グアテマラの抗生物質耐性に関する研究(Hospitals linked to antibiotic resistance in Guatemala)

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2025-08-20 ワシントン州立大学(WSU)

WSU主導のグアテマラに関する研究は、抗生物質耐性菌の保持において、医療機関への最近の受診が最大のリスク要因であることを明らかにした。自己判断の抗生物質使用は、リスク要因として有意ではなかった。また、都市部への居住、家庭にごみ収集がないこと、非ボトル飲料水の利用といった社会・環境要因も耐性菌保持のリスクを高めていた。これらの結果は、医療感染制御だけでなく、衛生・上下水道・ごみ処理といった公共インフラ面からの対策も重要であることを強調しており、政策や公衆衛生プログラムにおける介入の方向性を示す含みの深い知見と考える。

<関連情報>

コミュニティにおける広域スペクトラムセファロスポリン耐性エンテロバクター属の定着に関連するリスク要因:コミュニティと病院における抗生物質耐性研究(ARCH)グアテマラ Risk factors associated with community colonization of extended-spectrum cephalosporin-resistant Enterobacterales from an antibiotic resistance in communities and hospitals (ARCH) study, Guatemala

Brooke M. Ramay,Mark A. Caudell,Carmen Castillo,Laura Grajeda,Lucas F. Santos,Juan Carlos Romero,Maria Renee Lopez,Sylvia Omulo,Mariangeli Freitas Ning,Guy H. Palmer,Rachel M. Smith,Carolyn T. A. Herzig,Ashley Styczynski,Celia Cordon-Rosales & Douglas R. Call
Scientific Reports  Published:29 May 2025
DOI:https://doi.org/10.1038/s41598-025-03379-9

グアテマラの抗生物質耐性に関する研究(Hospitals linked to antibiotic resistance in Guatemala)

Abstract

Colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) in communities may contribute to proliferation of resistance genes and drug-resistant community and hospital infections. Previous work in the Western Highlands of Guatemala found that approximately 46% of the population is colonized with these bacteria, setting the stage to identify factors that are associated with increased odds of ESCrE colonization. Stool samples and questionnaire data were collected from randomly selected participants in the catchment area of the third largest tertiary hospital in Guatemala. Logistic regression path analysis was used for this cross-sectional study to identify potential direct and indirect risk factors for colonization with ESCrE. Participants (N = 951) had a higher odds of ESCrE colonization if they had exposure to a healthcare facility within 30 days of enrollment (OR: 2.12, 95% CI = 1.19–3.77), if they resided in urban areas (OR: 1.93, 95% CI 1.09–3.42), if they did not have a service to remove household trash (OR: 1.99, 95% CI 1.11–3.58), and if the household reported drinking water from non-bottled sources (OR:1.53, 95% CI 1.0–2.33). Antibiotic self-medication was not significantly associated with the risk of colonization (OR: 1.16, 95% CI 0.65–2.06). Multiple transmission-related factors were associated with increased likelihood of ESCrE colonization, but the cross-sectional nature of this study does not distinguish factors that are correlated with an individual’s risk for colonization whence exposed. Assessing risk factors associated with colonization with antibiotic resistant bacteria may be useful for identifying mitigation strategies and evaluating the effectiveness of interventions against antibiotic resistance in community settings.

医療・健康
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