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从中低收入国家“同一个健康”视角看饮用水中微生物的耐药性概况

Antimicrobial resistance profile of in drinking water from one health perspective in low and middle income countries.

作者信息

Desye Belay, Woldetsadik Mawugatie Temeselew, Asmare Lakew, Tsega Yawkal, Melak Dagnachew, Endawkie Abel, Daba Chala

机构信息

Department of Environmental Health College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

Department of Economic, College of Management and Economics, Wollo University, Dessie, Ethiopia.

出版信息

Front Public Health. 2024 Dec 3;12:1440908. doi: 10.3389/fpubh.2024.1440908. eCollection 2024.

Abstract

INTRODUCTION

Antimicrobial resistance is a major global public health concern, especially in low-resource settings. In low- and middle-income countries, the existing evidence about antimicrobial resistance in drinking water is inconsistence and not comprehensive. Therefore, this study aimed to estimate the pooled prevalence of antimicrobial resistance profiles of from drinking water in low- and middle-income countries.

METHODS

This study was conducted using comprehensive literature searches using various databases such as PubMed, Scientific Direct, HINARI, and Google Scholar. Data extraction was performed using Microsoft Excel and exported to STATA 14/SE software for analysis. We used the Joanna Briggs Institute's quality appraisal tool to ensure the quality of the included studies. A random effects model was employed to estimate the pooled prevalence. Publication bias was evaluated using funnel plots and Egger's regression test. Subgroup and sensitivity analysis were also conducted in this study.

RESULTS

The study found that the pooled prevalence of isolates in drinking water was 37.94% (95% CI: 26.73-49.13). The prevalence of multidrug resistance was 43.65% (95% CI: 31.15-56.15). Regarding specific antimicrobials, the pooled resistance levels of were 54.65% (95% CI: 41.35-67.96) against contrimoxazole, followed by 48.64% (95% CI: -3.6-101) against amoxicillin and 48% (95% CI: -18.1-114.2) against cefuroxime.

CONCLUSION

The findings indicated a significant prevalence of antimicrobial resistance of isolated from drinking water and its multidrug resistance. To address this issue, it recommends focusing on improving basic hygiene and sanitation practices and enhancing water and wastewater treatment systems.

SYSTEMATIC REVIEW REGISTRATION

Identifier CRD42024533592.

摘要

引言

抗菌药物耐药性是全球主要的公共卫生问题,在资源匮乏地区尤为如此。在低收入和中等收入国家,关于饮用水中抗菌药物耐药性的现有证据并不一致且不全面。因此,本研究旨在估计低收入和中等收入国家饮用水中抗菌药物耐药性概况的合并患病率。

方法

本研究通过使用各种数据库(如PubMed、科学Direct、HINARI和谷歌学术)进行全面的文献检索。使用Microsoft Excel进行数据提取,并导出到STATA 14/SE软件进行分析。我们使用乔安娜·布里格斯研究所的质量评估工具来确保纳入研究的质量。采用随机效应模型来估计合并患病率。使用漏斗图和埃格回归检验评估发表偏倚。本研究还进行了亚组和敏感性分析。

结果

研究发现,饮用水中分离株的合并患病率为37.94%(95%置信区间:26.73 - 49.13)。多重耐药率为43.65%(95%置信区间:31.15 - 56.15)。关于特定抗菌药物,分离株对复方新诺明的合并耐药水平为54.65%(95%置信区间:41.35 - 67.96),其次是对阿莫西林的48.64%(95%置信区间: - 3.6 - 101)和对头孢呋辛的48%(95%置信区间: - 18.1 - 114.2)。

结论

研究结果表明,从饮用水中分离出的具有抗菌药物耐药性及其多重耐药性的情况普遍存在。为解决这一问题,建议着重改善基本卫生和环境卫生做法,并加强水和废水处理系统。

系统评价注册

标识符CRD42024533592

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c820/11653505/df157dc119b0/fpubh-12-1440908-g001.jpg

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