扩大AMR监测与世卫组织的AWaRe分类:台湾全国职业队列研究 (2004-2020)
Erik Pieter de Jong1, Chia-Yu Chang2, Chi-Hsin Sally Chen1,2
1Global Health Program, National Taiwan University College of Public Health, Taipei City, Taiwan.
BMJ public health
|January 21, 2026
概括
这项研究开发了一种新的监测方法,使用了世卫组织的监测方法.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 职业健康 职业健康 职业健康
背景情况:
- 细菌感染和抗生素耐药性是全球重要的健康问题.
- 目前针对这些威胁的职业风险监测是分散的和不完整的.
- 现有的监控经常忽视关键部门,如畜牧业和农业.
研究的目的:
- 开发和验证一种新的监测方法,用于识别潜在耐药细菌感染的风险职业和工人.
- 将世界卫生组织的AWaRe (访问,观察,储备) 抗生素分类应用于一个大规模的索赔数据库.
- 综合评估职业环境和工人对抗性细菌感染的脆弱性.
主要方法:
- 在台湾,从16年的索赔数据中构建了一个超过400万名工人的回顾性职业队列.
- 鉴定了细菌感染,并使用处方抗生素的AWaRe分类推断了潜在的抗菌耐药性.
- 用复发事件的考克斯回归来分析与"储备"和/或"观察"抗生素使用相关的职业风险.
主要成果:
- 分析发现了大量的"储备" (约. 25,000) 和"储备"/"观察" (超过3100万) 的事件.
- 在特定职业群体中发现潜在耐药性细菌感染的风险显著增加.
- 蔬菜和作物种植者表现出使用储备抗生素治疗的感染风险增加 (HRs 1.48-1.49);住院护理工作者面临更高的风险 (aHR 2.21).
结论:
- 使用保险索赔数据和AWaRe分类的被动监控方法有效地识别高风险职业.
- 台湾的蔬菜/作物种植和住院护理服务的工人特别容易受到潜在的耐药性细菌感染.
- 这些发现支持针对这些确定的高风险群体进行有针对性的干预和加强感染预防策略的需要.
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