Key considerations on the potential impacts of the COVID-19 pandemic on antimicrobial resistance research and surveillance.
Key considerations on the potential impacts of the COVID-19 pandemic on antimicrobial resistance research and surveillance.
复制标题
DOI：
10.1093/trstmh/trab048
复制
发表时间：
2021-10-01
影响因子：
2.2
通讯作者：
Plant L
中科院分区：
文献类型：
--
作者：
Rodríguez-Baño J;Rossolini GM;Schultsz C;Tacconelli E;Murthy S;Ohmagari N;Holmes A;Bachmann T;Goossens H;Canton R;Roberts AP;Henriques-Normark B;Clancy CJ;Huttner B;Fagerstedt P;Lahiri S;Kaushic C;Hoffman SJ;Warren M;Zoubiane G;Essack S;Laxminarayan R;Plant L
COVID-19大流行期间，严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）患者的抗生素使用超过了细菌共感染和继发感染的发生率，表明处方不当和过度。即使在已建立抗菌素管理规划的环境中，在大流行背景下适当使用抗生素方面也暴露出弱点。此外，随着卫生系统资源转向大流行应对，抗菌素耐药性（AMR）监测和AMS的优先级已被降低。这一经验突出了抗微生物药物耐药性遏制和缓解战略的不足，需要临床和科学界紧急关注。这些挑战包括需要实施诊断管理，以评估2019冠状病毒病患者共感染和继发感染的全球发生率，包括耐多药病原体感染的发生率，以确定最有可能从抗生素治疗中受益的患者，并确定何时可以安全地停用、减少剂量或停止使用抗生素。需要对临床和社会抗生素使用和耐药趋势进行长期全球监测，以便为抗菌素耐药性流行病学的后续变化做好准备，同时确保供应链不中断，防止药物短缺和缺货。在资源受限的环境下，这些干预措施带来了实施方面的挑战，为抗生素耐药性的实施研究提供了理由。对这些做法的知识和支持将来自国际上协调一致的、有针对性的抗微生物药物耐药性研究，支持在当前COVID-19大流行或未来大流行的背景下，为应对未来出现的抗微生物药物耐药性挑战做好准备。
Antibiotic use in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients during the COVID-19 pandemic has exceeded the incidence of bacterial coinfections and secondary infections, suggesting inappropriate and excessive prescribing. Even in settings with established antimicrobial stewardship (AMS) programmes, there were weaknesses exposed regarding appropriate antibiotic use in the context of the pandemic. Moreover, antimicrobial resistance (AMR) surveillance and AMS have been deprioritised with diversion of health system resources to the pandemic response. This experience highlights deficiencies in AMR containment and mitigation strategies that require urgent attention from clinical and scientific communities. These include the need to implement diagnostic stewardship to assess the global incidence of coinfections and secondary infections in COVID-19 patients, including those by multidrug-resistant pathogens, to identify patients most likely to benefit from antibiotic treatment and identify when antibiotics can be safely withheld, de-escalated or discontinued. Long-term global surveillance of clinical and societal antibiotic use and resistance trends is required to prepare for subsequent changes in AMR epidemiology, while ensuring uninterrupted supply chains and preventing drug shortages and stock outs. These interventions present implementation challenges in resource-constrained settings, making a case for implementation research on AMR. Knowledge and support for these practices will come from internationally coordinated, targeted research on AMR, supporting the preparation for future challenges from emerging AMR in the context of the current COVID-19 pandemic or future pandemics.
登录
查看更多内容
影响因子：
7.7
作者：
Knight GM;Glover RE;McQuaid CF;Olaru ID;Gallandat K;Leclerc QJ;Fuller NM;Willcocks SJ;Hasan R;van Kleef E;Chandler CI
通讯作者：
Chandler CI
影响因子：
2.2
作者：
Dekker, Anne R. J.;Verheij, Theo J. M.;van der Velden, Alike W.
通讯作者：
van der Velden, Alike W.
DOI：
10.1016/j.cmi.2020.07.041
发表时间：
2021-01
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Garcia-Vidal C;Sanjuan G;Moreno-García E;Puerta-Alcalde P;Garcia-Pouton N;Chumbita M;Fernandez-Pittol M;Pitart C;Inciarte A;Bodro M;Morata L;Ambrosioni J;Grafia I;Meira F;Macaya I;Cardozo C;Casals C;Tellez A;Castro P;Marco F;García F;Mensa J;Martínez JA;Soriano A;COVID-19 Researchers Group
通讯作者：
COVID-19 Researchers Group
影响因子：
5.2
作者：
Beovic, Bojana;Dousak, May;Erdem, Hakan
通讯作者：
Erdem, Hakan
影响因子：
5.7
作者：
Bong, Choon-Looi;Brasher, Christopher;Enright, Angela
通讯作者：
Enright, Angela