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鉴于新冠疫情对伊朗南部抗生素耐药性的评估:一项回顾性观察研究。

Evaluation of antibiotics resistance in Southern Iran in light of COVID-19 pandemic: A retrospective observational study.

作者信息

Raoofi Rahim, Namavari Negin, Rahmanian Vahid, Dousthaghi Mohammad Hadi

机构信息

School of Medicine, Department of Infectious Diseases Jahrom University of Medical Sciences Jahrom Iran.

School of Medicine Jahrom University of Medical Science Jahrom Iran.

出版信息

Health Sci Rep. 2023 Mar 15;6(3):e1153. doi: 10.1002/hsr2.1153. eCollection 2023 Mar.

Abstract

BACKGROUND AND AIMS

Antimicrobial resistance (AMR) was taken as one of the high-priority long-lasting public health issues, although it might have been underrated in terms of COVID-19 pandemic emergence. Regarding limited data on assessing the pandemic effect on AMR trend in Iran, this study aimed to describe the epidemiology of antibiotics resistance during the COVID pandemic in southern Iran.

METHODS

This descriptive study was conducted on 2675 patients' samples collected and processed in a referral COVID-19 center hospital in southern Iran from March 21, 2019, to February 18, 2020 (prepandemic), and February 19, 2020, to March 21, 2021 (pandemic). Susceptibility test results in sensitivity and resistance levels were compared in prepandemic and pandemic periods.

RESULTS

Compared to prepandemic, the inpatient number has increased almost three times. On the other hand, there are around four times fewer outpatients now. More than 85% of the specimens were found in urine samples. In all, 92.22% of all bacteria samples were Gram-negative isolates, with accounting for 59.19% of them. The change rate of Gram-negative bacteria resistance to antimicrobials is an average of 7.74% ( < 0.001). On the other hand, the average change rate of Gram-positive bacteria resistant to antibiotics has decreased by 19.3% ( = 008). As a forerunner among other Gram-negative bacteria, the average change rate for and resistance to monitored antibiotics was 89% and 66.3%, respectively ( < 0.001).

CONCLUSION

During the Covid-19 pandemic, the increase in AMR among Gram-negative bacteria, particularly and , was observed compared to the prepandemic. This further limits treatment options, and endangers global public health.

摘要

背景与目的

抗菌药物耐药性(AMR)被视为长期重点关注的公共卫生问题之一,尽管在新冠疫情出现方面可能未得到充分重视。鉴于伊朗评估疫情对AMR趋势影响的数据有限,本研究旨在描述伊朗南部新冠疫情期间抗生素耐药性的流行病学情况。

方法

本描述性研究对2019年3月21日至2020年2月18日(疫情前)以及2020年2月19日至2021年3月21日(疫情期间)在伊朗南部一家新冠转诊中心医院收集并处理的2675例患者样本进行了研究。比较了疫情前和疫情期间敏感性和耐药水平的药敏试验结果。

结果

与疫情前相比,住院患者数量几乎增加了两倍。另一方面,现在门诊患者数量减少了约四倍。超过85%的标本来自尿液样本。总体而言,所有细菌样本中有92.22%为革兰氏阴性菌分离株,其中大肠杆菌占59.19%。革兰氏阴性菌对抗菌药物的耐药变化率平均为7.74%(P<0.001)。另一方面,革兰氏阳性菌对抗生素的耐药平均变化率下降了19.3%(P=0.008)。作为其他革兰氏阴性菌中的先驱,大肠杆菌和肺炎克雷伯菌对监测抗生素的耐药平均变化率分别为89%和66.3%(P<0.001)。

结论

在新冠疫情期间,与疫情前相比,革兰氏阴性菌,尤其是大肠杆菌和肺炎克雷伯菌的AMR有所增加。这进一步限制了治疗选择,并危及全球公共卫生。

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