Vernet Guy, Mary Catherine, Altmann Dany M, Doumbo Ogobara, Morpeth Susan, Bhutta Zulfiqar A, Klugman Keith P
Emerg Infect Dis. 2014 Mar;20(3):434-41. doi: 10.3201/EID2003.121157.
Antimicrobial drug resistance is usually not monitored in under-resourced countries because they lack surveillance networks, laboratory capacity, and appropriate diagnostics. This accelerating problem accounts for substantial number of excess deaths, especially among infants. Infections particularly affected by antimicrobial drug resistance include tuberculosis, malaria, severe acute respiratory infections, and sepsis caused by gram-negative bacteria. Nonetheless, mapping antimicrobial drug resistance is feasible in under-resourced countries, and lessons can be learned from previous successful efforts. Specimen shipping conditions, data standardization, absence of contamination, and adequate diagnostics must be ensured. As a first step toward solving this problem, we propose that a road map be created at the international level to strengthen antimicrobial resistance surveillance in under-resourced countries. This effort should include a research agenda; a map of existing networks and recommendations to unite them; and a communication plan for national, regional, and international organizations and funding agencies.
在资源匮乏的国家，通常不会对抗菌药物耐药性进行监测，因为这些国家缺乏监测网络、实验室能力和适当的诊断手段。这个日益严重的问题导致了大量额外死亡，尤其是在婴儿中。受抗菌药物耐药性影响特别严重的感染包括结核病、疟疾、严重急性呼吸道感染以及由革兰氏阴性菌引起的败血症。尽管如此，在资源匮乏的国家绘制抗菌药物耐药性图谱是可行的，并且可以从以往的成功经验中吸取教训。必须确保样本运输条件、数据标准化、无污染以及足够的诊断手段。作为解决这一问题的第一步，我们建议在国际层面制定一份路线图，以加强资源匮乏国家的抗菌药物耐药性监测。这项工作应包括一项研究议程；现有网络的地图以及将它们联合起来的建议；以及针对国家、区域和国际组织及资助机构的沟通计划。
