Global antimicrobial resistance: a system-wide comprehensive investigation using the Global One Health Index

作者：Nan Zhou, Zile Cheng, Xiaoxi Zhang, Chao Lv, Chaoyi Guo, Haodong Liu, Ke Dong, Yan Zhang, Chang Liu, Yung‐Fu Chang, Sheng Chen, Xiaokui Guo, Xiao‐Nong Zhou, Min Li, Yongzhang Zhu · 发表于：Infectious Diseases of Poverty · 年份：2022 · DOI：10.1186/s40249-022-01016-5 · 被引用次数：87 · 研究领域：Antibiotic Use and Resistance、Antibiotic Resistance in Bacteria、Pharmaceutical and Antibiotic Environmental Impacts

BACKGROUND: Antimicrobial resistance (AMR) is one of the top ten global public health challenges. However, given the lack of a comprehensive assessment of worldwide AMR status, our objective is to develop a One Health-based system-wide evaluation tool on global AMR. METHODS: We have further developed the three-hierarchical Global One Health Index (GOHI)-AMR indicator scheme, which consists of five key indicators, 17 indicators, and 49 sub-indicators, by incorporating 146 countries' data from diverse authoritative databases, including WHO's Global Antimicrobial Resistance and Use Surveillance System (GLASS) and the European CDC. We investigated the overall- or sub-rankings of GOHI-AMR at the international/regional/national levels for data preprocessing and score calculation utilizing the existing GOHI methodology. Additionally, a correlation analysis was conducted between the GOHI-AMR and other socioeconomic factors. RESULTS: The average GOHI-AMR score for 146 countries is 38.45. As expected, high-income countries (HICs) outperform the other three income groups on overall rankings and all five key indicators of GOHI-AMR, whereas low-income countries unexpectedly outperform upper-middle-income countries and lower-middle-income countries on the antibiotics-resistant key indicator (ARR) and ARR-subordinate indicators, including carbapenem-, β-lactam-, and quinolone resistance, and even HICs on aminoglycoside resistance. There were no significant differences among the four groups ...