COVID-19 對微生物產生抗生素抗藥性的影響

Impact of COVID-19 on Microbial Antibiotic Resistance

當微生物在接觸抗菌藥物後，抗菌藥物不能殺死或抑制微生物生長時，殘留的微生物擁有抵抗藥物的能力稱之為抗生素抗藥性(antimicrobial resistance，AMR)，這常導致感染更難治療並增加疾病傳播、加重疾病和死亡的風險，AMR多是由於在人類和動植物中持續過度使用和濫用抗生素造成的。在COVID-19大流行之前，AMR是我們最大的公共衛生問題之一，現在更發現在大流行後因為COVID-19影響醫療及民眾的行為，進而加劇微生物對抗生素產生抗藥性。研究發現COVID-19期間AMR升高，最常見的革蘭氏陰性抗藥性細菌是鮑氏不動桿菌、肺炎克雷伯菌；最常見的革蘭氏陽性抗藥性細菌是金黃色葡萄球菌和糞腸球菌，而自行抗生素用藥、經驗性抗生素給藥和一般科醫師(general practitioner)開立抗生素是COVID-19期間高抗藥性的危險因子。

When microorganisms are exposed to antimicrobial drugs that cannot kill or inhibit their growth, the ability of the remaining microorganisms to resist the drugs is called antibiotic resistance (antimicrobial resistance/AMR). This resistance often leads to infections that are more difficult to treat and increases the risk of disease spread, worsening disease, and death. Before the coronavirus disease (COVID-19) pandemic, AMR was one of the biggest public health problems. During the pandemic, COVID-19 affected medical care and public behavior, which in turn exacerbated microbial resistance to antibiotics. This study showed that AMR was elevated during COVID-19 pandemic, and the most common Gram-negative resistant bacteria were Acinetobacter baumannii and Klebsiella pneumoniae, whereas the most common Gram-positive resistant bacteria were Staphylococcus aureus and Enterococcus. Self-administration of antibiotics, empiric antibiotic administration, and general practitioner prescription of antibiotics are risk factors for high drug resistance during the COVID-19 pandemic.