Perceptions of antimicrobial resistance by international travellers.

随着全球抗生素耐药性（AMR）的增加，“现代医学终结”的风险（Chan：2012）1迫在眉睫。抗生素耐药性将给当地、区域和全球现有的公共卫生结构带来巨大压力，以应对与耐药性病原体相关的严重和旷日持久的疾病。由于没有新的抗菌产品可用，现在更加重视人类使用这些药品，以确保未来的使用和持续的疗效。许多变形菌和肠杆菌科的菌株已被证明对一线和二线抗生素具有耐药性，并且更令人担忧的是对最后手段药物（DoLR）具有耐药性，使得这些感染无法治疗。在其他严重感染中也发现了广泛的耐药性，如结核分枝杆菌、人类免疫缺陷病毒和疟原虫（疟疾），强调了人类面临的各种挑战。在国际旅行的推动下，耐药感染正在世界各地蔓延。感染不再局限于世界的一个角落，通过快速和持续的人类交流，抗菌素耐药性的威胁面临着每个人，无处不在。该项目将研究与AMR相关的国际旅行趋势，利用对研究数据既敏感又自反的扎根理论方法，为理解AM提供新概念的发展空间。目前还没有利用这一方法开展任何已知项目，但该项目将为应对这一新出现的全球威胁提供新的见解。半结构化的一对一访谈将为这个项目提供骨干。研究目标将涉及国际旅行的健康相关风险、AMR的抽象、感染预防和感染控制决策和实践以及暴露前后的感染预防。参与者将从英格兰的疫苗接种和医疗中心积极招募，重点关注那些前往高风险低收入和中等收入国家的个人（利用最新的世卫组织抗菌素耐药性报告），这些国家已经确定了耐药性感染的出现和转移。此外，还将根据世界卫生组织（WHO）主动AMR框架“GLASS”（全球抗菌素耐药性监测系统）和欧洲抗菌素耐药性监测网络（EARS-Net）对AMR趋势进行监测，以实时了解除Pro-MED（监测新发疾病的计划）外的主动威胁。本项目中的文献将有助于将研究纳入当前的社会和自然科学文献。该项目将使广泛的学科和受益者受益，如英国公共卫生部、欧洲联盟、世卫组织、联合国、多边、双边和政府公共卫生机构、国际发展机构、非政府卫生行为者和公众。（2012年）。欧盟和世界的抗菌素耐药性。http://www.who.int/dg/speeches/2012/amr_20120314/en/

With increasing global rates of antimicrobial resistance (AMR), the risk of an 'end to modern medicine' (Chan: 2012)1 looms large on the horizon. Antimicrobial resistance will place a huge strain on existing public health structures, locally, regionally and globally in dealing with the severe and protracted illnesses associated with resistant pathogens.With no new antimicrobial products available, greater emphasis is now being paid to human use of these pharmaceutical products to ensure future usage and continued efficacy. A number of strains of proteobacteria and entereobacteriacea have been shown to be resistant to first and second line antibiotics, and, more worryingly resistant to drugs of last resort (DoLR), rendering these infections as untreatable. Extensive drug resistance has also been identified in other serious infections such as Mycobacterium tuberculosis, Human Immunodeficiency Virus and Plasmodium (Malaria), emphasising the diverse challenge facing humanity. Resistant infections are spreading across the world, facilitated by international travel. Infections no longer remain confined to one corner of the world, through rapid and continuous human exchanges, the threat of antimicrobial resistance faces everybody, everywhere. This project will research trends of international travel associated with AMR, utilising a grounded theory approach that is both sensitive and reflexive to the research data that will allow space for development of new conceptualisations in understanding AM . No known project has been undertaken utilising this approach.This project will provide new insights into addressing this emerging global threat. Semi structured one-to-one interviews will provide the backbone to this project. Research aims will address health related risk of international travel, abstractions of AMR, infection prevention and infection control decision making and praxis and pre and post exposure infection prophylaxis. Participants will be actively recruited from vaccination and medical centres in England, with a focus on those individuals travelling to high-risk low and middle income countries (utilising the most current WHO antimicrobial resistance report) where emergence and transfer of resistance infections has been established. Trends in AMR will also be monitored according to the World Health Organisation's (WHO) active AMR framework 'GLASS' (Global Antimicrobial Resistance Surveillance Systems) and the European Antimicrobial Resistance Surveillance Network (EARS-Net) to capture a real-time perspective on active threats in addition to Pro-MED (program for monitoring emerging diseases). A literature included in this project will be undertaken to help situate the research into current social and natural science literature. The project will be of benefit to a broad range of academic disciplines and beneficiaries such as the Public Health England, the European Union, WHO, The United Nations, multilateral, bilateral and governmental public health institutions, international development agencies, non-governmental health actors, and the general public.1 Chan, M. (2012). Antimicrobial Resistance in the European Union and the World. http://www.who.int/dg/speeches/2012/amr_20120314/en/