塞浦路斯共和国2015 - 2023年艾滋病毒感染者的耐药模式:一项横断面研究

Resistance Patterns of in PLHIV: A Cross-Sectional Study from the Republic of Cyprus, 2015-2023.

作者信息

Takos Michaela, Siakallis George, Quattrocchi Annalisa, Alexandrou Maria, Papadamou Panagiota, Panagiotou Loukia, Alon-Ellenbogen Danny

机构信息

Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia 2417, Cyprus.

School of Health and Medical Sciences, St George's University of London, London SW17 0RE, UK.

出版信息

Antibiotics (Basel). 2025 Jun 7;14(6):589. doi: 10.3390/antibiotics14060589.

Abstract

The rise in antimicrobial-resistant (AMR) strains of is internationally recognised as a critical public health concern, with limited treatment options available. The urgency of this issue prompted the European Centre for Disease Prevention and Control to establish 'EURO-GASP' to monitor trends in resistance and address developments. Comprehensive data on AMR strains in people living with HIV (PLHIV) is limited, especially in Cyprus. To analyse trends in rates of resistant infections and identify any correlations between patient factors that may contribute to such in PLHIV in The Republic of Cyprus. We conducted a retrospective chart review study on resistance among PLHIV from the Gregorios HIV reference clinic in Larnaca, Cyprus, between 2015 and 2023. Antimicrobial susceptibility was assessed via disc diffusion or gradient strip method on GC II agar against a non-homogenous panel of antibiotic preparations, based on standard laboratory practice variation. Demographic and clinical data, including antibiograms, treatments and test of cure, were recorded. Statistical analysis was performed using Stata v16, with significance set at < 0.05. The study received approval from the Cyprus National Bioethics Committee. A total of 45 isolates from 39 patients were analysed, with 62% of these demonstrating resistance to at least one antibiotic. Resistance rates were not shown to change over time. We identified a statistically significant linear association between a person having a history of an STI and the number of antibiotics which the isolate is resistant to (β = 1.2; : 0.004). Notably, a single isolate demonstrated resistance to ceftriaxone, the first-line treatment currently recommended in both Europe and the United States. This finding is particularly alarming given the critical role of ceftriaxone in the management of gonorrhoea. Whilst there has been no increase in resistance rates over time, the detection of ceftriaxone-resistant is a significant public health concern. Given that having a history of an STI makes a person more likely to develop a resistant infection, PLHIV or those who engage in risky sexual behaviours are particularly vulnerable. There is a pressing need to enhance surveillance and implement routine susceptibility testing in Cyprus, given the country's role as a major international hub for travel and migration. Molecular analysis can further improve our understanding. Additionally, the global public health community must urgently prioritise the development of novel therapeutic agents for the treatment of gonorrhoea.

摘要

抗菌耐药(AMR)菌株的增加在国际上被公认为是一个严重的公共卫生问题,可用的治疗选择有限。这一问题的紧迫性促使欧洲疾病预防控制中心设立了“EURO - GASP”来监测耐药趋势并应对相关发展情况。关于艾滋病毒感染者(PLHIV)中AMR菌株的全面数据有限,在塞浦路斯尤其如此。为了分析塞浦路斯共和国PLHIV中耐药感染率的趋势,并确定可能导致此类情况的患者因素之间的任何相关性。我们对2015年至2023年期间塞浦路斯拉纳卡格雷戈里奥斯艾滋病毒参考诊所的PLHIV中的耐药情况进行了一项回顾性病历审查研究。根据标准实验室操作差异,通过纸片扩散法或梯度条带法在GC II琼脂上针对一组非同质抗生素制剂评估抗菌药敏性。记录了人口统计学和临床数据,包括抗菌谱、治疗和治愈检测情况。使用Stata v16进行统计分析,显著性设定为<0.05。该研究获得了塞浦路斯国家生物伦理委员会的批准。共分析了来自39名患者的45株分离株,其中62%对至少一种抗生素耐药。耐药率未显示随时间变化。我们发现有性传播感染病史的人与分离株耐药的抗生素数量之间存在统计学上显著的线性关联(β = 1.2;P:0.004)。值得注意的是,一株分离株对头孢曲松耐药,而头孢曲松是目前欧洲和美国都推荐的一线治疗药物。鉴于头孢曲松在淋病管理中的关键作用,这一发现尤其令人担忧。虽然随着时间推移耐药率没有增加,但检测到对头孢曲松耐药的[病原体名称未明确]是一个重大的公共卫生问题。鉴于有性传播感染病史的人更有可能发生耐药感染情况,PLHIV或那些从事危险性行为的人尤其脆弱。鉴于塞浦路斯作为主要国际旅行和移民枢纽的地位,迫切需要加强监测并开展常规药敏检测。分子分析可以进一步增进我们的了解。此外,全球公共卫生界必须紧急优先考虑开发用于治疗淋病的新型治疗药物。

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