{"title":"中国大陆幽门螺杆菌的抗生素耐药性:通过系统回顾和荟萃分析关注地域差异。","authors":"Shuyan Zeng, Qingzhou Kong, Xiaoqi Wu, Miao Duan, Xueping Nan, Xiaoyun Yang, Xiuli Zuo, Yueyue Li, Yanqing Li","doi":"10.1016/j.ijantimicag.2024.107325","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Empirical treatment needs to be supported by regional data, but knowledge of interregional differences is currently lacking in China. This study aimed to summarize and map the primary and secondary antibiotic resistance of H. pylori in different regions of mainland China.</p><p><strong>Methods: </strong>PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure and Wanfang databases were systematically reviewed for studies published between January 1st, 2000 and July 15th, 2023. Data related to primary and secondary H. pylori antibiotic resistance rates were included. Random-effects models were used to synthesize the pooled resistance rates.</p><p><strong>Results: </strong>Ultimately, 74 studies were included in the final analysis. Sixteen provinces reported resistance data. The overall resistance rates of H. pylori in mainland China were 30.72% (95% CI 27.53%-33.99%) to clarithromycin, 70.14% (95% CI 29.53%-37.46%) to metronidazole, and 32.98% (95% CI 28.73%-37.37%) to levofloxacin; for amoxicillin, tetracycline, and furazolidone, the rates were 2.41% (95% CI 1.43%-3.60%), 2.53% (95% CI 1.19%-4.28%) and 1.54% (95% CI 0.28%-3.62%), respectively. Spatial and temporal differences were observed. The resistance rates increased after treatment failure, however, secondary resistance to amoxicillin, tetracycline, and furazolidone were still low across the vast majority of study regions.</p><p><strong>Conclusion: </strong>Surveillance of the updated prevalence of antibiotic resistance of H. pylori for different regions is warranted, which should factor into clinical decision making and guideline recommendations.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antibiotic Resistance of Helicobacter pylori in Mainland China: A Focus on Geographic Differences through Systematic Review and Meta-analysis.\",\"authors\":\"Shuyan Zeng, Qingzhou Kong, Xiaoqi Wu, Miao Duan, Xueping Nan, Xiaoyun Yang, Xiuli Zuo, Yueyue Li, Yanqing Li\",\"doi\":\"10.1016/j.ijantimicag.2024.107325\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Empirical treatment needs to be supported by regional data, but knowledge of interregional differences is currently lacking in China. 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The overall resistance rates of H. pylori in mainland China were 30.72% (95% CI 27.53%-33.99%) to clarithromycin, 70.14% (95% CI 29.53%-37.46%) to metronidazole, and 32.98% (95% CI 28.73%-37.37%) to levofloxacin; for amoxicillin, tetracycline, and furazolidone, the rates were 2.41% (95% CI 1.43%-3.60%), 2.53% (95% CI 1.19%-4.28%) and 1.54% (95% CI 0.28%-3.62%), respectively. Spatial and temporal differences were observed. 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引用次数: 0
摘要
背景:经验性治疗需要地区数据的支持,但中国目前缺乏对地区间差异的了解。本研究旨在总结和绘制中国大陆不同地区幽门螺杆菌的一级和二级抗生素耐药性图谱:方法:系统检索了 PubMed、EMBASE、Web of Science、中国国家知识基础设施和万方数据库中 2000 年 1 月 1 日至 2023 年 7 月 15 日期间发表的研究。研究纳入了与原发性和继发性幽门螺杆菌抗生素耐药率相关的数据。随机效应模型用于综合计算耐药率:最终,74 项研究被纳入最终分析。16个省份报告了耐药性数据。中国大陆幽门螺杆菌对克拉霉素的总体耐药率为 30.72%(95% CI 27.53%-33.99%),对甲硝唑的耐药率为 70.14%(95% CI 29.53%-37.46%),对左氧氟沙星的耐药率为 32.98%(95% CI 28.73%-37.37%)。37%);阿莫西林、四环素和呋喃唑酮的发病率分别为 2.41% (95% CI 1.43%-3.60%) 、2.53% (95% CI 1.19%-4.28%) 和 1.54% (95% CI 0.28%-3.62%) 。观察到了空间和时间上的差异。耐药率在治疗失败后有所增加,但在绝大多数研究地区,对阿莫西林、四环素和呋喃唑酮的二次耐药率仍然很低:结论:有必要对不同地区幽门螺杆菌抗生素耐药性的最新流行情况进行监测,并将其纳入临床决策和指南建议中。
Antibiotic Resistance of Helicobacter pylori in Mainland China: A Focus on Geographic Differences through Systematic Review and Meta-analysis.
Background: Empirical treatment needs to be supported by regional data, but knowledge of interregional differences is currently lacking in China. This study aimed to summarize and map the primary and secondary antibiotic resistance of H. pylori in different regions of mainland China.
Methods: PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure and Wanfang databases were systematically reviewed for studies published between January 1st, 2000 and July 15th, 2023. Data related to primary and secondary H. pylori antibiotic resistance rates were included. Random-effects models were used to synthesize the pooled resistance rates.
Results: Ultimately, 74 studies were included in the final analysis. Sixteen provinces reported resistance data. The overall resistance rates of H. pylori in mainland China were 30.72% (95% CI 27.53%-33.99%) to clarithromycin, 70.14% (95% CI 29.53%-37.46%) to metronidazole, and 32.98% (95% CI 28.73%-37.37%) to levofloxacin; for amoxicillin, tetracycline, and furazolidone, the rates were 2.41% (95% CI 1.43%-3.60%), 2.53% (95% CI 1.19%-4.28%) and 1.54% (95% CI 0.28%-3.62%), respectively. Spatial and temporal differences were observed. The resistance rates increased after treatment failure, however, secondary resistance to amoxicillin, tetracycline, and furazolidone were still low across the vast majority of study regions.
Conclusion: Surveillance of the updated prevalence of antibiotic resistance of H. pylori for different regions is warranted, which should factor into clinical decision making and guideline recommendations.
期刊介绍:
The International Journal of Antimicrobial Agents is a peer-reviewed publication offering comprehensive and current reference information on the physical, pharmacological, in vitro, and clinical properties of individual antimicrobial agents, covering antiviral, antiparasitic, antibacterial, and antifungal agents. The journal not only communicates new trends and developments through authoritative review articles but also addresses the critical issue of antimicrobial resistance, both in hospital and community settings. Published content includes solicited reviews by leading experts and high-quality original research papers in the specified fields.