应对2019冠状病毒病大流行之后的抗生素耐药性趋势:来自五个疫情最严重国家的见解

Shraddha Asthana, Manoharan Shankar, Preeti
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摘要

在COVID-19大流行发生之前,抗生素耐药性一直是一个突出的障碍。由于无法有效治疗新发现的冠状病毒病,加上COVID-19患者中细菌合并感染的增加,抗生素的消费量急剧增加。尽管COVID-19疫情在一定程度上有助于减少感染的传播,但抗生素耐药性的增加仍然是一个重大后果。利率上升是一个全球性问题。本综述的目的是研究巴西、中国、印度、俄罗斯和美利坚合众国在COVID-19大流行之前和之后的抗生素耐药性趋势。结果发现,巴西耐药率最高的最麻烦的病原体是不动杆菌,该细菌对美罗培南、环丙沙星、庆大霉素和阿米卡星的耐药性达到峰值。此外,中国的病原体对大环内酯类、青霉素类和氨基糖苷类具有难以置信的易感性;然而,几种病原菌的耐药率变化不大。在印度,阿奇霉素的使用增加导致各种细菌病原体中出现大环内酯类耐药性,而强力霉素的长期使用尚未导致任何四环素耐药性。尽管如此,真菌感染的发生率有所增加,导致与covid -19相关的毛霉病在印度人群中更加频繁。虽然俄罗斯常见的病原体对大多数抗生素具有极强的耐药性,但鲍曼不动杆菌是报告的主要耐药细菌。美利坚合众国被认为对万古霉素、氟喹诺酮类药物和广谱β-内酰胺酶产生抗生素具有集中耐药性。在世界与COVID-19的斗争中,抗生素耐药性增长的惊人速度确实令人担忧。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Confronting trends of antibiotic resistance beyond the COVID-19 pandemic: insight from five worst hit countries
Antibiotic resistance is and has been a prominent obstacle prior to the occurrence of the COVID-19 pandemic. Due to the inability to efficiently treat the newly discovered coronavirus disease and the rise of bacterial co-infections in COVID-19 patients, the consumption of antibiotics increased drastically. Although the COVID-19 situation has somewhat contributed to reducing the spread of infections, the increment in antibiotic resistance is still a significant consequence. This emergence of increased rates is a global issue. The purpose of this review is to study the trend of antibiotic resistance before and since the COVID-19 pandemic in Brazil, China, India, Russia, and The United States of America. It was found that the most troublesome pathogens with the highest resistance rates in Brazil were Acinetobacter spp. The said bacterium species had developed peak resistance against meropenem, ciprofloxacin, gentamicin, and amikacin. Also, China had incredibly susceptible pathogens resistant towards macrolides, penicillins, and aminoglycosides; however, not much change was witnessed in the resistance rates of several pathogens. In India, increased usage of azithromycin led to the emergence of macrolide resistance among various bacterial pathogens, whereas the perpetual usage of doxycycline had not yet resulted in any tetracycline resistance. Although, the occurrence of fungal infections had enlarged, causing COVID-19-associated mucormycosis more frequent among the Indian population. While commonly present pathogens in Russia were extremely resistant to most antibiotic classes, Acinetobacter baumannii was the chief resistant bacterium reported. The United States of America was recognized with concentrated resistance against vancomycin, fluoroquinolones, and extended-spectrum β-lactamase producing antibiotics. This alarming rate of growing antibiotic resistance in world’s battle with COVID-19 is indeed a matter of concern.
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