Pinto Henrique, Simões Manuel, Borges Anabela
LEPABE-Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, s/n, 4200-465 Porto, Portugal.
DEQ-Department of Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, s/n, 4200-465 Porto, Portugal.
Antibiotics (Basel). 2021 Jul 8;10(7):825. doi: 10.3390/antibiotics10070825.
This study sought to assess the prevalence and impact of biofilms on two commonly biofilm-related infections, bloodstream and urinary tract infections (BSI and UTI). Separated systematic reviews and meta-analyses of observational studies were carried out in PubMed and Web of Sciences databases from January 2005 to May 2020, following PRISMA protocols. Studies were selected according to specific and defined inclusion/exclusion criteria. The obtained outcomes were grouped into biofilm production (BFP) prevalence, BFP in resistant vs. susceptible strains, persistent vs. non-persistent BSI, survivor vs. non-survivor patients with BSI, and catheter-associated UTI (CAUTI) vs. non-CAUTI. Single-arm and two-arm analyses were conducted for data analysis. In vitro BFP in BSI was highly related to resistant strains (odds ratio-OR: 2.68; 95% confidence intervals-CI: 1.60-4.47; < 0.01), especially for methicillin-resistant . BFP was also highly linked to BSI persistence (OR: 2.65; 95% CI: 1.28-5.48; < 0.01) and even to mortality (OR: 2.05; 95% CI: 1.53-2.74; < 0.01). spp. was the microorganism group where the highest associations were observed. Biofilms seem to impact BSI independently from clinical differences, including treatment interventions. Regarding UTI, multi-drug resistant and extended-spectrum -lactamase-producing strains of , were linked to a great BFP prevalence (OR: 2.92; 95% CI: 1.30-6.54; < 0.01 and OR: 2.80; 95% CI: 1.33-5.86; < 0.01). More in vitro BFP was shown in CAUTI compared to non-CAUTI, but with less statistical confidence (OR: 2.61; 95% CI: 0.67-10.17; < 0.17). This study highlights that biofilms must be recognized as a BSI and UTI resistance factor as well as a BSI virulence factor.
本研究旨在评估生物膜对两种常见的与生物膜相关的感染，即血流感染和尿路感染（BSI和UTI）的发生率及影响。按照PRISMA方案，于2005年1月至2020年5月在PubMed和Web of Sciences数据库中对观察性研究进行了单独的系统评价和荟萃分析。根据特定且明确的纳入/排除标准选择研究。将获得的结果分为生物膜产生（BFP）发生率、耐药菌株与敏感菌株中的BFP、持续性与非持续性BSI、BSI存活患者与非存活患者，以及导管相关尿路感染（CAUTI）与非CAUTI。采用单臂和双臂分析进行数据分析。BSI中的体外BFP与耐药菌株高度相关（优势比-OR：2.68；95%置信区间-CI：1.60-4.47；P<0.01），尤其是对耐甲氧西林的……BFP也与BSI的持续性高度相关（OR：2.65；95%CI：1.28-5.48；P<0.01），甚至与死亡率相关（OR：2.05；95%CI：1.53-2.74；P<0.01）。……属是观察到关联度最高的微生物组。生物膜似乎独立于包括治疗干预在内的临床差异对BSI产生影响。关于UTI，多重耐药和产超广谱β-内酰胺酶的……菌株与较高的BFP发生率相关（OR：2.92；95%CI：1.30-6.54；P<0.01和OR：2.80；95%CI：1.33-5.86；P<0.01）。与非CAUTI相比，CAUTI中显示出更多的体外BFP，但统计学置信度较低（OR：2.61；95%CI：0.67-10.17；P<0.17）。本研究强调，生物膜必须被视为BSI和UTI的耐药因素以及BSI的毒力因素。
