COVID-19 限制措施限制了人际交往,降低了大肠杆菌的抗菌药耐药率。

IF 3.7 Q2 INFECTIOUS DISEASES JAC-Antimicrobial Resistance Pub Date : 2024-08-08 eCollection Date: 2024-08-01 DOI:10.1093/jacamr/dlae125
Peter Collignon, John Beggs, Jennifer Robson
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引用次数: 0

摘要

背景:抗生素耐药性在全球呈上升趋势,是一个重大的 "一体健康 "问题。与抗生素的使用相比,人与人之间的传播或 "传染 "对耐药菌株的传播有多大影响,目前仍不清楚。作为 COVID-19 应对措施的一部分,澳大利亚于 2020 年初推出了严格的人员流动限制措施。除了内部封锁措施外,从海外进入澳大利亚的人员流动也受到严格限制。这些情况为研究人员流动与耐药率变化之间的关系提供了一个独特的机会:方法:对 2016 年至 2023 年期间超过 646 000 份大肠埃希菌尿液分离物的每月耐药性数据进行建模,以统计封锁前、封锁期间和封锁后耐药性趋势的变化。数据可用于三种临床环境(社区、医院和老年护理机构)。此外,还提供了抗生素使用量和澳大利亚人口流动的数据:结果:2020 年,抵达澳大利亚的人数减少了 95%。抗生素在社区的使用量下降了20%以上。限制措施实施后,所有抗生素的耐药性趋势率都急剧下降。耐药性趋势率的下降在限制期间持续存在。值得注意的是,所有三种临床情况下的耐药性趋势率都有所下降。取消限制后,几乎所有抗生素的耐药性趋势率都出现了上升,但抗生素的使用量却没有出现相应的上升:结论:限制人员流动似乎对大肠杆菌的耐药率产生了巨大影响。结论:限制人员流动似乎对大肠杆菌的耐药率产生了巨大影响,由此导致的人与人之间交往的减少似乎比抗生素使用模式与抗生素耐药性的变化关系更为密切。
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COVID-19 restrictions limited interactions of people and resulted in lowered E. coli antimicrobial resistance rates.

Background: Antibiotic resistance is rising globally and is a major One Health problem. How much person-to-person transmission or 'contagion' contributes to the spread of resistant strains compared with antibiotic usage remains unclear. As part of its COVID-19 response, Australia introduced strict people movement restrictions in early 2020. Along with internal lockdown measures, movement of people into Australia from overseas was severely restricted. These circumstances provided a unique opportunity to examine the association of people movements with changes in resistance rates.

Methods: Monthly resistance data on over 646 000 Escherichia coli urine isolates from 2016 till 2023 were modelled for statistical changes in resistance trends during pre-lockdown, lockdown and post-lockdown periods. Data were available for three clinical contexts (community, hospital and aged-care facilities). Data were also available for antibiotic usage volumes and movements of people into Australia.

Results: In 2020, arrivals into Australia decreased by >95%. Antibiotic community use fell by >20%. There were sharp falls in trend rates of resistance for all antibiotics examined after restrictions were instituted. This fall in trend rates of resistance persisted during restrictions. Notably, trend rates of resistance fell in all three clinical contexts. After removal of restrictions, an upsurge in trend rates of resistance was seen for nearly all antibiotics but with no matching upsurge in antibiotic use.

Conclusions: Restricting the movement of people appeared to have a dramatic effect on resistance rates in E. coli. The resulting reduced person-to-person interactions seems more closely associated with changes in antibiotic resistance than antibiotic usage patterns.

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