背景:抗菌素耐药性(AMR)构成了全球健康威胁,中低收入国家承担了不成比例的负担。需要在一个健康框架下监测AMR,以阐明临床,动物,环境AMR。这篇综述旨在描述加纳的AMR状况,专注于一个健康。
方法:本综述利用PRISMA指南和主要数据库系统地搜索和分析了2014年1月1日至2023年5月1日发布的加纳AMR。
结果:在符合纳入标准的48篇文章中,对人类进行了28项研究,14项研究涉及动物,6项研究集中在环境上。在整个人类中总共鉴定出48种不同的病原体,动物,和环境部门,最常见的是大肠杆菌(67%,n=32),克雷伯菌属。(52%,n=25),假单胞菌属。(40%,n=19),和沙门氏菌。(38%,n=18)。一般来说,在各部门的各种细菌中,抗生素耐药性很高。这些细菌对常用抗生素表现出耐药性,对氨苄西林和四环素的耐药性超过80%,志贺氏菌属的多药耐药性(MDR)为17.6%。在不动杆菌属中达到100%。
结论:本次审查重申了加纳AMR的重大挑战,在人类中观察到很高的患病率,动物,和环境部门。关键病原体(例如,在各个行业发现的金黄色葡萄球菌和大肠杆菌)强调,迫切需要采用“一个健康”方法来解决加纳的AMR。
BACKGROUND: Antimicrobial resistance (AMR) poses a global health threat, with lower-middle-income countries bearing a disproportionate burden. Surveillance of AMR under a One Health framework is needed to elucidate the associations among clinical, animal, and environmental AMR. This review aimed to describe the state of AMR in Ghana, focusing on One Health.
METHODS: This review utilized the PRISMA guidelines and major databases to systematically search and analyze AMR in Ghana published from 1 January 2014 to 1 May 2023.
RESULTS: Out of the 48 articles that met the inclusion criteria, 28 studies were conducted on humans, 14 studies involved animals, and 6 studies focused on the environment. A total of 48 different pathogens were identified across the human, animal, and environmental sectors, with the most common being Escherichia coli (67%, n = 32), Klebsiella spp. (52%, n = 25), Pseudomonas spp. (40%, n = 19), and Salmonella spp. (38%, n = 18). Generally, a high prevalence of antibiotic resistance was observed among various bacterial species across the sectors. These bacteria exhibited resistance to commonly used antibiotics, with resistance to ampicillin and tetracycline exceeding 80%, and multidrug resistance (MDR) ranging from 17.6% in Shigella spp. to 100% in Acinetobacter spp.
CONCLUSIONS: This review reaffirms the significant challenge of AMR in Ghana, with a high prevalence observed in the human, animal, and environmental sectors. Key pathogens (e.g., Staphylococcus aureus and Escherichia coli) found across the sectors emphasize the urgent need for a One Health approach to tackle AMR in Ghana.