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利用肺炎克雷伯菌表型数据研究撒哈拉以南非洲地区抗菌药物耐药性的演变并预测其未来趋势:一项为期 12 年的分析。

Investigating the evolution and predicting the future outlook of antimicrobial resistance in sub-saharan Africa using phenotypic data for Klebsiella pneumoniae: a 12-year analysis.

机构信息

Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.

出版信息

BMC Microbiol. 2023 Aug 8;23(1):214. doi: 10.1186/s12866-023-02966-y.

DOI:10.1186/s12866-023-02966-y
PMID:37553587
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10408162/
Abstract

BACKGROUND

Antimicrobial resistance (AMR) is a major public health challenge, particularly in sub-Saharan Africa (SSA). This study aimed to investigate the evolution and predict the future outlook of AMR in SSA over a 12-year period. By analysing the trends and patterns of AMR, the study sought to enhance our understanding of this pressing issue in the region and provide valuable insights for effective interventions and control measures to mitigate the impact of AMR on public health in SSA.

RESULTS

The study found that general medicine patients had the highest proportion of samples with AMR. Different types of samples showed varying levels of AMR. Across the studied locations, the highest resistance was consistently observed against ceftaroline (ranging from 68 to 84%), while the lowest resistance was consistently observed against ceftazidime avibactam, imipenem, meropenem, and meropenem vaborbactam (ranging from 92 to 93%). Notably, the predictive analysis showed a significant increasing trend in resistance to amoxicillin-clavulanate, cefepime, ceftazidime, ceftaroline, imipenem, meropenem, piperacillin-tazobactam, and aztreonam over time.

CONCLUSIONS

These findings suggest the need for coordinated efforts and interventions to control and prevent the spread of AMR in SSA. Targeted surveillance based on local resistance patterns, sample types, and patient populations is crucial for effective monitoring and control of AMR. The study also highlights the urgent need for action, including judicious use of antibiotics and the development of alternative treatment options to combat the growing problem of AMR in SSA.

摘要

背景

抗菌药物耐药性(AMR)是一个主要的公共卫生挑战,尤其是在撒哈拉以南非洲(SSA)地区。本研究旨在调查 12 年内 SSA 地区 AMR 的演变情况并预测其未来趋势。通过分析 AMR 的趋势和模式,本研究旨在增进我们对该地区这一紧迫问题的理解,并为有效干预和控制措施提供有价值的见解,以减轻 AMR 对 SSA 公共卫生的影响。

结果

研究发现,普通内科患者的 AMR 样本比例最高。不同类型的样本显示出不同程度的 AMR。在所研究的地点中,头孢洛林的耐药率始终最高(范围为 68%至 84%),而头孢他啶阿维巴坦、亚胺培南、美罗培南和美罗培南-维巴坦的耐药率始终最低(范围为 92%至 93%)。值得注意的是,预测分析显示,阿莫西林-克拉维酸、头孢吡肟、头孢他啶、头孢洛林、亚胺培南、美罗培南、哌拉西林-他唑巴坦和氨曲南的耐药率随着时间的推移呈现显著的增加趋势。

结论

这些发现表明,需要协调努力和干预措施来控制和预防 SSA 地区 AMR 的传播。基于当地耐药模式、样本类型和患者人群的有针对性的监测对于有效监测和控制 AMR 至关重要。本研究还强调了采取行动的紧迫性,包括合理使用抗生素和开发替代治疗方案,以应对 SSA 地区日益严重的 AMR 问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/10408162/9407fb869e94/12866_2023_2966_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/10408162/117055b128b7/12866_2023_2966_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/10408162/34b7ed954295/12866_2023_2966_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/10408162/9407fb869e94/12866_2023_2966_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/10408162/117055b128b7/12866_2023_2966_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/10408162/34b7ed954295/12866_2023_2966_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/604c/10408162/9407fb869e94/12866_2023_2966_Fig3_HTML.jpg

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