2007年至2017年土耳其血培养中分离出的铜绿假单胞菌抗生素耐药率的荟萃分析。
A meta-analysis of antibiotic resistance rates in Pseudomonas aeruginosa isolated in blood cultures in Turkey between 2007 and 2017.
作者信息
Isik Sinem Akkaya, Yenilmez Ercan, Cetinkaya Riza Aytac, Gorenek Levent, Kose Sukran
机构信息
Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.
出版信息
North Clin Istanb. 2021 May 26;8(3):286-297. doi: 10.14744/nci.2020.93195. eCollection 2021.
OBJECTIVE
The prevalence of Pseudomonas aeruginosa has remained stable in recent years, and resistant strains has increased dramatically. In this meta-analysis, we aimed to analyze the P. aeruginosa strains isolated from blood cultures in Turkey during the last 11 years and to reveal their antimicrobial susceptibility.
METHODS
Data collected between 2007 and 2017 were divided into two groups as Group-1; 2007-2011 and Group-2; 2012-2017. The differences in antibiotic resistance rates between Group-1 and Group-2 were analyzed. The study data were included according to PRISMA criteria, then meta-analysis was performed.
RESULTS
A total of 30 study data from 25 studies were included in the study. The prevalence rate of meropenem (MEM) resistance in P. aeruginosa in Turkey was 25.1% (95% Cl: 20.65-29.83) according to a meta-analysis of 637 isolates. MEM resistance rates in Group-1 and Group-2 were 23.4% (95% Cl: 18.34-28.99) and 29.3% (95% Cl: 21.23-38.23), respectively. The prevalence rate of imipenem (IMP) resistance in P. aeruginosa in Turkey was 26.8% (%95 Cl: 23.40-30.35) according to a meta-analysis of 1421 isolates. IMP resistance rates in Group-1 and Group-2 were 26.2% (95% Cl: 22.41-30.27) and 28.4% (95% Cl: 21.57-35.88), respectively. Ciprofloxacin (CIP) resistance rate was 27.04% (95% Cl: 21.88-32.52) in 1388 isolates. CIP resistance rates in Group-1 and Group-2 were 30.8% (95% Cl: 24.35-37.56) and 18.6% (95% Cl: 10.72-28.11), respectively. The prevalence rate of piperacillin-tazobactam (TZP) resistance in P. aeruginosa in Turkey was 29.2% (95% Cl: 21.058-38.088) according to a meta-analysis of 1030 isolates. TZP resistance rates in Group-1 and Group-2 were 26.1% (95% Cl: 17.76-35.31) and 38.2% (95% Cl: 18.48-60.27), respectively.
CONCLUSION
There is a remarkable increase in resistance rates in P. aeruginosa to MEM and TZP in Turkey due to frequent use. Other antibiotics with antipseudomonal effect should be prioritized in the treatment of these infections.
目的
近年来铜绿假单胞菌的流行率保持稳定，但耐药菌株显著增加。在这项荟萃分析中，我们旨在分析过去11年土耳其血培养分离出的铜绿假单胞菌菌株，并揭示其抗菌药敏性。
方法
收集2007年至2017年的数据并分为两组，第一组为2007 - 2011年，第二组为2012 - 2017年。分析第一组和第二组之间抗生素耐药率的差异。根据PRISMA标准纳入研究数据，然后进行荟萃分析。
结果
该研究共纳入来自25项研究的30条研究数据。对637株菌株进行荟萃分析后，土耳其铜绿假单胞菌对美罗培南（MEM）的耐药率为25.1%（95%可信区间：20.65 - 29.83）。第一组和第二组对MEM的耐药率分别为23.4%（95%可信区间：18.34 - 28.99）和29.3%（95%可信区间：21.23 - 38.23）。对142１株菌株进行荟萃分析后，土耳其铜绿假单胞菌对亚胺培南（IMP）的耐药率为26.8%（95%可信区间：23.40 - 30.35）。第一组和第二组对IMP的耐药率分别为26.2%（95%可信区间：22.41 - 30.27）和28.4%（95%可信区间：21.57 - 35.88）。对1388株菌株进行分析，环丙沙星（CIP）耐药率为27.04%（95%可信区间：21.88 - 32.52）。第一组和第二组对CIP的耐药率分别为30.8%（95%可信区间：24.35 - 37.56）和18.6%（95%可信区间：10.72 - 28.11）。对1030株菌株进行荟萃分析后，土耳其铜绿假单胞菌对哌拉西林 - 他唑巴坦（TZP）的耐药率为29.2%（95%可信区间：21.058 - 38.088）。第一组和第二组对TZP的耐药率分别为26.1%（95%可信区间：17.76 - 35.31）和38.2%（95%可信区间：18.48 - 60.27）。
结论
由于频繁使用，土耳其铜绿假单胞菌对MEM和TZP的耐药率显著增加。在治疗这些感染时，应优先选用其他具有抗假单胞菌作用的抗生素。
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