卡塔尔耐药细菌感染的流行病学：系统回顾和荟萃分析

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-03-05 DOI:10.1016/j.jiph.2025.102732

Rasha Abu El-Ruz , Ovelia A. Masoud , Amal A. Ibrahim , Tawanda Chivese , Susu M. Zughaier

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引用次数: 0

摘要

抗生素耐药性（AMR）是目前无声的大流行，每年造成约500万人死亡。据世界卫生组织称，抗菌素耐药性是全球最大的公共卫生威胁之一，也是全球第三大死亡原因。方法本系统综述和荟萃分析旨在提供卡塔尔首次AMR的综合流行病学评估。我们对三个数据库（PubMed， Embase和Web of Science）进行了广泛的搜索，使用广泛的搜索词，没有任何限制。采用Freeman-Turkey转换和随机效应模型对患病率进行meta分析。对三类进行亚组分析；复合分离株，反应性分离株，抗性分离株。结果共检索文献1258篇，纳入文献55篇。所有分离株的总流行率为13.64 %(95 %CI: 6.80 - 22.11, I2=99 %)，所有研究均为方便抽样的横断面，在卫生保健机构进行。复合分离株亚群患病率为8.87 %(95 %CI: 2.72 ~ 17.77, I2=98.7)，非应答株为11.37 %(95 %CI: 4.31 ~ 20.72, I2=98.3 %)，非耐药株为23.55 %（95 %CI: 10.12 ~ 40.14, I2=99.1）。否则抗性分离分层分析显示ESBL患病率为38.94 %(95 % CI: 21.63 - 57.79, I2 = 99.2 %),MDR是15.99 %(95 % CI: 2.46 - 37.00, I2 = 99 %),耐甲氧西林金黄色葡萄球菌是52.37 %(95 % CI: 13.91 - 89.50, I2 = 88 %),院内感染的患病率为23.55 %(95 % CI: 10.12 - 40.14, I2 = 98.2 %)。ESKAPE菌株占耐药的大部分。结论卡塔尔的AMR总体流行率接近全球估计值，但耐药分离株流行率高于高收入国家的全球估计值。需要协调抗菌素耐药性公共卫生应对措施，包括抗击抗菌素耐药性的国家行动计划和抗菌素管理规划。抗菌素耐药性流行病学研究需要改进，扩大对不同人群的覆盖范围，以确保在确定细菌感染和抗生素分类方面更加清晰和精确。

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The epidemiology of antimicrobial resistant bacterial infection in Qatar: A systematic review and meta-analysis

Background

Antimicrobial resistance (AMR) is the current silent pandemic responsible for approximately five million deaths annually. According to the WHO, antimicrobial resistance is one of the top global public health threats and the third leading cause of death worldwide.

Method

This systematic review and meta-analyses aims to provide Qatar's first comprehensive epidemiological assessment of AMR. We conducted extensive search of three databases (PubMed, Embase and Web of Science) using broad search terms with no restrictions. The meta-analysis of prevalence was done using the Freeman-Turkey transformation and random effects models. Subgroup analysis was performed for three categories; the composite isolates, otherwise responsive isolates, and otherwise resistant isolates.

Results

The search yielded a total of 1258 publications, of which 55 publications were included. The overall prevalence of all isolates was 13.64 % (95 %CI: 6.80 – 22.11, I²=99 %), all the studies were cross-sectional of convenience sampling, conducted in healthcare settings. The subgroup prevalence for the composite isolates was 8.87 % (95 %CI: 2.72 – 17.77, I²=98.7), otherwise responsive isolates was 11.37 % (95 %CI: 4.31 – 20.72, I²=98.3 %), otherwise resistant isolates was 23.55 % (95 %CI: 10.12 – 40.14, I²=99.1). The otherwise resistant isolates stratified analyses revealed that ESBL prevalence was 38.94 % (95 %CI: 21.63 – 57.79, I²=99.2 %), MDR was 15.99 % (95 %CI: 2.46 – 37.00, I²=99 %), MRSA was 52.37 % (95 %CI: 13.91 – 89.50, I2=88 %), Nosocomial infections prevalence was 23.55 % (95 %CI: 10.12 – 40.14, I²=98.2 %). The ESKAPE bacterial strains accounted for the majority of resistance.

Conclusion

Qatar’s AMR overall prevalence is close to the global estimates, however the resistant isolates prevalence is higher than average according to the global estimates for high-income countries. The AMR public health response including national action plan to combat AMR and antimicrobial stewardship programs need to be orchestrated. AMR epidemiological research needs improvement in expanding coverage across diverse population groups to ensure greater clarity and precision in identifying bacterial infections and antibiotic classifications.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.