关键词: antimicrobial resistant community-acquired ethnicity health disparities race

来  源:   DOI:10.1101/2024.04.24.24306289   PDF(Pubmed)

Abstract:
UNASSIGNED: Racial and ethnic disparities in infectious disease burden have been reported in the USA and globally, most recently for COVID-19. It remains unclear whether such disparities also exist for priority bacterial pathogens that are increasingly antibiotic-resistant. We conducted a scoping review to summarize published studies that report on colonization or community-acquired infection with pathogens among different races and ethnicities.
UNASSIGNED: We conducted an electronic literature search of MEDLINE®, Daily, Global Health, Embase, Cochrane Central, and Web of Science from inception to January 2022 for eligible observational studies. Abstracts and full-text publications were screened in duplicate for studies that reported data for race or ethnicity for at least one of the pathogens of interest.
UNASSIGNED: Fifty-four observational studies in 59 publications met our inclusion criteria. Studies reported results for Enterobacterales, Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus, and were conducted in Australia, Brazil, Israel, New Zealand, and USA. USA studies most often examined Black and Hispanic minority groups with studies regularly reporting a higher risk of these pathogens in Black persons and mixed results for Hispanic persons. Ethnic minority groups (e.g. Bedouins in Israel, Aboriginals in Australia) were often reported to be at a higher risk in other countries.
UNASSIGNED: Sufficient evidence was identified in this scoping review justifying future systematic reviews and meta-analyses evaluating the relationship between community-acquired pathogens and race and ethnicity. However, we noted that only a fraction of studies reported data stratified by race and ethnicity, highlighting a substantial gap in the literature.
摘要:
据报道,美国和全球的传染病负担存在种族和民族差异,最近一次是COVID-19。目前尚不清楚这种差异是否也存在于越来越具有抗生素抗性的优先细菌病原体中。我们进行了范围审查,以总结已发表的有关不同种族和种族之间病原体定植或社区获得性感染的研究。
我们对MEDLINE®进行了电子文献检索,每日,全球卫生,Embase,CochraneCentral,和WebofScience从成立到2022年1月,用于符合条件的观察性研究。摘要和全文出版物一式两份进行筛选,研究报告了至少一种目的病原体的种族或种族数据。
59篇出版物中的54项观察性研究符合我们的纳入标准。研究报告了肠杆菌的结果,屎肠球菌,大肠杆菌,肺炎克雷伯菌,铜绿假单胞菌,和金黄色葡萄球菌,并在澳大利亚进行,巴西,以色列,新西兰,和美国。美国的研究最常检查黑人和西班牙裔少数群体,研究定期报告黑人中这些病原体的风险较高,而西班牙裔则混合结果。少数族裔群体(例如以色列的贝都因人,据报道,澳大利亚的原住民)在其他国家/地区的风险较高。
在本范围审查中确定了充分的证据,证明了未来的系统评价和荟萃分析评估社区获得性病原体与种族和民族之间的关系。然而,我们注意到,只有一小部分研究报告了按种族和族裔分层的数据,突出了文献中的实质性差距。
背景:
先前已经报道了关键细菌病原体在定殖和社区获得性感染方面的种族和种族差异,但是迄今为止还没有收集全球证据。在MEDLINE搜索文献,每日,全球卫生,Embase,Cochrane系统评价数据库,Cochrane中央控制试验登记册,和WebofScience核心合集从成立到2022年1月,利用社区获得性感染的MeSH术语和关键词,门诊病人,门诊护理,社会经济因素,健康状况差异,医疗保健差异,大陆人口组,种族群体,革兰氏阴性细菌,和个别ESKAPE病原体。
据我们所知,这是首份全球证据汇编,表明在对抗菌药物耐药性(AMR)日益增强的优先细菌病原体的定植/感染方面存在种族和族裔差异.虽然我们纳入的大多数研究都是在美国进行的,我们还确定了巴西的相关研究,以色列,澳大利亚,和新西兰。总的来说,属于这些国家内的种族或少数族裔群体的人,尤其是美国和巴西的黑人,澳大利亚和新西兰的原住民,和阿拉伯人或贝都因人在以色列-在定植/感染与大多数群体相比,目的病原体的风险更高,尽管这种差异没有生物学基础。我们发现了一些值得在未来研究中考虑的差距,包括研究中种族和民族的不一致分类,在美国土著和原住民人群中进行的研究有限,加拿大,中美洲和南美洲,缺乏研究报告定植或感染率按个体种族或民族分层。
我们的研究结果表明,全球努力公平地预防,诊断,除非考虑考虑种族和族裔差异的策略,否则治疗AMR日益增加的细菌感染将具有挑战性。
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