Zikora Kizito Glory Anyaegbunam , Ifeanyi Elibe Mba , Yandev Doowuese , Ngozi J. Anyaegbunam , Toluwalase Mba , Fetuata Aminat Aina , Vincent Nnamdigadi Chigor , Emeka Innocent Nweze , Emmanuel A. Eze
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Till now, the source of AMR and how resistant clones are selected in the environment remain largely elusive, and potential anthropogenic transmission has been reported in different studies. Various drug-resistant pathogens, lineages, resistant clones, outbreak clusters, plasmid replicates, and genes that play a critical role in resistance dissemination have been identified. Maintenance of certain multidrug-resistant (MDR) determinants has also been shown to enhance or support the propagation of MDR. So far, significant advances have been made in understanding the burden of AMR. However, overcoming AMR requires a holistic approach, as there is no single approach with sufficient precision to curb the threat. While strengthening AMR surveillance efforts is essential, as we have shown, there is also a need to intensify efforts to strengthen therapeutic interventions, especially in priority regions such as Africa. 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引用次数: 0
摘要
在全球范围内,耐药性病原体引起的感染是威胁治疗工作的重大挑战。据世界卫生组织(WHO)称,抗菌药耐药性(AMR)是全球十大公共卫生威胁之一。从各种来源(人类、动物和环境)分离出了具有高度多宿主适应性、显著遗传多样性(多系)、高毒力因子和基因交换的生物体,即使之前没有接触过抗生素。迄今为止,AMR 的来源以及耐药克隆是如何在环境中被筛选出来的,在很大程度上仍是未知数,不同的研究也报道了潜在的人为传播。各种耐药病原体、菌系、耐药克隆、疫情集群、质粒复制以及在耐药性传播中发挥关键作用的基因已被确认。某些耐多药(MDR)决定因子的维持也被证明会增强或支持 MDR 的传播。迄今为止,在了解 AMR 的负担方面已经取得了重大进展。然而,克服 AMR 需要采取综合方法,因为没有一种方法能够足够精确地遏制这一威胁。正如我们所表明的那样,加强 AMR 监测工作至关重要,同时还需要加大力度加强治疗干预,尤其是在非洲等重点地区。在此,我们讨论了 AMR 的负担以及 AMR 在人类、动物和环境中的传播(非医疗驱动因素)。我们进一步深入探讨了有关非洲的重大问题,并讨论了涉及疫苗和其他可行生物材料的治疗干预措施如何能够在最大程度上减轻 AMR 负担方面发挥关键作用。
Antimicrobial resistance containment in Africa: Moving beyond surveillance
Worldwide, infections caused by drug-resistant pathogens constitute a significant challenge threatening therapeutic efforts. According to the World Health Organization (WHO), antimicrobial resistance (AMR) ranks among the top 10 global public health threats. Organisms with a high rate of multiple host adaptivity, significant genetic diversity (multiple lineages), high virulence factors, and genetic exchange have been isolated from various sources (humans, animals, and the environment) even without exposure to prior antibiotics. Till now, the source of AMR and how resistant clones are selected in the environment remain largely elusive, and potential anthropogenic transmission has been reported in different studies. Various drug-resistant pathogens, lineages, resistant clones, outbreak clusters, plasmid replicates, and genes that play a critical role in resistance dissemination have been identified. Maintenance of certain multidrug-resistant (MDR) determinants has also been shown to enhance or support the propagation of MDR. So far, significant advances have been made in understanding the burden of AMR. However, overcoming AMR requires a holistic approach, as there is no single approach with sufficient precision to curb the threat. While strengthening AMR surveillance efforts is essential, as we have shown, there is also a need to intensify efforts to strengthen therapeutic interventions, especially in priority regions such as Africa. Herein, we discussed the burden of AMR and the dissemination of AMR in humans, animals, and the environment (non-medical drivers). We further delved into the big questions on Africa and discussed how therapeutic interventions involving vaccines and other viable biomaterials could be pivotal in reducing the burden of AMR to the barest minimum.