背景:关于武装冲突与抗菌素耐药性的发展和传播之间的联系的数据很少。
目的:我们进行了系统综述,目的是总结有关21世纪武装冲突期间抗生素耐药性的流行和特征以及抗生素耐药性发展原因的现有数据。
方法:数据来源:从2000年1月1日至2023年11月30日检索PubMed和SCOPUS数据库。
方法:本系统综述包括报告武装冲突和抗菌素耐药性数据的原始文章。没有尝试从未发表的研究中获取信息。未应用语言限制。数据综合方法:定量和定性信息均通过文字描述进行汇总。
方法:部署在武装冲突地区的病人或士兵。
方法:在确诊细菌感染后,培养依赖性抗生素敏感性测试或抗生素耐药性遗传决定因子的分子检测。偏见风险评估:评估纳入研究的质量,我们采用了JoannaBriggs研究所推荐的工具.
结果:确定了34项研究,2004年11月至2023年11月出版。纳入研究的质量在47%和53%的研究中是高的和中等的,分别。纳入的研究报告了多重耐药细菌的高感染率和定植率。在乌克兰东部冲突期间进行的研究报告了新德里金属β-内酰胺酶生产者的高比率。
结论:我们的研究结果证实,战争会导致大量多药耐药感染,并可能传播。冲突地区医疗机构的感染控制和适当的抗菌药物管理至关重要。
BACKGROUND: Scant data are available on the link between armed conflicts and the development and spread of antimicrobial resistance.
OBJECTIVE: We performed a systematic review with the aim to summarize the available data on the prevalence and features of antibiotic resistance and the causes of antibiotic resistance development during armed conflicts in the 21st century.
METHODS: Data sources: PubMed and SCOPUS databases were searched from 1 January 2000 to 30 November 2023.
METHODS: Original articles reporting data on armed conflicts and antimicrobial resistance were included in this systematic review. No attempt was made to obtain information from unpublished studies. No language restriction was applied. Methods of data synthesis: Both quantitative and qualitative information were summarized by means of textual descriptions.
METHODS: Patients or soldiers deployed in armed conflict zones.
METHODS: culture-dependent antibiotic sensitivity testing or molecular detection of the genetic determinants of antibiotic resistance after a confirmed diagnosis of bacterial infection. Assessment of risk of bias: To evaluate the quality of the included studies, we adapted the tool recommended by the Joanna Briggs Institute.
RESULTS: Thirty-four studies were identified, published between November 2004 and November 2023. The quality of included studies was high and medium in 47% and 53% of the studies, respectively. The included studies reported high infection and colonization rates of multidrug-resistant bacteria. Studies performed during the Eastern Ukraine conflict reported high rates of New Delhi metallo-β-lactamase producers.
CONCLUSIONS: Our findings confirm that wars lead to a large pool of multidrug-resistant infections that could potentially spread. Infection control in healthcare facilities in conflict zones and proper antimicrobial stewardship are crucial.