Global contributors to antibiotic resistance
Global contributors to antibiotic resistance
复制标题
DOI：
10.4103/jgid.jgid_110_18
复制
发表时间：
2019-01-01
影响因子：
1.6
通讯作者：
Horng, Helen
中科院分区：
文献类型：
--
作者：
Chokshi, Aastha;Sifri, Ziad;Horng, Helen
前言：如今，耐药感染已变得越来越普遍。因此，有必要审查导致发展中国家和发达国家抗生素耐药性上升的关键社会经济和政治因素。这项研究旨在确定在每种类型的国家中导致抗生素耐药性发展的各种因素。方法：应用PubMed检索2017年1月前发表的初步研究、系统综述和叙述性综述。搜索词包括抗生素耐药性、抗菌素耐药性、超级细菌、多重耐药生物、发展中国家、发达国家。纳入了来自不同国家的出版物，以确保可概括性。如果出版物没有提到导致耐药性的因素，专注于耐药性的分子基础，或者如果它们是病例报告，则被排除在外。使用了来自国家和国际卫生机构的可公开获得的报告。结果：在发展中国家，确定的关键因素包括：(1)缺乏对耐药性发展的监测，(2)现有抗生素的质量较差，(3)临床误用，(4)抗生素的易得性。在发达国家，医院一级的监管不力和食品生产动物过度使用抗生素是导致抗生素耐药性的主要原因。最后，由于缺乏对抗生素研究的经济激励，新型抗生素的研究正在放缓。结论：总体而言，发展中国家和发达国家不同的多种因素导致了全球抗生素耐药性的增加。这些结果突显了在全球范围内改善抗生素使用和研究的监管框架的必要性。
Introduction: Antibiotic-resistant infections have become increasingly prevalent nowadays. As a result, it is essential to examine the key socioeconomic and political factors which contribute to the rise in the prevalence of antibiotic resistance in developing and developed nations. This study aims to identify the various contributors to the development of antibiotic resistance in each type of nation. Methods: PUBMED was used to identify primary research, systematic reviews, and narrative reviews published before Jan 2017. Search terms included antibiotic resistance, antimicrobial resistance, superbugs, multidrug-resistant organisms, developing countries, developed countries. Publications from different countries were included to ensure generalizability. Publications were excluded if they didn't mention factors causing resistance, focused on the molecular basis of resistance, or if they were case reports. Publicly available reports from national and international health agencies were used. Results: In developing countries, key contributors identified included: (1) Lack of surveillance of resistance development, (2) poor quality of available antibiotics, (3) clinical misuse, and (4) ease of availability of antibiotics. In developed countries, poor hospital-level regulation and excessive antibiotic use in food-producing animals play a major role in leading to antibiotic resistance. Finally, research on novel antibiotics is slow ing down due to the lack of economic incentives for antibiotic research. Conclusion: Overall, multiple factors, which are distinct for developing and developed countries, contribute to the increase in the prevalence of antibiotic resistance globally. The results highlight the need to improve the regulatory framework for antibiotic use and research globally.