印度尼西亚的抗生素耐药性:广谱β -内酰胺酶产生细菌的系统回顾和荟萃分析(2008-2024)。

IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Tropical Medicine & International Health Pub Date : 2025-04-01 Epub Date: 2025-01-31 DOI:10.1111/tmi.14090
Ika N Kadariswantiningsih, Derren David Rampengan, Roy Novri Ramadhan, Alina Idrisova, Bulat Idrisov, Maulana A Empitu
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引用次数: 0

摘要

目的:广谱β -内酰胺酶产生菌对常用抗生素产生耐药性,对公众健康构成重大威胁。本荟萃分析旨在确定印度尼西亚广谱β -内酰胺酶产生细菌的患病率和分布。方法:本系统综述和荟萃分析遵循PRISMA指南,估计2008年至2024年印度尼西亚广谱β -内酰胺酶产生细菌的患病率。通过PubMed、ScienceDirect、b谷歌Scholar和Index Medicus进行系统检索,并使用随机效应模型分析数据以解决异质性。结果:系统搜索得到1160条记录。剔除重复和筛选合格性后,64项研究纳入定性综合,48项研究适合定量分析。印度尼西亚广谱产β -内酰胺酶细菌的总流行率为46.38% (95% CI: 39.55%-53.21%),具有显著的异质性(I2 = 99.05%),反映了方法、人群和地区背景的巨大差异。虽然苏门答腊岛的患病率最高,为63.99% (95% CI: 62.09%-65.89%),而加里曼丹最低,为15.24% (95% CI: 9.45%-21.02%),但由于显著的异质性,这些发现必须谨慎解释。医院患病率为47.13% (95% CI: 39.71% ~ 54.54%),社区患病率为47.26% (95% CI: 26.47% ~ 59.95%)。成人患病率(44.56%,95% CI: 35.48% ~ 53.64%)高于儿童(32.38%,95% CI: 20.85% ~ 43.91%)。产广谱β -内酰胺酶大肠杆菌患病率为57.84% (95% CI: 45.97% ~ 69.72%),肺炎克雷伯菌患病率为51.03% (95% CI: 41.19% ~ 60.86%)。结论:这些发现突出表明,印度尼西亚迫切需要采取严格的感染控制措施、量身定制的监测规划和有效的抗生素管理,以减轻广谱β -内酰胺酶产生细菌对公共卫生的影响。巨大的异质性强调了印度尼西亚抗菌素耐药性流行病学的复杂性,需要谨慎解释汇总流行率和标准化方法,以确保准确的流行率估计。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antibiotic resistance in Indonesia: A systematic review and meta-analysis of extended-spectrum beta-lactamase-producing bacteria (2008-2024).

Objective: Extended-spectrum beta-lactamase-producing bacteria pose a significant threat to public health due to their resistance to commonly used antibiotics. This meta-analysis aims to determine the prevalence and distribution of extended-spectrum beta-lactamase-producing bacteria in Indonesia.

Methods: This systematic review and meta-analysis adhere to PRISMA guidelines to estimate the prevalence of extended-spectrum beta-lactamase-producing bacteria in Indonesia from 2008 to 2024. Systematic searches were conducted by PubMed, ScienceDirect, Google Scholar, and Index Medicus, and data were analyzed using a random-effects model to address heterogeneity.

Results: A systematic search yielded 1160 records. After duplicate removal and eligibility screening, 64 studies were included in the qualitative synthesis, and 48 were suitable for quantitative analysis. The pooled prevalence of extended-spectrum beta-lactamase-producing-producing bacteria in Indonesia was 46.38% (95% CI: 39.55%-53.21%) with significant heterogeneity (I2 = 99.05%), reflecting substantial variability in methodologies, populations, and regional contexts. While Sumatra shows the highest prevalence at 63.99% (95% CI: 62.09%-65.89%) and Kalimantan the lowest at 15.24% (95% CI: 9.45%-21.02%), these findings must be interpreted with caution due to the significant heterogeneity. In hospitals, the prevalence was 47.13% (95% CI: 39.71%-54.54%), and in community was 47.26% (95% CI: 26.47%-59.95%). Adults had a higher prevalence (44.56%, 95% CI: 35.48%-53.64%) than children (32.38%, 95% CI: 20.85%-43.91%). The prevalence of extended-spectrum beta-lactamase-producing Escherichia coli was 57.84% (95% CI: 45.97%-69.72%), and Klebsiella pneumoniae was 51.03% (95% CI: 41.19%-60.86%).

Conclusion: These findings highlight the urgent need for stringent infection control measures, tailored surveillance programmes, and effective antibiotic stewardship in Indonesia to mitigate the impact of extended-spectrum beta-lactamase-producing bacteria on public health. The substantial heterogeneity underscores the complexity of antimicrobial resistance epidemiology in Indonesia, necessitating cautious interpretation of pooled prevalence and standardised methodologies for future research to ensure accurate prevalence estimates.

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来源期刊
Tropical Medicine & International Health
Tropical Medicine & International Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.80
自引率
0.00%
发文量
129
审稿时长
6 months
期刊介绍: Tropical Medicine & International Health is published on behalf of the London School of Hygiene and Tropical Medicine, Swiss Tropical and Public Health Institute, Foundation Tropical Medicine and International Health, Belgian Institute of Tropical Medicine and Bernhard-Nocht-Institute for Tropical Medicine. Tropical Medicine & International Health is the official journal of the Federation of European Societies for Tropical Medicine and International Health (FESTMIH).
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