Poverty and prevalence of antimicrobial resistance in invasive isolates
Poverty and prevalence of antimicrobial resistance in invasive isolates
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DOI：
10.1016/j.ijid.2016.09.026
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发表时间：
2016-11-01
影响因子：
8.4
通讯作者：
Laxminarayan, Ramanan
中科院分区：
文献类型：
--
作者：
Alvarez-Uria, Gerardo;Gandra, Sumanth;Laxminarayan, Ramanan
目的：评估一个国家的收入状况与三种最常见的引起医院和社区感染的细菌的抗菌素耐药性（AMR）流行率之间的关系：第三代头孢菌素（3GC）耐药大肠埃希菌、耐甲氧西林金黄色葡萄球菌（MRSA）和3GC耐药克雷伯菌属。使用来自ResistanceMap数据库和世界银行的2013-2014年国家特定数据，通过具有稳健标准误差的线性回归研究了侵入性样本中AMR患病率与人均国民总收入（GNI）之间的关联。结果：模型预测3GC耐药大肠杆菌的患病率分别下降11.3%（95%可信区间（CI）6.5-16.2%）、18.2%（95% CI 11-25.5%）和12.3%（95% CI 5.5-19.1%）。大肠杆菌、3GC耐药克雷伯菌和MRSA分别占人均国民总收入的每一个对数。对3GC耐药的E.结论：人均国民收入与MRSA和耐3GC大肠杆菌的感染率呈显著负相关。这些结果强调迫切需要制定新的政策，旨在减少资源贫乏环境中的AMR。(C)2016年6月，作者。由爱思唯尔有限公司代表国际传染病学会出版。
Objectives: To evaluate the association between the income status of a country and the prevalence of antimicrobial resistance (AMR) in the three most common bacteria causing infections in hospitals and in the community: third-generation cephalosporin (3GC)-resistant Escherichia coli, methicillin-resistant Staphylococcus aureus (MRSA), and 3GC-resistant Klebsiella species.Methods: Using 2013-2014 country-specific data from the ResistanceMap repository and the World Bank, the association between the prevalence of AMR in invasive samples and the gross national income (GNI) per capita was investigated through linear regression with robust standard errors. To account for non-linear association with the dependent variable, GNI per capita was log-transformed.Results: The models predicted an 11.3% (95% confidence interval (CI) 6.5-16.2%), 18.2% (95% CI 11-25.5%), and 12.3% (95% CI 5.5-19.1%) decrease in the prevalence of 3GC-resistant E. coli, 3GC-resistant Klebsiella species, and MRSA, respectively, for each log GNI per capita. The association was stronger for 3GC-resistant E. coli and Klebsiella species than for MRSA.Conclusions: A significant negative association between GNI per capita and the prevalence of MRSA and 3GC-resistant E. coli and Klebsiella species was found. These results underscore the urgent need for new policies aimed at reducing AMR in resource-poor settings. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.