Global trends of ceftazidime-avibactam resistance in gram-negative bacteria: systematic review and meta-analysis.

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

Antimicrobial Resistance and Infection Control Pub Date : 2025-02-11 DOI:10.1186/s13756-025-01518-5

Yang Wang, Mohammad Sholeh, LunDi Yang, Matin Zafar Shakourzadeh, Masoumeh Beig, Khalil Azizian

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Abstract

Background: The emergence of antimicrobial resistance in Gram-negative bacteria (GNB) is a major global concern. Ceftazidime-avibactam (CAZ-AVI) has been identified as a potential treatment option for complicated infections.

Objectives: This meta-analysis aimed to evaluate the global resistance proportions of GNB to CAZ-AVI comprehensively.

Methods: Studies were searched in Scopus, PubMed, and EMBASE (until September 2024), and statistical analyses were conducted using STATA software (version 20.0).

Results: CAZ-AVI resistance proportions were determined in 136 studies, with 25.8% (95% CI 22.2-29.7) for non-fermentative gram-negative bacilli and 6.1% (95% CI 4.9-7.4) for Enterobacterales. The CAZ-AVI resistance proportion significantly increased from 5.6% (95% CI 4.1-7.6) of 221,278 GNB isolates in 2015-2020 to 13.2% (95% CI 11.4-15.2) of 285,978 GNB isolates in 2021-2024. Regionally, CAZ-AVI resistance was highest in Asia 19.3% (95% CI 15.7-24.23.4), followed by Africa 13.6% (95% CI 5.6-29.2), Europe 11% (95% CI 7.8-15.2), South America 6.1% (95% CI 3.2-11.5) and North America 5.3% (95% CI 4.2-6.7). Among GNB resistance profiles, colistin-resistant isolates and XDR isolates exhibited the highest resistance proportions (37.1%, 95% CI 14-68 and 32.1%, 95% CI 18.5-49.6), respectively), followed by carbapenem-resistant isolates and MDR isolates [(25.8%, 95% CI 22.6-29.3) and (13%, 95% CI 9.6, 17.3)].

Conclusion: A high proportion of GNB isolates from urinary tract infections remained susceptible to CAZ-AVI, indicating its potential as a suitable treatment option. However, the increasing resistance trends among GNB are concerning and warrant continuous monitoring to maintain CAZ-AVI's effectiveness against GNB infections.

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来源期刊

Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

9.70

自引率

3.60%

发文量

140

审稿时长

13 weeks

期刊介绍： Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.