Huong Nguyen Xuan, Harrison Michelle, Kasahara Erena, Marais Ben, Putri Nina Dwi, Williams Phoebe Cm
Phan Chau Trinh University, Vietnam.
Sydney Infectious Diseases Institute, University of Sydney, Sydney, Australia.
Curr Opin Pediatr. 2025 Apr 1;37(2):116-123. doi: 10.1097/MOP.0000000000001437. Epub 2025 Feb 4.
The densely populated Asia Pacific region is home to 600 million children, and suffers from a significant burden of morbidity and mortality due to infections associated with antimicrobial resistance (AMR). We aimed to identify the drivers, challenges and potential opportunities to alter the burden of AMR within the region.
Despite the high AMR burden borne by the Asia Pacific region, there are limited (and geographically imbalanced) published data to delineate the contemporary epidemiology of serious multidrug-resistant bacterial infections in children. Furthermore, the region is impacted by overcrowded and poorly resourced healthcare facilities, insufficient microbiological resources, and widespread community and environmental antibiotic use leading to limited efficacy for frequently prescribed antibiotics. Vaccine coverage is also inadequate and inequitable, further driving the burden of infectious disease (and antibiotic overuse) in children.
There are many challenges in implementing antimicrobial stewardship and infection prevention and control programs to reduce the excessive AMR disease burden in children across the Asia Pacific region, yet locally-driven strategies have successfully reduced antibiotic overuse in some settings, and should be replicated. Reducing the AMR disease burden will require improved healthcare resourcing, including better access to microbiological diagnosis, and multidisciplinary approaches to enhance infection prevention and antibiotic prescribing.
人口密集的亚太地区有6亿儿童，因与抗菌药物耐药性（AMR）相关的感染而承受着巨大的发病和死亡负担。我们旨在确定改变该地区AMR负担的驱动因素、挑战和潜在机会。
尽管亚太地区承受着很高的AMR负担，但用于描述儿童严重多重耐药细菌感染当代流行病学的已发表数据有限（且在地理上分布不均衡）。此外，该地区受到医疗保健设施拥挤和资源匮乏、微生物资源不足以及社区和环境中抗生素广泛使用的影响，导致常用抗生素疗效有限。疫苗接种覆盖率也不足且不公平，进一步加重了儿童传染病负担（以及抗生素过度使用）。
在亚太地区实施抗菌药物管理以及感染预防和控制计划以减轻儿童过度的AMR疾病负担面临诸多挑战，但当地驱动的策略已在某些情况下成功减少了抗生素的过度使用，应予以推广。减轻AMR疾病负担将需要改善医疗资源，包括更好地获得微生物诊断，以及采取多学科方法加强感染预防和抗生素处方。
