Facultad de Medicina Veterinaria y Zootecnia, Universidad Central del Ecuador, Quito, Ecuador.
Department of Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
PLoS One. 2019 Aug 15;14(8):e0221133. doi: 10.1371/journal.pone.0221133. eCollection 2019.
Antimicrobial resistance (AMR) rates may display seasonal variation. However, it is not clear whether this seasonality is influenced by the seasonal variation of infectious diseases, geographical region or differences in antibiotic prescription patterns. Therefore, we assessed the seasonality of AMR rates in respiratory bacteria.
Seven electronic databases (Embase.com, Medline Ovid, Cochrane CENTRAL, Web of Science, Core Collection, Biosis Ovid, and Google Scholar), were searched for relevant studies from inception to Jun 25th, 2019. Studies describing resistance rates of Streptococcus pneumoniae and Haemophilus influenzae were included in this review. By using random-effects meta-analysis, pooled odd ratios of seasonal AMR rates were calculated using winter as the reference group. Pooled odd ratios were obtained by antibiotic class and geographical region.
We included 13 studies, of which 7 were meta-analyzed. Few studies were done in H. influenzae, thus this was not quantitively analyzed. AMR rates of S. pneumoniae to penicillins were lower in other seasons than in winter with pooled OR = 0.71; 95% CI = 0.65-0.77; I2 = 0.0%, and to all antibiotics with pooled OR = 0.68; 95% CI = 0.60-0.76; I2 = 14.4%. Irrespective of geographical region, the seasonality of AMR rates in S. pneumoniae remained the same.
The seasonality of AMR rates could result from the seasonality of infectious diseases and its accompanied antibiotic use.
抗菌药物耐药率（AMR）可能存在季节性变化。然而，目前尚不清楚这种季节性变化是否受到传染病季节性变化、地理位置或抗生素处方模式差异的影响。因此，我们评估了呼吸道细菌 AMR 率的季节性。
从建库至 2019 年 6 月 25 日，我们在 7 个电子数据库（Embase.com、Medline Ovid、Cochrane CENTRAL、Web of Science、核心合集、Biosis Ovid 和 Google Scholar）中搜索了相关研究。本综述纳入了描述肺炎链球菌和流感嗜血杆菌耐药率的研究。使用随机效应荟萃分析，以冬季为参考组计算季节性 AMR 率的合并优势比。通过抗生素类别和地理位置获得合并优势比。
我们纳入了 13 项研究，其中 7 项进行了荟萃分析。针对流感嗜血杆菌的研究较少，因此未进行定量分析。肺炎链球菌对青霉素的耐药率在其他季节均低于冬季，合并优势比为 0.71；95%CI：0.65-0.77；I2=0.0%；对所有抗生素的耐药率合并优势比为 0.68；95%CI：0.60-0.76；I2=14.4%。无论地理位置如何，肺炎链球菌 AMR 率的季节性变化保持不变。
AMR 率的季节性可能是由传染病的季节性及其伴随的抗生素使用引起的。
