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社会经济地位与优先关注的细菌性病原体的定植或感染风险:一项全球证据图谱

Socioeconomic status and the risk for colonisation or infection with priority bacterial pathogens: a global evidence map.

作者信息

Blackmon Sarah, Avendano Esther E, Nirmala Nanguneri, Chan Courtney W, Morin Rebecca A, Balaji Sweta, McNulty Lily, Argaw Samson Alemu, Doron Shira, Nadimpalli Maya L

机构信息

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.

WCG Clinical, Princeton, NJ, USA.

出版信息

Lancet Microbe. 2025 Apr;6(4):100993. doi: 10.1016/j.lanmic.2024.100993. Epub 2024 Dec 6.

Abstract

Low socioeconomic status likely exacerbates risks for bacterial infections; however, global evidence for this relationship has not been synthesised. We systematically reviewed the existing literature for studies detailing the socioeconomic status of participants and their risk for colonisation or community-acquired infection with priority bacterial pathogens that are increasingly becoming antibiotic resistant. 50 studies from 14 countries reported outcomes by the participants' educational attainment, access to health care, income level, residential crowding status, socioeconomic status deprivation score, community setting, or access to clean water, sanitation, and hygiene. Low educational attainment, lower than average income levels, inadequate access to health care, presence of residential crowding, and high socioeconomic status deprivation scores were generally associated with elevated risks of colonisation or infection. Limited research has been conducted on these outcomes in low-income and middle-income countries, and findings regarding the effects of community settings (eg, urban vs rural) on these outcomes have been conflicting. Only a proportion of studies focused on pathogen colonisation and infection yielded data stratified by the socioeconomic status of participants. Stratified data should be included in future research to enhance understanding of the complex relationship between socioeconomic status and health, particularly in low-income and middle-income countries.

摘要

社会经济地位低下可能会加剧细菌感染的风险;然而,尚未对这一关系的全球证据进行综合分析。我们系统地回顾了现有文献,以查找那些详细阐述参与者社会经济地位及其感染优先关注的、日益产生抗生素耐药性的细菌性病原体或社区获得性感染风险的研究。来自14个国家的50项研究报告了参与者的教育程度、医疗保健可及性、收入水平、居住拥挤状况、社会经济地位剥夺得分、社区环境或清洁水、卫生设施和个人卫生的可及性等方面的结果。教育程度低、收入水平低于平均水平、医疗保健可及性不足、居住拥挤以及社会经济地位剥夺得分高通常与定植或感染风险升高相关。在低收入和中等收入国家,针对这些结果开展的研究有限,而且关于社区环境(如城市与农村)对这些结果影响的研究结果相互矛盾。只有一部分关注病原体定植和感染的研究提供了按参与者社会经济地位分层的数据。未来的研究应纳入分层数据,以增进对社会经济地位与健康之间复杂关系的理解,尤其是在低收入和中等收入国家。

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