The impact of armed conflict on the development and global spread of antibiotic resistance: a systematic review

被引：12
作者：
Granata, Guido [1 ]
Petersen, Eskild [2 ,3 ]
Capone, Alessandro [1 ]
Donati, Daniele [4 ]
Andriolo, Benedetta [1 ]
Gross, Maya [1 ]
Cicalini, Stefania [1 ]
Petrosillo, Nicola [4 ,5 ]
机构：
[1] Ist Ricovero & Cura Carattere Sci, Natl Inst Infect Dis L Spallanzani, Syst & Immune Depress Associated Infect Unit, Rome, Italy
[2] Roskilde Univ, PandemiX Ctr Excellence, Roskilde, Denmark
[3] European Soc Clin Microbiol & Infect Dis, Emerging Infect Subcomm, Basel, Switzerland
[4] Fdn Policlin Univ Campus Biomed, Infect Prevent & Control Infect Dis Serv, Rome, Italy
[5] European Soc Clin Microbiol & Infect Dis, Int Affairs Subcomm, Basel, Switzerland
来源：
CLINICAL MICROBIOLOGY AND INFECTION | 2024年 / 30卷 / 07期
关键词：
Antimicrobial resistance; Antimicrobial stewardship; Armed conflicts; Extended-spectrumI3-lactamase; Infection control; Methicillin-resistant Staphylococcus aureus; New Delhimetallo-I3-lactamase; Spread of multidrug-resistant bacteria; Ukrainian conflict; War wounds; BAUMANNII-CALCOACETICUS COMPLEX; MULTIDRUG-RESISTANT; ACINETOBACTER-BAUMANNII; MOLECULAR EPIDEMIOLOGY; ANTIMICROBIAL RESISTANCE; INFECTIOUS COMPLICATIONS; STAPHYLOCOCCUS-AUREUS; WOUND INFECTIONS; BACTERIAL-FLORA; EASTERN UKRAINE;
D O I：
10.1016/j.cmi.2024.03.029
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
Background: Scant data are available on the link between armed conflicts and the development and spread of antimicrobial resistance. Objectives: 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. Study eligibility criteria: 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 No attempt was made to obtain information from unpublished studies.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. Participants: Patients or soldiers deployed in armed conflict zones. Tests: 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- I3 -lactamase producers. Discussion: 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. Guido Granata, Clin Microbiol Infect 2024;30:858 (c) 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码：858 / 865
页数：8
相关论文
共 64 条
  • [11] European Commission (EC), Ukraine: 2,000 Ukrainian patients transferred to European hospitals since the start of the war
  • [12] Multidrug-resistant gram-negative bacilli colonization risk factors among trauma patients
    Gilbert, Laura J.
    Li, Ping
    Murray, Clinton K.
    Yun, Heather C.
    Aggarwal, Deepak
    Weintrob, Amy C.
    Tribble, David R.
    [J]. DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2016, 84 (04) : 358 - 360
  • [13] MOLECULAR EPIDEMIOLOGY OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII COMPLEX ISOLATES FROM PATIENTS THAT WERE INJURED DURING THE EASTERN UKRAINIAN CONFLICT
    Granzer, Heike
    Hagen, Ralf Matthias
    Warnke, Philipp
    Bock, Wolfgang
    Baumann, Tobias
    Schwarz, Norbert Georg
    Podbielski, Andreas
    Frickmann, Hagen
    Koeller, Thomas
    [J]. EUROPEAN JOURNAL OF MICROBIOLOGY AND IMMUNOLOGY, 2016, 6 (02): : 109 - 117
  • [14] Factors associated with recovery of Acinetobacter baumannii in a combat support hospital
    Griffith, Matthew E.
    Gonzalez, Russell S.
    Holcomb, John B.
    Hospenthal, Duane R.
    Wortmann, Glenn W.
    Murray, Clinton K.
    [J]. INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2008, 29 (07) : 664 - 666
  • [15] Molecular Epidemiology of Carbapenem-Resistant Acinetobacter baumannii Isolated from War-Injured Patients from the Eastern Ukraine
    Higgins, Paul G.
    Hagen, Ralf Matthias
    Podbielski, Andreas
    Frickmann, Hagen
    Warnke, Philipp
    [J]. ANTIBIOTICS-BASEL, 2020, 9 (09): : 1 - 10
  • [16] Multidrug-Resistant Bacterial Colonization of Combat-Injured Personnel at Admission to Medical Centers After Evacuation From Afghanistan and Iraq
    Hospenthal, Duane R.
    Crouch, Helen K.
    English, Judith F.
    Leach, Fluryanne
    Pool, Jane
    Conger, Nicholas G.
    Whitman, Timothy J.
    Wortmann, Glenn W.
    Robertson, Janelle L.
    Murray, Clinton K.
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2011, 71 : S52 - S57
  • [17] Infection Control Challenges in Deployed US Military Treatment Facilities
    Hospenthal, Duane R.
    Crouch, Helen K.
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2009, 66 (04): : S120 - S128
  • [18] Molecular analysis of imipenem-resistant Acinetobacter baumannii isolated from US service members wounded in Iraq, 2003-2008
    Huang, X. -Z.
    Chahine, M. A.
    Frye, J. G.
    Cash, D. M.
    Lesho, E. P.
    Craft, D. W.
    Lindler, L. E.
    Nikolich, M. P.
    [J]. EPIDEMIOLOGY AND INFECTION, 2012, 140 (12) : 2302 - 2307
  • [19] Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp isolates from military and civilian patients treated at the Walter Reed Army Medical Center
    Hujer, Kristine M.
    Hujer, Andrea M.
    Hulten, Edward A.
    Bajaksouzian, Saralee
    Adams, Jennifer M.
    Donskey, Curtis J.
    Ecker, David J.
    Massire, Christian
    Eshoo, Mark W.
    Sampath, Rangarajan
    Thomson, Jodi M.
    Rather, Philip N.
    Craft, David W.
    Fishbain, Joel T.
    Ewell, Allesa J.
    Jacobs, Michael R.
    Paterson, David L.
    Bonomo, Robert A.
    [J]. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2006, 50 (12) : 4114 - 4123
  • [20] Jackson D S, 1984, J R Army Med Corps, V130, P97
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