东南亚儿童抗菌素耐药性:系统性审查
Robert C Duguid1, Elizabeth A Ashley2,3, Paul Turner3,4
1Department of Infectious Diseases, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
BMJ public health
|May 5, 2025
概括
抗菌素耐药性 (AMR) 是对儿童的重大威胁.
科学领域:
- 儿童传染病 儿童传染病
- 抗微生物药物管理委员会
- 全球卫生安全 全球卫生安全
背景情况:
- 抗菌素耐药性 (AMR) 在儿童中造成大量疾病和死亡的负担.
- 常见的经验性抗生素的有效性降低使儿科感染治疗复杂化.
- 东南亚地区面临的AMR在儿科人口中日益增长的挑战.
研究的目的:
- 系统地审查影响东南亚儿童的细菌病原体中的抗菌素耐药性 (AMR).
- 分析对世界卫生组织 (WHO) 推的实证抗生素的不敏感性模式.
- 评估2010年至2023年间的抗菌耐药性趋势,重点关注全球抗菌耐药性监测系统 (GLASS) 数据.
主要方法:
- 使用PRISMA框架进行系统的文献审查.
- 分析东南亚0-18岁儿童的细菌分离物.
- 对病原体对实证抗生素不敏感性的描述性统计分析.
主要成果:
- 评估了来自111项研究的21,191个分离物 (484,540名儿童),主要来自印度.
- 在格拉姆阴性病原体中观察到的高不敏感率: *Klebsiella* spp. 这两种药物包括 gentamicin 64%,第三代黄素 76%,和 Escherichia coli (第三代黄素 73%, gentamicin 48%).
- 黄金葡萄球菌 (Staphylococcus aureus) 的甲基西林耐药性为43%.
结论:
- 在东南亚的儿科病原体中存在非常高的AMR率.
- 数据质量是可变的,并且在地理上集中,限制了概括性.
- 加强临床监测网络对于改善该地区抗菌耐药性监测至关重要.
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