绘制比哈尔的AMR感染景观:加强政策和临床实践的影响
Vinay Modgil1, Sundeep Sahay1,2, Neelam Taneja3
1Society for Health Information Systems Programmes (HISP India), New Delhi 110025, India.
Antibiotics (Basel, Switzerland)
|July 29, 2025
概括
抗菌素耐药性 (AMR) 是印度的一个主要威胁. 这项研究揭示了比哈尔邦的高病原体耐药性,并证明数字工具可以在资源有限的环境中改善AMR监测.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
背景情况:
- 抗菌素耐药性 (AMR) 是一个关键的全球健康问题,特别影响低收入和中等收入国家 (LMICs),监测有限.
- 比哈尔是一个人口密且资源不足的印度州,缺乏全面的国家AMR监测.
- 在LMICs的监测基础设施发展不足,阻碍了有效的AMR制策略.
研究的目的:
- 在比哈尔邦的五家三级护理医院在三年内 (2022-2024) 描述AMR感染格局.
- 评估整合数字工作流程的可行性,以实时进行微生物学报告和AMR监测.
- 评估数字化整合对实验室测试和数据质量的影响.
主要方法:
- 在超过48,000个临床样本 (尿液,,血液) 上进行标准化抗微生物敏感性测试 (AST),遵循CLSI指南.
- 将设施级数据数字化为开源的AMR报告系统,用于自动生成抗生素图.
- 空间分析和微生物学实验室评估以确定诊断访问差异.
主要成果:
- 在关键病原体中观察到高水平的耐药性,对常见的抗生素如β-乳糖胺,卡巴烯和诺.
- 抗微生物敏感性的显著变化,例如,大肠杆菌对酸黄的敏感性在44.7%至86.5%之间.
- 两家医院的甲素耐药黄金葡萄球菌 (MRSA) 患病率超过65%,明显高于全国平均水平. 数字化整合使文化测试增加了四倍,并提高了数据的完整性.
结论:
- 这项研究提供了第一个全面的,国家级的AMR监测数据从印度随着时间的推移.
- 政策建议包括建立国家一级的AMR监测仪表板,并将药物采购与当地耐药性模式保持一致.
- 局部化抗生素图对在资源有限的环境中指导实证治疗至关重要,该研究为LMICs提供了一个可扩展的框架.
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