在COVID-19大流行之前,期间和之后,儿科尿路病原体抗微生物耐药性的变化
Seon Hee Lim1, Kyo Jin Jo1, Shin Yun Byun1
1Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea.
Antibiotics (Basel, Switzerland)
|December 30, 2025
概括
儿童尿路感染 (UTI) 在COVID-19大流行期间增加了对西普洛素的耐药性,特别是在婴儿中. 这一趋势在流行后持续,强调了需要更好地管理抗生素的需要.
科学领域:
- 儿童传染病 儿童传染病
- 抗微生物耐药性 (AMR) 是一种
- 流行病学 流行病学
背景情况:
- 儿童尿路感染 (UTI) 由于抗菌素耐药性 (AMR) 的上升,造成了治疗挑战.
- COVID-19大流行影响了儿童的抗生素处方模式,但其对AMR趋势的影响尚不清楚.
- 调查在不同流行病阶段患有发烧性尿路感染住院的幼儿的AMR趋势至关重要.
研究的目的:
- 分析24个月以下患有发烧性尿路感染住院的儿童尿路病原体的抗菌素耐药性 (AMR) 趋势.
- 为了比较COVID-19流行前,期间和后的AMR模式.
- 确定儿童发烧性尿路感染中西普罗夫洛克萨不敏感性的预测因素.
主要方法:
- 对于因第一次发烧性尿路感染住院的24个月以下儿童进行了回顾性研究 (2008-2023年).
- 按年龄分层 (<100天 vs. 100天-24个月) 和流行时期 (COVID-19前,期间,后).
- 间断时间序列 (ITS) 分析和后勤回归以评估西普洛素不敏感性的趋势和预测因素.
主要成果:
- 在COVID-19大流行期间,西普罗夫洛克萨辛的敏感性显著下降,特别是在婴儿<100天.
- ITS分析显示,在大流行开始时,西普罗夫洛克萨不敏感性立即增加了12.1%,这种情况继续下去.
- 扩展谱β-乳糖酶 (ESBL) 生产是对西普洛素耐药性的最强预测因素.
结论:
- 这项研究表明,在COVID-19大流行期间,儿科发烧性尿路感染中,西普罗夫洛克萨辛不敏感性显著增加.
- 成年人使用抗生素和克隆传播可能会导致AMR的持久性和传播.
- 综合抗生素管理和基因组监测对于打击儿科AMR至关重要.
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