Akingbola Adewunmi, Adegbesan Abiodun Christopher, Olorunfemi Olaoluwa, Adegoke Kolade, Abereoje Kehinde, Adewole Olajumoke, Oluwasola Victor Olamide, Igboanugo Somadila, Aiyenuro Ademola
Department of Public Health and Primary Care, University of Cambridge Old Schools Trinity Lane CB2 1TN Cambridgeshire England, UK.
African Cancer Institute, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
Ann Med. 2025 Dec;57(1):2536197. doi: 10.1080/07853890.2025.2536197. Epub 2025 Aug 22.
INTRODUCTION/BACKGROUND: Antimicrobial resistance (AMR) remains a critical global health issue, particularly in low- and middle-income countries like Nigeria. Colistin, a last-resort antibiotic for multidrug-resistant Gram-negative infections, has seen rising resistance, posing a significant challenge for neonatal sepsis management. This narrative review focuses on colistin resistance in neonates in Nigeria, addressing a critical public health threat. With rising antimicrobial resistance, understanding its epidemiology in vulnerable populations is essential for effective interventions.
A narrative mini-review was conducted, focusing on literature, systematic reviews, and global and national reports on colistin resistance in neonates. Data were synthesized from studies across Africa, with an emphasis on epidemiological insights and implications for public health in Nigeria.
The review identified an increasing trend of colistin resistance in Gram-negative bacteria in neonates across Nigeria. Key findings highlight the presence of mobile colistin resistance (MCR) genes, such as mcr-1, in clinical isolates from neonates, despite limited exposure to colistin. The analysis also emphasized the limitations in screening practices and gaps in neonatal AMR surveillance in Nigeria. The results suggest that inadequate antimicrobial stewardship, overuse of antibiotics, and poor healthcare infrastructure contribute to the rapid emergence of colistin resistance in neonates.
Colistin resistance in neonates poses a grave threat to public health. Addressing this issue requires urgent improvements in antimicrobial stewardship, neonatal care, and AMR surveillance systems. Strengthening laboratory capacities, improving infection prevention practices, and global cooperation are critical to mitigating the spread of colistin-resistant infections in neonates and reducing mortality in low-resource settings.
引言/背景：抗菌药物耐药性（AMR）仍然是一个关键的全球卫生问题，在尼日利亚等低收入和中等收入国家尤为突出。黏菌素是治疗多重耐药革兰氏阴性菌感染的最后一道防线抗生素，其耐药性不断上升，给新生儿败血症的管理带来了重大挑战。本叙述性综述聚焦于尼日利亚新生儿中的黏菌素耐药性，应对这一关键的公共卫生威胁。随着抗菌药物耐药性的上升，了解其在脆弱人群中的流行病学情况对于有效干预至关重要。
进行了一项叙述性小型综述，重点关注有关新生儿黏菌素耐药性的文献、系统评价以及全球和国家报告。数据综合自非洲各地的研究，重点关注流行病学见解及其对尼日利亚公共卫生的影响。
该综述发现尼日利亚各地新生儿革兰氏阴性菌中黏菌素耐药性呈上升趋势。主要发现突出了在新生儿临床分离株中存在移动性黏菌素耐药（MCR）基因，如mcr-1，尽管新生儿接触黏菌素的情况有限。分析还强调了尼日利亚筛查实践的局限性以及新生儿AMR监测方面的差距。结果表明，抗菌药物管理不善、抗生素过度使用以及医疗保健基础设施薄弱导致新生儿中黏菌素耐药性迅速出现。
新生儿中的黏菌素耐药性对公共卫生构成严重威胁。解决这一问题需要紧急改善抗菌药物管理、新生儿护理和AMR监测系统。加强实验室能力、改进感染预防措施以及全球合作对于减轻新生儿中耐黏菌素感染的传播和降低资源匮乏地区的死亡率至关重要。
