PRO: The COVID-19 pandemic will result in increased antimicrobial resistance rates
PRO: The COVID-19 pandemic will result in increased antimicrobial resistance rates
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DOI：
10.1093/jacamr/dlaa049
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发表时间：
2020-09-01
影响因子：
3.4
通讯作者：
Nguyen, M. Hong
中科院分区：
文献类型：
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作者：
Clancy, Cornelius J.;Buehrle, Deanna J.;Nguyen, M. Hong
我们认为，COVID-19 大流行将导致抗菌素耐药性 (AMR) 增加。广谱抗生素的使用在住院的 COVID-19 患者中很常见，并且超过了报告的继发感染率，表明不必要的处方。在 COVID-19 疫情中心和专门提供 COVID-19 护理的非疫情中心医院单位内，选择压力可能尤其严重。增加 COVID-19 患者住院或预后不良的可能性的危险因素，例如高龄、居住在疗养院、虚弱、糖尿病和心肺或其他潜在的全身性疾病，也容易发生 AMR 感染。由于第一波 COVID-19 的震中也是 AMR 的震中，因此对 AMR 出现的担忧加剧。 COVID-19 对全球经济系统、治理、公共卫生支出和基础设施造成的破坏性直接和间接影响可能会加剧抗菌素耐药性的传播。我们预计，COVID-19 对抗菌素耐药性的影响将因震中和非震中、地理区域、地区内医院和特定医院单位内的不同而有所不同。
We argue that the COVID-19 pandemic will result in increased antimicrobial resistance (AMR). Broad-spectrum antibiotic use is common among hospitalized COVID-19 patients and in excess of reported secondary infection rates, suggesting unnecessary prescribing. Selection pressure is likely to be particularly intense in COVID-19 epicentres and within non-epicentre hospital units dedicated to COVID-19 care. Risk factors that increase the likelihood of hospitalization or poor outcomes among COVID-19 patients, such as advanced age, nursing home residence, debilitation, diabetes and cardiopulmonary or other underlying systemic diseases, also predispose to AMR infections. Worry for AMR emergence is heightened since first-wave COVID-19 epicentres were also AMR epicentres. Disruptive direct and indirect effects of COVID-19 globally on economic systems, governance and public health expenditure and infrastructure may fuel AMR spread. We anticipate that the impact of COVID-19 on AMR will vary between epicentres and non-epicentres, by geographic region, hospital to hospital within regions and within specific hospital units.