与人类中产广谱β-内酰胺酶肠杆菌相关因素的专题描述。

Jamie Goltz, Carl Uhland, Sydney Pearce, Colleen Murphy, Carolee Carson, Jane Parmley
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引用次数: 0

摘要

背景:产生广谱β-内酰胺酶(ESBL)的肠杆菌科细菌与加拿大人的严重耐药性感染有关。人类通过许多相互关联的途径接触产 ESBL 肠杆菌科细菌。为了更好地保护加拿大人,必须了解哪些来源和活动对加拿大的 ESBL 暴露和感染途径贡献最大:本范围综述旨在专题描述人类发展指数非常高的国家中与产 ESBL 肠杆菌科细菌定植、携带和/或感染人类可能相关的因素,并描述研究特征:搜索了四个数据库(PubMed、CAB Direct、Web of Science、EBSCOhost),以检索可能相关的研究。对纳入的文章进行筛选,确定因素,按主题分组并进行描述:结果:审查确定了 381 篇相关文章。这些因素被分为 13 个主题:抗菌药物使用、动物、合并症和症状、社区、人口统计学、饮食和药物使用、医疗保健、家庭、职业、先前的 ESBL 结肠化/携带/感染、居住护理、旅行和其他。报告中最常见的主题是人口统计学、医疗保健、抗生素使用以及合并症和症状。大多数文章报告了医院环境中的因素(86%),并评估了产ESBL肠杆菌科细菌感染的因素(52%):本次范围界定综述提供了有价值的信息,说明了哪些因素主题已被充分描述(如医疗保健),哪些因素主题较少被探讨(如饮食或动物接触)。所确定的主题跨越了人类、动物和环境的背景和环境,支持了从不同角度和多部门方法来减少抗菌药耐药性暴露的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thematic description of factors linked with extended-spectrum beta-lactamase-producing Enterobacteriaceae in humans.

Background: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are associated with serious antimicrobial-resistant infections in Canadians. Humans are exposed to ESBL-producing Enterobacteriaceae through many interconnected pathways. To better protect Canadians, it is important to generate an understanding of which sources and activities contribute most to ESBL exposure and infection pathways in Canada.

Objective: The aims of this scoping review were to thematically describe factors potentially associated with ESBL-producing Enterobacteriaceae colonization, carriage and/or infection in humans from countries with a very high human development index and describe the study characteristics.

Methods: Four databases (PubMed, CAB Direct, Web of Science, EBSCOhost) were searched to retrieve potentially relevant studies. Articles were screened for inclusion, and factors were identified, grouped thematically and described.

Results: The review identified 381 relevant articles. Factors were grouped into 13 themes: antimicrobial use, animals, comorbidities and symptoms, community, demographics, diet and substance use, health care, household, occupation, prior ESBL colonization/carriage/infection, residential care, travel, and other. The most common themes reported were demographics, health care, antibiotic use and comorbidities and symptoms. Most articles reported factors in hospital settings (86%) and evaluated factors for ESBL-producing Enterobacteriaceae infections (52%).

Conclusion: This scoping review provided valuable information about which factor themes have been well described (e.g., health care) and which have been explored less frequently (e.g., diet or animal contact). Themes identified spanned human, animal and environmental contexts and settings, supporting the need for a diversity of perspectives and a multisectoral approach to mitigating exposure to antimicrobial resistance.

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