耐多药麻风分枝杆菌全球流行情况的计算调查：系统回顾与荟萃分析

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2024-11-07 DOI:10.1016/j.jctube.2024.100495

Hamidreza Zivarifar , Forough Ahrari , Mohsen Karbalaei

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引用次数: 0

摘要

背景麻风病是由麻风分枝杆菌（M. leprae）引起的一种慢性传染病，但这种细菌耐药菌株的出现，尤其是耐多药（MDR）菌株的出现，令人严重关切。本研究旨在评估 MDR M. Leprae 在全球的流行情况及其影响。方法根据 PRISMA 指南，我们系统回顾了截至 2023 年 8 月的 ISI Web of Science、MEDLINE 和 EMBASE，以评估 MDR M. Leprae 的流行情况。我们纳入了有关 MDR 麻风菌的人类临床试验，但排除了综述、动物研究和无法获得的全文。我们使用综合荟萃分析软件对数据进行了分析，并使用Egger检验、Begg检验和修剪填充法解决了发表偏倚问题。结果共初步确定了861篇文章，其中28篇符合纳入定量综述的方法学标准。据统计，耐药性麻风杆菌的综合感染率约为 11.7 %（95 % CI：7.7-17.3；I2：90.79；P 值 = 0.01）。具体的耐药率包括：7.4%对达克松耐药，5.1%对利福平耐药。MDR麻风杆菌的总体耐药率为2.2%（95% CI：1.2-3.9；I2：82.68；P值=0.01）。细菌密度和麻风期等因素与 DR M. Leprae 风险升高有关（OR：2.69；95 % CI：1.35-2.48）。对发表偏倚的系统评估表明，发表偏倚对总体结果的影响很小。结论全球范围内MDR麻风杆菌的流行率不断上升，需要紧急采取战略性干预措施以防止其进一步扩散，这反过来又能有效治疗麻风病人。

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Computational investigation of the global prevalence of multidrug resistant Mycobacterium leprae: A systematic review and meta-analysis

Background

Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) However, the emergence of drug-resistant strains of this bacterium, especially multidrug-resistant (MDR) strains, is a serious concern. This study aimed to evaluate the global prevalence of MDR M. leprae and its implications.

Methods

Using PRISMA guidelines, we systematically reviewed ISI Web of Science, MEDLINE, and EMBASE up to August 2023 to assess the prevalence of MDR M. leprae. We included human clinical trials on MDR M. leprae, as well as excluded reviews, animal studies, and unavailable full texts. Data was analyzed using Comprehensive Meta-Analysis software, and publication bias was addressed using Egger’s, Begg’s tests, and the trim-fill method.

Results

Overall, 861 articles were initially identified, of which 28 met the methodological criteria for inclusion in the quantitative synthesis. Statistically, the combined prevalence of drug resistant M. leprae was approximated at 11.7 % (95 % CI: 7.7–17.3; I²: 90.79; p value = 0.01). Specific drug resistance rates included 7.4 % to dapsone and 5.1 % to rifampin, among others. The global rate for MDR M. leprae was measured at 2.2 % (95 % CI: 1.2–3.9; I²: 82.68; p value = 0.01). Factors such as bacterial density and the lepromatous phase were associated with elevated DR M. leprae risk (OR: 2.69; 95 % CI: 1.35–2.48). A systematic assessment of publication bias indicated a minimal impact on the general results.

Conclusions

The increasing prevalence of MDR M. leprae globally requires urgent and strategic interventions to prevent further spread, which in turn is effective in treating leprosy patients.

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.