Insights into Haemophilus macrolide resistance: A comprehensive systematic review and meta-analysis.

IF 3.4 2区医学 Q1 PARASITOLOGY

PLoS Neglected Tropical Diseases Pub Date : 2025-03-04 eCollection Date: 2025-03-01 DOI:10.1371/journal.pntd.0012878

Irfan Ahmad, Aziz Kubaev, Ahmed Hussein Zwamel, Roopashree R, Lalji Baldaniya, Jaswinder Kaur, Bindu Rani, Masoumeh Beig

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引用次数: 0

Abstract

Background: Haemophilus spp., particularly Haemophilus influenzae, are major global pathogens causing various infections. Macrolides are crucial in treating these infections, but rising resistance to macrolides in Haemophilus spp. highlights the growing threat of antimicrobial resistance (AMR).

Objective: This study aims to assess the prevalence of macrolide resistance in Haemophilus spp, across different global regions.

Methods: A systematic literature search was conducted across PubMed, Embase, Web of Science, and Scopus databases from May 2015 to December 2023 to identify studies on macrolide resistance in Haemophilus spp. The review included English-language full-text articles that reported resistance proportions and sample sizes. Study quality was assessed using the JBI Critical Appraisal Tool. Statistical analysis was performed using a random-effects model using the metafor package in R.

Results: A total of 10,114 articles were retrieved, and after a comprehensive evaluation, 15 studies (from 19 reports) met the eligibility criteria for inclusion in this systematic review and meta-analysis. Most studies (eight reports from three countries) focused on clarithromycin susceptibility, revealing a pooled prevalence of 7.2%. High heterogeneity was observed for azithromycin (I² = 96.31%, p < 0.001). Azithromycin resistance was higher than clarithromycin, with a resistance rate of 9.3% (nine reports), while erythromycin resistance was significantly higher at 79% (four reports). Subgroup analysis revealed significant variations in resistance prevalence based on geographic location and continent for azithromycin, erythromycin, and clarithromycin. Additionally, notable differences were observed in resistance rates depending on antimicrobial susceptibility testing (AST) methods and AST guidelines for both azithromycin and erythromycin. Clarithromycin resistance increased from 0.7% (2015-2019) to 12.6% (2020-2023).

Conclusion: The study underscores the significant challenges of macrolide resistance in treating Haemophilus spp. infections. Additionally, ongoing surveillance of resistance patterns and exploring contributing factors are crucial to enhancing treatment effectiveness.

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大环内酯血杆菌耐药性研究：一项全面的系统综述和荟萃分析。

背景：嗜血杆菌属，特别是流感嗜血杆菌，是引起各种感染的主要全球病原体。大环内酯类药物在治疗这些感染方面至关重要，但嗜血杆菌对大环内酯类药物的耐药性不断上升，突显了抗菌素耐药性（AMR）日益增长的威胁。目的：本研究旨在评估全球不同地区嗜血杆菌大环内酯类药物耐药性的流行情况。方法：系统检索2015年5月至2023年12月的PubMed、Embase、Web of Science和Scopus数据库，以确定嗜血杆菌大环内酯类药物耐药的研究，纳入报告耐药比例和样本量的英文全文文章。使用JBI关键评估工具评估研究质量。结果：共检索到10114篇文献，经过综合评价，15项研究（来自19份报告）符合纳入本系统评价和荟萃分析的资格标准。大多数研究（来自3个国家的8份报告）侧重于克拉霉素敏感性，显示总患病率为7.2%。阿奇霉素的异质性较高（I²= 96.31%,p < 0.001）。阿奇霉素耐药率高于克拉霉素，耐药率为9.3%（9份报告），红霉素耐药率显著高于克拉霉素，为79%（4份报告）。亚组分析显示，阿奇霉素、红霉素和克拉霉素的耐药率在地理位置和大陆上存在显著差异。此外，阿奇霉素和红霉素的耐药率也存在显著差异，这取决于抗菌素敏感性试验（AST）方法和AST指南。克拉霉素耐药性从0.7%（2015-2019年）上升至12.6%（2020-2023年）。结论：该研究强调了大环内酯类药物耐药治疗嗜血杆菌感染的重大挑战。此外，持续监测耐药模式和探索促成因素对提高治疗效果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE

自引率

10.50%

发文量

723

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).