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抗生素耐药性的全球影响因素

Global Contributors to Antibiotic Resistance.

作者信息

Chokshi Aastha, Sifri Ziad, Cennimo David, Horng Helen

机构信息

Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

出版信息

J Glob Infect Dis. 2019 Jan-Mar;11(1):36-42. doi: 10.4103/jgid.jgid_110_18.

Abstract

INTRODUCTION

Antibiotic-resistant infections have become increasingly prevalent nowadays. As a result, it is essential to examine the key socioeconomic and political factors which contribute to the rise in the prevalence of antibiotic resistance in developing and developed nations. This study aims to identify the various contributors to the development of antibiotic resistance in each type of nation.

METHODS

PUBMED was used to identify primary research, systematic reviews, and narrative reviews published before Jan 2017. Search terms included antibiotic resistance, antimicrobial resistance, superbugs, multidrug-resistant organisms, developing countries, developed countries. Publications from different countries were included to ensure generalizability. Publications were excluded if they didn't mention factors causing resistance, focused on the molecular basis of resistance, or if they were case reports. Publicly available reports from national and international health agencies were used.

RESULTS

In developing countries, key contributors identified included: (1) Lack of surveillance of resistance development, (2) poor quality of available antibiotics, (3) clinical misuse, and (4) ease of availability of antibiotics. In developed countries, poor hospital-level regulation and excessive antibiotic use in food-producing animals play a major role in leading to antibiotic resistance. Finally, research on novel antibiotics is slow ing down due to the lack of economic incentives for antibiotic research.

CONCLUSION

Overall, multiple factors, which are distinct for developing and developed countries, contribute to the increase in the prevalence of antibiotic resistance globally. The results highlight the need to improve the regulatory framework for antibiotic use and research globally.

摘要

引言

如今,抗生素耐药性感染日益普遍。因此,审视促成发展中国家和发达国家抗生素耐药性患病率上升的关键社会经济和政治因素至关重要。本研究旨在确定各类国家中抗生素耐药性产生的各种促成因素。

方法

利用PUBMED检索2017年1月之前发表的原始研究、系统评价和叙述性综述。检索词包括抗生素耐药性、抗菌药物耐药性、超级细菌、多重耐药生物体、发展中国家、发达国家。纳入不同国家的出版物以确保普遍性。如果出版物未提及耐药性产生的因素、专注于耐药性的分子基础或为病例报告,则将其排除。使用了国家和国际卫生机构公开可得的报告。

结果

在发展中国家,确定的关键促成因素包括:(1)缺乏对耐药性发展的监测,(2)现有抗生素质量差,(3)临床滥用,以及(4)抗生素易于获取。在发达国家,医院层面监管不力以及食用动物抗生素使用过量在导致抗生素耐药性方面起主要作用。最后,由于缺乏抗生素研究的经济激励措施,新型抗生素的研究正在放缓。

结论

总体而言,发展中国家和发达国家不同的多种因素导致全球抗生素耐药性患病率上升。结果凸显了改善全球抗生素使用和研究监管框架的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/661f/6380099/e421fb1dc65e/JGID-11-36-g001.jpg

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