Yıldız Serap Süzük, Hekimoğlu Can Hüseyin, Sucaklı Mustafa Bahadır, Bakkaloğlu Zekiye, Çevik Yasemin Numanoğlu, Ünaldı Özlem, Arslantürk Hayal, Zikusooka Monica, Keçik Melda, Nellums Laura, Elci Omur Cinar
Department of Microbiology Reference Laboratory and Biological Product, Ministry of Health, General Directorate of Public Health, Ankara, Türkiye.
World Health Organization, Türkiye Country Office, Ankara, Türkiye.
Eur J Public Health. 2023 Oct 10;33(5):809-814. doi: 10.1093/eurpub/ckad119.
The long-standing antimicrobial resistance (AMR) pandemic has proven difficult to resolve and is becoming more complex, especially in the context of increasing forced migration, with little evidence around patterns of AMR in migrant communities. This study aimed to determine the frequency in the carriage of common types of antimicrobial-resistant bacteria between Syrian refugees and the local communities in Türkiye: extended-spectrum β-lactamase (ESBL), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE).
We collected nasal swabs and stool samples from the study participants, the local community members, and refugees, between September 2020 and March 2021. We screened clinical samples for the presence of ESBL, MRSA and VRE. Antimicrobial-resistant bacterial isolates were tested by phenotypic analysis to determine the AMR status.
The study included a total of 3960 participants: 1453 individuals in the local community (36.2%) and 2525 Syrian refugees (63.8%). Overall, a significantly greater proportion of refugees (6.7%) carried MRSA compared to the local community (3.2%) (P < 0.001). The ESBL-positivity rate was 17.9% in Syrian refugees and 14.3% in the local community (P = 0.041). Carbapenemase activity was detected in three isolates from Syrian refugees. No VRE was detected in Syrian refugees or the local community.
This large, community-based study on the frequency and the distribution of AMR among Syrian refugees and the local population is the first study in Türkiye.
长期存在的抗菌药物耐药性（AMR）大流行已被证明难以解决，且日益复杂，尤其是在被迫迁移人数不断增加的背景下，关于移民社区抗菌药物耐药性模式的证据很少。本研究旨在确定土耳其叙利亚难民与当地社区之间常见类型的抗菌药物耐药菌的携带频率：超广谱β-内酰胺酶（ESBL）、耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）。
我们在2020年9月至2021年3月期间从研究参与者、当地社区成员和难民中收集了鼻拭子和粪便样本。我们对临床样本进行筛查，以检测ESBL、MRSA和VRE的存在。通过表型分析对抗菌药物耐药细菌分离株进行检测，以确定AMR状态。
该研究共纳入3960名参与者：当地社区1453人（36.2%），叙利亚难民2525人（63.8%）。总体而言，与当地社区（3.2%）相比，携带MRSA的难民比例（6.7%）显著更高（P＜0.001）。叙利亚难民的ESBL阳性率为17.9%，当地社区为14.3%（P = 0.041）。在来自叙利亚难民的三份分离株中检测到碳青霉烯酶活性。在叙利亚难民或当地社区中未检测到VRE。
这项关于叙利亚难民和当地人口中AMR频率及分布的大型社区研究是土耳其的第一项此类研究。
