Objective  To analyze the global anti-microbial resistance (AMR) burden of in-tra-abdominal infections (IAIs) in 2019.

Methods  Data were obtained from the results of Global Bur-den of Disease Study 2019 (GBD 2019), including death, years of life lost, year lived with disability, and disability-adjusted life-years (DALYs) for AMR in IAIs. A counterfactual analysis was used to estimate the burden directly and indirectly caused by AMR.

Results  Globally, there were 210 300 deaths at-tributed to AMR and 804 900 deaths associated with bacterial AMR in IAIs in 2019. There were 5.66 million DALYs attributed to AMR and 21.59 million DALYs associated with AMR in IAIs in 2019. The highest burden of AMR was observed in south Asia, directly causing 57 620 deaths. Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecium were directly responsible for 160 000 deaths worldwide, accounting for 76% of all pathogens. More than 62% of global deaths (130 800) attributed to fluoroquinolones, carbapenems, and third-generation cephalosporins. Fluoroquino-lone-resistant Enterococcus faecium was an important pathogen-antimicrobial combination causing death, with 19 900 deaths attributed to AMR caused by this bacterium.

Conclusions  Bacterial AMR in IAIs remains a major challenge in global public health, and prevention and control strategies should be developed in relation to the prevalence of pathogen-antimicrobial combinations in different regions and the accessibility of healthcare resources.

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