Koch Benjamin J, Park Daniel E, Hungate Bruce A, Liu Cindy M, Johnson James R, Price Lance B
Center for Ecosystem Science and Society, Northern Arizona University, Flagstaff, AZ, USA.
Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA.
Commun Med (Lond). 2024 Dec 26;4(1):278. doi: 10.1038/s43856-024-00693-7.
Infections caused by antibiotic-resistant bacteria are increasingly frequent, burdening healthcare systems worldwide. As pathogens acquire resistance to all known antibiotics - i.e., become pan-resistant - treatment of the associated infections will become exceedingly difficult. We hypothesized that the emergence of pan-resistant bacterial pathogens will result in a sharp increase in human mortality.
We tested this hypothesis by modeling the impact of a single hypothetical pan-resistant Escherichia coli strain on sepsis deaths in the United States. We used long-term data on sepsis incidence, mortality rates, strain dynamics, and treatment outcomes to parameterize a set of models encompassing a range of plausible future scenarios. All models accounted for historical and projected temporal changes in population size and age distribution.
The models suggest that sepsis deaths could increase 18- to 46-fold within 5 years of the emergence of a single pan-resistant E. coli strain. This large and rapid change contrasts sharply with the current expectation of gradual change under continuing multidrug-resistance.
Failure to prevent the emergence of pan-resistance would have dire consequences for public health.
由抗生素耐药细菌引起的感染日益频繁，给全球医疗系统带来沉重负担。随着病原体对所有已知抗生素产生耐药性，即成为泛耐药菌，相关感染的治疗将变得极其困难。我们推测泛耐药细菌病原体的出现将导致人类死亡率急剧上升。
我们通过模拟一种假设的单一泛耐药大肠杆菌菌株对美国败血症死亡的影响来检验这一假设。我们使用了关于败血症发病率、死亡率、菌株动态和治疗结果的长期数据，对一系列涵盖一系列合理未来情景的模型进行参数化。所有模型都考虑了人口规模和年龄分布的历史和预测时间变化。
模型表明，在单一泛耐药大肠杆菌菌株出现后的5年内，败血症死亡人数可能增加18至46倍。这种巨大而迅速的变化与当前对持续多重耐药情况下逐渐变化的预期形成鲜明对比。
未能预防泛耐药的出现将对公共卫生造成严重后果。
