利用模糊集定性比较分析法研究环境和食物链中产生超广谱β-内酰胺酶与疑似败血症患者感染情况之间的关系。
Investigating the relationship between extended spectrum β-lactamase producing in the environment and food chains with the presence of this infection in people suspected of septicemia: Using the fuzzy set qualitative comparative analysis.
作者信息
Eshrati Babak, Baradaran Hamid Reza, Motevalian Seyed Abbas, Majidpour Ali, Boustanshenas Mina, Soleymanzadeh Moghadam Somayeh, Moradi Yousef
机构信息
Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology, School of Public Health, University of Medical Sciences, Tehran, Iran.
出版信息
J Environ Health Sci Eng. 2020 Oct 25;18(2):1509-1520. doi: 10.1007/s40201-020-00567-9. eCollection 2020 Dec.
PROPOSE
Among antibiotic resistance cases, resistance to β-lactam antibiotics is a major concern for the treatment of microbial infections. Furthermore, the prevalence of extended-spectrum β-lactamases (ESBL) in environment, food, and human resources of Iran has increased over the past few years. This study aimed to predict the relationship between the prevalence of ESBL in the environment and the food chains with the presence of this infection in people suspected of septicemia using fuzzy set qualitative comparative analysis model.
METHODS
In this analytical cross sectional study samples were collected from the environment (hospital sewage, downstream and upstream urban sewage, and slaughterhouse sewage), food (chicken), and human chains (people suspected of septicemia) in Tehran province, Iran. This study was conducted from September to February 2019 and the prevalence of ESBL was calculated in each resource. Then, the relationship between the prevalence of ESBL in the environment and food chains and its prevalence in the human chain was predicted using the fuzzy set qualitative comparative analysis.
RESULTS
The results showed the prevalence of ESBL in those suspected of septicemia in September, October, November, December, January and February was 58.1%, 60%, 33.3%, 100%, 43%, and 57.8%, respectively. Also, the results of the fuzzy set qualitative comparative analysis indicated hospital wastewater and chicken contamination with ESBL were the main causes of contamination with ESBL in people suspected of septicemia.
CONCLUSIONS
According to the results of this study, if there is a contamination of hospital wastewater and chickens in an area, it can be claimed that people suspected of septicemia are infected with ESBL , and the percentage of this contamination can be high. On the other hand, controlling ESBL in hospital wastewater (environmental chain) and chickens (food chain) can prevent contamination in people with suspected septicemia.
目的
在抗生素耐药性病例中，对β-内酰胺类抗生素的耐药性是治疗微生物感染的主要关注点。此外，在过去几年中，伊朗环境、食品和人力资源中广谱β-内酰胺酶（ESBL）的流行率有所上升。本研究旨在使用模糊集定性比较分析模型预测环境和食物链中ESBL的流行率与疑似败血症患者中这种感染的存在之间的关系。
方法
在这项分析性横断面研究中，从伊朗德黑兰省的环境（医院污水、城市污水下游和上游以及屠宰场污水）、食品（鸡肉）和人类链（疑似败血症患者）中采集样本。本研究于2019年9月至2月进行，并计算了每种资源中ESBL的流行率。然后，使用模糊集定性比较分析预测环境和食物链中ESBL的流行率与其在人类链中的流行率之间的关系。
结果
结果显示，9月、10月、11月、12月、1月和2月疑似败血症患者中ESBL的流行率分别为58.1%、60%、33.3%、100%、43%和57.8%。此外，模糊集定性比较分析的结果表明，医院废水和鸡肉被ESBL污染是疑似败血症患者被ESBL污染的主要原因。
结论
根据本研究结果，如果一个地区存在医院废水和鸡肉污染，可以认为疑似败血症患者感染了ESBL，且这种污染的比例可能很高。另一方面，控制医院废水（环境链）和鸡肉（食物链）中的ESBL可以预防疑似败血症患者的污染。
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