Chan Yi Qi, Chen Kailin, Chua Gilbert T, Wu Peng, Tung Keith T S, Tsang Hing Wai, Lung David, Ip Patrick, Chui Celine S L
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong, China.
JAC Antimicrob Resist. 2022 Apr 19;4(2):dlac036. doi: 10.1093/jacamr/dlac036. eCollection 2022 Apr.
Antimicrobial resistance is an increasingly important issue in public health as antibiotics are overused. Resistance to antimicrobial agents can pose significant challenges to infection treatment.
To evaluate risk factors associated with carriage of antimicrobial-resistant (AMR) bacteria in children in the Asia-Pacific region to consolidate evidence for future implementation of antibiotic prescribing practice.
Three electronic databases-PubMed, EMBASE and Cochrane Library-were searched. Observational studies that investigated the risk factors for carriage of MRSA, penicillin-resistant , ESBL-producing and among the paediatric population in community settings in the Asia-Pacific region were considered eligible. Summary statistics from the identified studies were pooled using meta-analyses.
From the 4145 search results, 25 papers were included in this review. Sixteen papers were included in the meta-analysis based on reported risk factors. Young age of 2-6 months compared with children aged 7-60 months (OR 2.74, 95% CI: 1.75-4.29), antibiotic use within the past 3 months (OR 2.65, 95% CI: 1.70-4.12), daycare attendance (OR 1.49, 95% CI: 1.17-1.91) and hospital admission within the past 3 months (OR 3.43, 95% CI: 2.13-5.51) were found to be significant risk factors for AMR bacterial carriage, whilst breastfeeding (OR 0.69, 95% CI: 0.60-0.81) and concurrent colonization of (OR 0.59, 95% CI: 0.38-0.91) are protective factors.
The findings support that there are a number of significant risk factors associated with carriage of AMR bacteria in the Asia-Pacific paediatric population. To combat antimicrobial resistance in the future, these risk factors should be considered, and measures taken to mitigate associated carriage.
由于抗生素的过度使用，抗菌素耐药性在公共卫生领域正成为一个日益重要的问题。对抗菌药物的耐药性可能给感染治疗带来重大挑战。
评估亚太地区儿童携带耐抗菌药物（AMR）细菌的相关风险因素，以巩固未来抗生素处方实践的证据。
检索了三个电子数据库——PubMed、EMBASE和Cochrane图书馆。调查亚太地区社区环境中儿科人群携带耐甲氧西林金黄色葡萄球菌、耐青霉素、产超广谱β-内酰胺酶和其他细菌的风险因素的观察性研究被认为符合要求。使用荟萃分析汇总已识别研究的汇总统计数据。
从4145个搜索结果中，本综述纳入了25篇论文。基于报告的风险因素，16篇论文被纳入荟萃分析。与7至60个月大的儿童相比，2至6个月大的幼儿（比值比2.74，95%置信区间：1.75至4.29）、过去3个月内使用抗生素（比值比2.65，95%置信区间：1.70至4.12）、日托出勤（比值比1.49，95%置信区间：1.17至1.91）和过去3个月内住院（比值比3.43，95%置信区间：2.13至5.51）被发现是AMR细菌携带的显著风险因素，而母乳喂养（比值比0.69，95%置信区间：0.60至0.81）和其他细菌的同时定植（比值比0.59，95%置信区间：0.38至0.91）是保护因素。
研究结果支持亚太地区儿科人群中存在一些与AMR细菌携带相关的显著风险因素。为了未来对抗菌素耐药性，应考虑这些风险因素，并采取措施减轻相关携带情况。
