"eLife Sciences Publications, Ltd","license":[{"start":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T00:00:00Z","timestamp":1473120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T00:00:00Z","timestamp":1473120000000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T00:00:00Z","timestamp":1473120000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004397","name":"Ministry of Public Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004397","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["100484\/Z\/12\/Z"],"award-info":[{"award-number":["100484\/Z\/12\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["101103\/Z\/13\/Z"],"award-info":[{"award-number":["101103\/Z\/13\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Little is known about the excess mortality caused by multidrug-resistant (MDR) bacterial infection in low- and middle-income countries (LMICs). We retrospectively obtained microbiology laboratory and hospital databases of nine public hospitals in northeast Thailand from 2004 to 2010, and linked these with the national death registry to obtain the 30-day mortality outcome. The 30-day mortality in those with MDR community-acquired bacteraemia, healthcare-associated bacteraemia, and hospital-acquired bacteraemia were 35% (549\/1555), 49% (247\/500), and 53% (640\/1198), respectively. We estimate that 19,122 of 45,209 (43%) deaths in patients with hospital-acquired infection due to MDR bacteria in Thailand in 2010 represented excess mortality caused by MDR. We demonstrate that national statistics on the epidemiology and burden of MDR in LMICs could be improved by integrating information from readily available databases. The prevalence and mortality attributable to MDR in Thailand are high. This is likely to reflect the situation in other LMICs.<\/jats:p>","DOI":"10.7554\/elife.18082","type":"journal-article","created":{"date-parts":[[2016,9,5]],"date-time":"2016-09-05T19:58:52Z","timestamp":1473105532000},"source":"Crossref","is-referenced-by-count":229,"title":["Epidemiology and burden of multidrug-resistant bacterial infection in a developing country"],"prefix":"10.7554","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2555-6980","authenticated-orcid":true,"given":"Cherry","family":"Lim","sequence":"first","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maliwan","family":"Hongsuwan","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanaporn","family":"Wuthiekanun","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Visanu","family":"Thamlikitkul","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soawapak","family":"Hinjoy","sequence":"additional","affiliation":[{"name":"Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2309-1171","authenticated-orcid":true,"given":"Nicholas PJ","family":"Day","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1718-2782","authenticated-orcid":true,"given":"Sharon J","family":"Peacock","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"London School of Hygiene and Tropical Medicine, London, United Kingdom"},{"name":"University of Cambridge, Addenbrooke\u2019s Hospital, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7240-5320","authenticated-orcid":true,"given":"Direk","family":"Limmathurotsakul","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom"},{"name":"Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4374","published-online":{"date-parts":[[2016,9,6]]},"reference":[{"key":"bib1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s13756-015-0059-2","article-title":"Community acquired multi-drug resistant clinical isolates of Escherichia coli in a tertiary care center of Nepal","volume":"4","author":"Ansari","year":"2015","journal-title":"Antimicrobial Resistance and Infection Control"},{"key":"bib2","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1191\/096228001680195157","article-title":"A review of adjusted estimators of attributable risk","volume":"10","author":"Benichou","year":"2001","journal-title":"Statistical Methods in Medical Research"},{"key":"bib3","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/1751-0473-3-17","article-title":"Purposeful selection of variables in logistic regression","volume":"3","author":"Bursac","year":"2008","journal-title":"Source Code for Biology and Medicine"},{"key":"bib4","article-title":"Antibiotic resistance threats in the United States, 2013","author":"Center for Disease Controls and Prevention, U.S. Department of Health and Human Services","year":"2013","unstructured":"Center for Disease Controls and Prevention, U.S. Department of Health and Human Services. 2013. 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