Phu Doan Hoang, Wongtawan Tuempong, Truong Dinh Bao, Van Cuong Nguyen, Carrique-Mas Juan, Thomrongsuwannakij Thotsapol
Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand.
College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand.
One Health. 2022 Nov 19;15:100465. doi: 10.1016/j.onehlt.2022.100465. eCollection 2022 Dec.
Vietnam is a low- and middle-income country (LMIC), a primary food producer, and an antimicrobial resistance (AMR) hotspot. AMR is recognized as a One Health challenge since it may transfer between humans, animals and the environment. This study aimed to apply systematic review and meta-analysis to investigate the phenotypic profiles and correlations of antimicrobial-resistant across three compartments: humans, animals and the environment in Vietnam. A total of 89 articles found in PubMed, Science Direct, and Google Scholar databases were retrieved for qualitative synthesis. and non-typhoidal (NTS) were the most common bacterial species in studies of all compartments (60/89 studies). Among antimicrobials classified as critically important, the resistance levels were observed to be highest to quinolones, 3rd generation of cephalosporins, penicillins, and aminoglycosides. Of 89 studies, 55 articles reported the resistance prevalence of and NTS in healthy humans, animals and the environment against ciprofloxacin, ceftazidime, ampicillin, gentamicin, sulfamethoxazole-trimethoprim, chloramphenicol was used for meta-analysis. The pooled prevalence was found highest in against ampicillin 84.0% (95% CI 73.0-91.0%) and sulfamethoxazole-trimethoprim 66.0% (95% CI 56.0-75.0%) while in NTS they were 34.0% (95% CI 24.0-46.0%), 33.0% (95% CI 25.0-42.0%), respectively. There were no significant differences in the pooled prevalence of and NTS to these antimicrobials across healthy humans, animals and the environment, except for ceftazidime-resistant (χ = 8.29, = 0.02), chloramphenicol-resistant (χ = 9.65, < 0.01) and chloramphenicol-resistant NTS (χ = 7.51, p = 0.02). Findings from the multiple meta-regression models indicated that the AMR levels in (β = 1.887, < 0.001) and the North (β = 0.798, = 0.047) had a higher fraction of AMR than NTS and other regions of Vietnam. The outcomes of this study play an important role as the baseline information for further investigation and follow-up intervention strategies to tackle AMR in Vietnam, and more generally, can be adapted to other LMICs.
越南是一个中低收入国家,是主要的粮食生产国,也是抗菌药物耐药性(AMR)热点地区。抗菌药物耐药性被视为一项“同一健康”挑战,因为它可能在人类、动物和环境之间传播。本研究旨在应用系统评价和荟萃分析,调查越南人类、动物和环境三个领域抗菌药物耐药的表型特征及其相关性。从PubMed、Science Direct和谷歌学术数据库中检索到89篇文章进行定性综合分析。伤寒杆菌和非伤寒沙门氏菌(NTS)是所有领域研究中最常见的细菌种类(60/89项研究)。在被列为极为重要的抗菌药物中,对喹诺酮类、第三代头孢菌素、青霉素类和氨基糖苷类的耐药水平最高。在89项研究中,55篇文章报告了健康人类、动物和环境中伤寒杆菌和NTS对环丙沙星、头孢他啶、氨苄西林、庆大霉素、复方磺胺甲恶唑、氯霉素的耐药率,用于荟萃分析。汇总患病率在伤寒杆菌中对氨苄西林最高,为84.0%(95%CI 73.0 - 91.0%),对复方磺胺甲恶唑为66.0%(95%CI 56.0 - 75.0%),而在NTS中分别为34.0%(95%CI 24.0 - 46.0%)、33.0%(95%CI 25.0 - 42.0%)。除了对头孢他啶耐药的伤寒杆菌(χ² = 8.29,P = 0.02)、对氯霉素耐药的伤寒杆菌(χ² = 9.65,P < 0.01)和对氯霉素耐药的NTS(χ² = 7.51,P = 0.02)外,健康人类、动物和环境中伤寒杆菌和NTS对这些抗菌药物的汇总患病率没有显著差异。多元荟萃回归模型的结果表明,伤寒杆菌(β = 1.887,P < 0.001)和北部地区(β = 0.798,P = 0.047)的抗菌药物耐药水平高于NTS和越南其他地区。本研究结果作为进一步调查和后续干预策略的基线信息,在应对越南抗菌药物耐药性方面发挥着重要作用,更广泛地说,也可适用于其他中低收入国家。