Antimicrobial resistance: the major contribution of poor governance and corruption to this growing problem.
Antimicrobial resistance: the major contribution of poor governance and corruption to this growing problem.
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DOI：
10.1371/journal.pone.0116746
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Khan F
中科院分区：
文献类型：
--
作者：
Collignon P;Athukorala PC;Senanayake S;Khan F
确定政府，社会和经济因素在驱动抗生素耐药性方面的重要性，与通常认为的主要驱动因素抗生素使用和经济发展水平相比。一项关于欧洲抗生素耐药性变化的回顾性多变量分析，涉及人类抗生素使用、私人医疗保健支出、高等教育、经济发展水平（人均GDP）和治理质量（腐败）。该模型使用涉及7种常见人类血流分离株的面板数据集进行估计，涵盖1998-2010年期间的28个欧洲国家。在各国抗生素耐药性的总变化中，只有28%可归因于抗生素使用的变化。如果考虑时间效应，解释力将增加到33%。然而，当腐败指标的控制作为一个额外的变量，抗生素耐药性的总变化的63%，现在解释的回归。完整的多变量回归在拟合优度方面仅实现了额外的7%，表明腐败是解释抗生素耐药性的主要社会经济因素。在多变量分析中，一个国家的收入水平似乎对耐药率没有影响。腐败的估计影响具有统计学意义（p< 0.01）。该系数表明，腐败指标每提高一个单位，抗生素耐药性就会减少约0.7个单位。私人卫生支出的估计系数表明，减少一个单位与抗生素耐药性减少0.2个单位有关。这些发现支持了这样的假设，即治理不善和腐败导致抗生素耐药性水平，并且比抗生素使用量与耐药性率更好地相关。我们的结论是，解决腐败和改善治理将导致抗生素耐药性的减少。
To determine how important governmental, social, and economic factors are in driving antibiotic resistance compared to the factors usually considered the main driving factors—antibiotic usage and levels of economic development. A retrospective multivariate analysis of the variation of antibiotic resistance in Europe in terms of human antibiotic usage, private health care expenditure, tertiary education, the level of economic advancement (per capita GDP), and quality of governance (corruption). The model was estimated using a panel data set involving 7 common human bloodstream isolates and covering 28 European countries for the period 1998–2010. Only 28% of the total variation in antibiotic resistance among countries is attributable to variation in antibiotic usage. If time effects are included the explanatory power increases to 33%. However when the control of corruption indicator is included as an additional variable, 63% of the total variation in antibiotic resistance is now explained by the regression. The complete multivariate regression only accomplishes an additional 7% in terms of goodness of fit, indicating that corruption is the main socioeconomic factor that explains antibiotic resistance. The income level of a country appeared to have no effect on resistance rates in the multivariate analysis. The estimated impact of corruption was statistically significant (p< 0.01). The coefficient indicates that an improvement of one unit in the corruption indicator is associated with a reduction in antibiotic resistance by approximately 0.7 units. The estimated coefficient of private health expenditure showed that one unit reduction is associated with a 0.2 unit decrease in antibiotic resistance. These findings support the hypothesis that poor governance and corruption contributes to levels of antibiotic resistance and correlate better than antibiotic usage volumes with resistance rates. We conclude that addressing corruption and improving governance will lead to a reduction in antibiotic resistance.
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DOI：
10.1111/j.1468-0084.2008.00542.x
发表时间：
2009-02-01
影响因子：
2.5
作者：
Roodman, David
通讯作者：
Roodman, David
影响因子：
11.8
作者：
Boucher, Helen W.;Talbot, George H.;Bartlett, John
通讯作者：
Bartlett, John
DOI：
10.1007/s10096-010-1031-y
发表时间：
2010-12-01
影响因子：
4.5
作者：
Kennedy, K.;Collignon, P.
通讯作者：
Collignon, P.
影响因子：
13.7
作者：
Hall, RE;Jones, CI
通讯作者：
Jones, CI
影响因子：
5.2
作者：
Hawkey, Peter M.;Jones, Annie M.
通讯作者：
Jones, Annie M.