{"title":"囊性纤维化患者对碳青霉烯类耐药性的现状:系统回顾与元分析》。","authors":"Mohamed J Saadh, Armaghan Lohrasbi, Elaheh Ghasemian, Marzieh Hashemian, Anahita Etemad, Zahra Dargahi, Vahab Hassan Kaviar","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background</b>: Antibiotic resistance in cystic fibrosis (CF) is a well-known phenomenon. However, the comprehensive epidemiological impact of antibiotic resistance in CF is not clearly documented. So, this meta-analysis evaluated the proportion rates of carbapenem resistance (imipenem, meropenem, and doripenem) in CF based on publication date (1979-2000, 2001-2010, and 2011-2021), continents, pathogens, and antimicrobial susceptibility testing (AST). <b>Methods</b>: We searched studies in PubMed, Scopus, and Web of Science (until April 2021). Statistical analyses were conducted using STATA software (version 14.0). <b>Results</b>: The 110 studies included in the analysis were performed in 25 countries and investigated 13,324 pathogens associated with CF. The overall proportion of imipenem, meropenem, and doripenem resistance in CF were 43% (95% CI 36-49), 48% (95% CI 40-57), 28% (95% CI 23-33), and 45% (95% CI 32-59), respectively. Our meta-analysis showed that trends of imipenem, meropenem, and doripenem-resistance had gradual decreases over time (1979-2021). This could be due to the limited clinical effectiveness of these antibiotics to treat CF cases over time. Among the opportunistic pathogens associated with CF, the highest carbapenem resistance rates were shown in <i>Stenotrophomonas maltophilia</i>, <i>Burkholderia</i> spp., <i>Pseudomonas aeruginosa</i>, and <i>Staphylococcus aureus</i>. The highest and lowest carbapenem resistance rates among <i>P. aeruginosa</i> in CF patients were shown against meropenem (23%) and doripenem (39%). <b>Conclusions</b>: We showed that trends of carbapenem resistance had decreased over time (1979-2021). This could be due to the limited clinical effectiveness of these antibiotics to treat CF cases over time. Plans should be directed to fight biofilm-associated infections and prevent the emergence of mutational resistance. Systematic surveillance for carbapenemase-producing pathogens in CF by molecular surveillance is necessitated.</p>","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/9c/yjbm_95_4_495.PMC9765336.pdf","citationCount":"0","resultStr":"{\"title\":\"The Status of Carbapenem Resistance in Cystic Fibrosis: A Systematic Review and Meta-Analysis.\",\"authors\":\"Mohamed J Saadh, Armaghan Lohrasbi, Elaheh Ghasemian, Marzieh Hashemian, Anahita Etemad, Zahra Dargahi, Vahab Hassan Kaviar\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background</b>: Antibiotic resistance in cystic fibrosis (CF) is a well-known phenomenon. However, the comprehensive epidemiological impact of antibiotic resistance in CF is not clearly documented. 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引用次数: 0
摘要
背景:囊性纤维化(CF)中的抗生素耐药性是一个众所周知的现象。然而,抗生素耐药性对 CF 流行病学的全面影响尚未得到明确记载。因此,本荟萃分析根据发表时间(1979-2000 年、2001-2010 年和 2011-2021 年)、大陆、病原体和抗菌药物药敏试验 (AST),评估了 CF 中碳青霉烯类耐药(亚胺培南、美罗培南和多立培南)的比例率。研究方法我们在 PubMed、Scopus 和 Web of Science(截至 2021 年 4 月)中检索了相关研究。使用 STATA 软件(14.0 版)进行统计分析。结果纳入分析的 110 项研究在 25 个国家进行,调查了与 CF 相关的 13,324 种病原体。CF中亚胺培南、美罗培南和多瑞培南耐药的总体比例分别为43%(95% CI 36-49)、48%(95% CI 40-57)、28%(95% CI 23-33)和45%(95% CI 32-59)。我们的荟萃分析表明,随着时间的推移(1979-2021 年),亚胺培南、美罗培南和多瑞培南耐药率呈逐渐下降趋势。这可能是由于随着时间的推移,这些抗生素治疗 CF 病例的临床效果有限。在与 CF 相关的机会性病原体中,对碳青霉烯类抗生素耐药率最高的是嗜麦芽血单胞菌、伯克霍尔德氏菌属、铜绿假单胞菌和金黄色葡萄球菌。在 CF 患者的铜绿假单胞菌中,对美罗培南(23%)和多立培南(39%)的碳青霉烯类耐药率最高和最低。结论:我们发现,随着时间的推移(1979-2021 年),碳青霉烯类耐药性呈下降趋势。这可能是因为随着时间的推移,这些抗生素治疗 CF 病例的临床效果有限。应针对生物膜相关感染制定计划,防止出现变异耐药性。有必要通过分子监测对 CF 中产生碳青霉烯酶的病原体进行系统监测。
The Status of Carbapenem Resistance in Cystic Fibrosis: A Systematic Review and Meta-Analysis.
