撒哈拉以南非洲抗微生物药物耐药性重要武器综述

Noel Gahamanyi, Therese Umuhoza, S. Saeed, L. N. Mayigane, J. N. Hakizimana
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引用次数: 3

摘要

抗菌素耐药性是人类面临的十大全球健康威胁之一,而撒哈拉以南非洲地区由于其卫生系统薄弱和资源有限而成为受影响最严重的地区之一。由于抗菌素耐药性病原体的数量不断增加和新型抗菌素的缺乏,预防感染和寻找替代治疗方案的工作正在进行中。本综述的目的是评估SSA中抗AMR的重要武器。重点强调的武器包括疫苗、教育和意识、使用水、环境卫生和个人卫生的感染预防和控制(IPC)、替代治疗方案、同一健康(OH)方法、抗菌素耐药性监测、抗菌素耐药性国家行动计划(nap)、抗菌素管理(AMS)方案以及良好治理和法规。尽管在SSA中的应用还没有达到令人满意的水平,但处理SSA中抗菌素耐药性的先进技术包括:(i)宏基因组学,(ii)抗菌素耐药性监测中的全基因组测序(WGS),以跟踪耐药性趋势并知道何时进行干预,以及(iii)基于基因组学数据在抗菌素耐药性预测中使用人工智能。撒哈拉以南非洲地区对抗抗菌素耐药性威胁的斗争采用了许多目前可用的战略,开发新的战略将降低这种威胁对子孙后代的影响。
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A Review of the Important Weapons against Antimicrobial Resistance in Sub-Saharan Africa
Antimicrobial resistance (AMR) is one of the top 10 global health threats facing humanity, and the sub-Saharan Africa (SSA) is among the heavily affected regions due to its weak health systems and limited resources. Due to an escalating number of AMR pathogens and the scarcity of new antimicrobials, efforts in the prevention of infections and the search for alternative treatment options are ongoing. The objective of this review was to assess important weapons against AMR in SSA. The highlighted weapons include vaccines, education and awareness, infection prevention and control (IPC) using water, sanitation, and hygiene (WASH), alternative treatment options, the One Health (OH) approach, AMR surveillance, operational national action plans (NAPs) on AMR, antimicrobial stewardship (AMS) programs, and good governance and regulations. Despite not being used at a satisfactory level in SSA, advanced techniques in dealing with AMR in SSA include (i) metagenomics, (ii) whole-genome sequencing (WGS) in AMR surveillance to track resistance trends and know when to intervene, and (iii) use of artificial intelligence in AMR prediction based on genomics data. The fight against AMR threat in SSA has embraced a number of currently available strategies, and developing new ones will lower the consequences of such a threat for future generations.
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