Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.

中文翻译：

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南亚和东南亚的碳青霉烯类耐药鲍曼不动杆菌和肠杆菌科细菌。


耐碳青霉烯类革兰氏阴性菌，特别是鲍曼不动杆菌-乙酸钙复合物和肠杆菌科细菌，正在加剧全球公共卫生威胁。我们回顾了南亚和东南亚国家中这些耐碳青霉烯类革兰氏阴性菌的流行病学和患病率，这些国家的耐药率是世界上最高的。这些国家拥有世界三分之一以上的人口，其中一些国家还是主要的医疗旅游目的地。数据存在重大差距，而且几乎普遍缺乏包括分子流行病学检测在内的全面监测计划，这使得深入了解问题的根源和严重程度变得困难。抗生素处方不当、卫生系统不堪重负以及国际旅行（包括医疗旅游现象）等复杂因素的结合可能导致这些细菌在南亚和东南亚的医院中迅速增加和传播。在印度、巴基斯坦和越南，环境和社区中也发现了耐碳青霉烯类肠杆菌科细菌，这可能是由于环境卫生和卫生条件差造成的。为了减少此类细菌在南亚和东南亚的流行并防止其在全球传播，包括这些地区以外的国家在内的大量政治意愿和努力至关重要。