Background: Antibiotic resistance in cystic fibrosis (CF) is a well-known phenomenon. However, the comprehensive epidemiological impact of antibiotic resistance in CF is not clearly documented. So, this meta-analysis evaluated the proportion rates of carbapenem resistance (imipenem, meropenem, and doripenem) in CF based on publication date (1979-2000, 2001-2010, and 2011-2021), continents, pathogens, and antimicrobial susceptibility testing (AST). Methods: We searched studies in PubMed, Scopus, and Web of Science (until April 2021). Statistical analyses were conducted using STATA software (version 14.0). Results: The 110 studies included in the analysis were performed in 25 countries and investigated 13,324 pathogens associated with CF. The overall proportion of imipenem, meropenem, and doripenem resistance in CF were 43% (95% CI 36-49), 48% (95% CI 40-57), 28% (95% CI 23-33), and 45% (95% CI 32-59), respectively. Our meta-analysis showed that trends of imipenem, meropenem, and doripenem-resistance had gradual decreases over time (1979-2021). This could be due to the limited clinical effectiveness of these antibiotics to treat CF cases over time. Among the opportunistic pathogens associated with CF, the highest carbapenem resistance rates were shown in Stenotrophomonas maltophilia, Burkholderia spp., Pseudomonas aeruginosa, and Staphylococcus aureus. The highest and lowest carbapenem resistance rates among P. aeruginosa in CF patients were shown against meropenem (23%) and doripenem (39%). Conclusions: We showed that trends of carbapenem resistance had decreased over time (1979-2021). This could be due to the limited clinical effectiveness of these antibiotics to treat CF cases over time. Plans should be directed to fight biofilm-associated infections and prevent the emergence of mutational resistance. Systematic surveillance for carbapenemase-producing pathogens in CF by molecular surveillance is necessitated.
期刊介绍:
The Yale Journal of Biology and Medicine (YJBM) is a graduate and medical student-run, peer-reviewed, open-access journal dedicated to the publication of original research articles, scientific reviews, articles on medical history, personal perspectives on medicine, policy analyses, case reports, and symposia related to biomedical matters. YJBM is published quarterly and aims to publish articles of interest to both physicians and scientists. YJBM is and has been an internationally distributed journal with a long history of landmark articles. Our contributors feature a notable list of philosophers, statesmen, scientists, and physicians, including Ernst Cassirer, Harvey Cushing, Rene Dubos, Edward Kennedy, Donald Seldin, and Jack Strominger. Our Editorial Board consists of students and faculty members from Yale School of Medicine and Yale University Graduate School of Arts & Sciences. All manuscripts submitted to YJBM are first evaluated on the basis of scientific quality, originality, appropriateness, contribution to the field, and style. Suitable manuscripts are then subject to rigorous, fair, and rapid peer review.