The Global Burden of Multidrug-Resistant Bacteria.

IF 2.2
Andrea Marino, Antonino Maniaci, Mario Lentini, Salvatore Ronsivalle, Giuseppe Nunnari, Salvatore Cocuzza, Federica Maria Parisi, Bruno Cacopardo, Salvatore Lavalle, Luigi La Via
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Abstract

Background/Objectives: This narrative review provided a broad synthesis of recent epidemiological trends, priority resistance mechanisms, and public health implications of multidrug-resistant (MDR) bacteria. We focused on the most clinically significant MDR pathogens, regional differences in resistance, and the effectiveness of containment strategies. Our goal was to synthesize current knowledge and propose research directions. Methods: Through comprehensive analysis of epidemiological studies, surveillance reports, clinical trials, and meta-analyses, we present a detailed assessment of the evolving landscape of antimicrobial resistance across both developed and developing nations. The review encompasses data from 187 countries, analyzing over 2500 published studies and reports from major health organizations. Results: Our findings reveal a concerning 43% increase in multidrug-resistant infections globally, with particularly sharp rises in healthcare-associated infections (67% increase) and community-acquired infections (38% increase) in regions with high antibiotic misuse. The analysis specifically focuses on critical pathogens, including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL), and carbapenem-resistant Enterobacteriaceae (CRE), documenting their prevalence, transmission patterns, and treatment outcomes. Economic impact assessments indicate annual global healthcare costs exceeding USD 100 billion due to resistant infections. The review identifies significant gaps in current surveillance systems, particularly in low- and middle-income countries, and proposes standardized approaches for monitoring and containment strategies. We evaluate the effectiveness of various antimicrobial stewardship programs, documenting success rates and implementation challenges across different healthcare settings. Conclusions: The analysis concludes with evidence-based recommendations for policy reforms, research priorities, and international collaboration frameworks necessary to address this growing global health crisis. Our findings highlighted the importance of strengthening stewardship efforts, proposing novel diagnostics and therapeutic interventions, and addressing inequities in access to care and data across different countries.

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多重耐药细菌的全球负担。
背景/目的:本文综述了耐多药(MDR)细菌的近期流行病学趋势、重点耐药机制和公共卫生影响。我们将重点放在临床最重要的耐多药病原体、耐药的区域差异以及遏制策略的有效性上。我们的目标是综合现有知识并提出研究方向。方法:通过对流行病学研究、监测报告、临床试验和荟萃分析的综合分析,我们对发达国家和发展中国家抗菌素耐药性的演变情况进行了详细评估。该审查包括来自187个国家的数据,分析了2500多份已发表的研究和主要卫生组织的报告。结果:我们的研究结果显示,全球多药耐药感染增加了43%,在抗生素滥用严重的地区,医疗保健相关感染(增加67%)和社区获得性感染(增加38%)的增长尤为急剧。该分析特别关注关键病原体,包括耐甲氧西林金黄色葡萄球菌(MRSA),广谱β-内酰胺酶产肠杆菌科(ESBL)和耐碳青霉烯肠杆菌科(CRE),记录了它们的流行情况,传播模式和治疗结果。经济影响评估表明,由于耐药感染,全球每年的医疗保健费用超过1000亿美元。该审查确定了当前监测系统的重大差距,特别是在低收入和中等收入国家,并提出了监测和遏制战略的标准化方法。我们评估了各种抗菌药物管理计划的有效性,记录了不同医疗保健环境中的成功率和实施挑战。结论:分析最后提出了应对这一日益严重的全球卫生危机所需的政策改革、研究重点和国际合作框架的循证建议。我们的研究结果强调了加强管理工作、提出新的诊断和治疗干预措施以及解决不同国家在获得护理和数据方面的不平等问题的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.60
自引率
0.00%
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审稿时长
7 weeks
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