Na Li, Elaheh Ebrahimi, Mohammad Sholeh, Reyhane Dousti, Ebrahim Kouhsari
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引用次数: 0
Abstract
Colistin is a last-resort treatment for multidrug-resistant Gram-negative bacterial infections, particularly in critically ill patients. Nevertheless, it remains a major threat to public health. We assessed the proportion of colistin-resistant Gram-negative isolates from intensive care unit (ICU) infections in different years, areas, pathogens, and antimicrobial susceptibility tests (AST). We searched the studies in PubMed, Scopus, Embase, and Web of Science (until November 2021). Statistical analyses were conducted using STATA software (ver. 14.0). The overall rate of colistin resistance was 5.18% (95% CI 2.70%–8.22%). The proportion of colistin resistance was 4% (95% CI 2%–7%) before 2015 and 6% (95% CI 4%–9%) in 2015–2019. The rates of colistin resistance in Europe, America, Asia, and Africa were 8.24%, 3.78%, 3.60%, and 0%, respectively. The proportion of colistin-resistant non-fermenting Gram-negative bacilli isolated from the ICU was 2.25% (Acinetobacter baumannii [1.68%] and Pseudomonas aeruginosa [3.30%]). A 4-fold increase in colistin resistance was observed when comparing EUCAST and CLSI. We described the global epidemiology of colistin resistance over time and shown the distribution of colistin-resistant strains in different countries. Robust antimicrobial stewardship programs can increase the success of ICU physicians in improving patient outcomes.
粘菌素是治疗耐多药革兰氏阴性细菌感染的最后手段,特别是对危重病人。然而,它仍然是对公众健康的一个重大威胁。我们评估了不同年份、地区、病原体和抗菌药物敏感性试验(AST)中重症监护病房(ICU)感染中耐粘菌素革兰氏阴性分离株的比例。我们检索了PubMed、Scopus、Embase和Web of Science中的研究(截止到2021年11月)。采用STATA软件进行统计分析。14.0)。总体粘菌素耐药率为5.18% (95% CI 2.70% ~ 8.22%)。2015年之前粘菌素耐药比例为4% (95% CI 2%-7%), 2015-2019年为6% (95% CI 4%-9%)。欧洲、美洲、亚洲和非洲的粘菌素耐药率分别为8.24%、3.78%、3.60%和0%。ICU分离出耐粘菌素非发酵革兰氏阴性杆菌比例为2.25%(鲍曼不动杆菌1.68%,铜绿假单胞菌3.30%)。当比较EUCAST和CLSI时,观察到粘菌素耐药性增加了4倍。我们描述了随着时间的推移粘菌素耐药性的全球流行病学,并显示了粘菌素耐药菌株在不同国家的分布。强有力的抗菌药物管理计划可以增加ICU医生在改善患者预后方面的成功。
期刊介绍:
APMIS, formerly Acta Pathologica, Microbiologica et Immunologica Scandinavica, has been published since 1924 by the Scandinavian Societies for Medical Microbiology and Pathology as a non-profit-making scientific journal.