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抗菌药物耐药性研究重点的专家共识,以聚焦抗菌疫苗和单克隆抗体的开发和应用。

Expert consensus on antimicrobial resistance research priorities to focus development and implementation of antibacterial vaccines and monoclonal antibodies.

机构信息

Infection Control Program, Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Center, Geneva, Switzerland.

Instituto de Biomedicina de Sevilla (IBiS), Infectious Diseases and Microbiology Division, Hospital Universitario Virgen Macarena, Department of Medicine, University of Sevilla/CSIC, Sevilla, Spain.

出版信息

Euro Surveill. 2024 Nov;29(47). doi: 10.2807/1560-7917.ES.2024.29.47.2400212.

Abstract

To reduce antimicrobial resistance (AMR), pathogen-specific AMR burden data are crucial to guide target selection for research and development of vaccines and monoclonal antibodies (mAbs). We identified knowledge gaps through previously conducted systematic reviews, which informed a Delphi expert consultation on future AMR research priorities and harmonisation strategies to support data-driven decision-making. Consensus (≥80% agreement) on importance and feasibility of research topics was achieved in two rounds, involving 24 of 39 and 19 of 24 invited experts, respectively. Priority pathogens and resistance profiles for future research were identified: third generation cephalosporin-resistant and for bloodstream and urinary tract infections, respectively, and meticillin-resistant for surgical-site infections. Prioritised high-risk populations included surgical, haemato-oncological and transplant patients. Mortality and resource use were prioritised as health-economic outcomes. The importance of age-stratified data and inclusion of a non-infected comparator group were highlighted. This agenda provides guidance for future research to fill knowledge gaps and support data-driven selection of target pathogens and populations for new preventive and treatment strategies, specifically vaccines and mAbs, to effectively address the AMR burden in Europe. These research priorities are also relevant to improve the evidence base for future AMR burden estimates.

摘要

为了减少抗菌素耐药性(AMR),病原体特异性 AMR 负担数据对于指导疫苗和单克隆抗体(mAb)研发的目标选择至关重要。我们通过之前进行的系统评价发现了知识空白,并在此基础上进行了德尔菲专家咨询,以确定未来 AMR 研究重点和协调战略,以支持数据驱动的决策。两轮咨询分别有 24 名和 19 名受邀专家达成了重要性和研究可行性的共识(≥80%的专家意见一致)。确定了未来研究的优先病原体和耐药谱:第三代头孢菌素耐药的 和 分别用于血流感染和尿路感染,以及耐甲氧西林的 用于手术部位感染。优先考虑的高危人群包括外科、血液肿瘤学和移植患者。死亡率和资源利用被作为健康经济学结果进行了优先排序。强调了按年龄分层数据的重要性和纳入非感染对照组的重要性。该议程为未来的研究提供了指导,以填补知识空白,并支持针对新的预防和治疗策略(特别是疫苗和 mAb)选择目标病原体和人群的数据驱动决策,从而有效应对欧洲的 AMR 负担。这些研究重点对于提高未来 AMR 负担估计的证据基础也具有重要意义。

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