Department of Pharmacy, Clinical Pharmaceutics Room, Sichuan Science City Hospital, Mianyang, 621000, China.
Sichuan College of Traditional Chinese Medicine, Mianyang, 621000, China.
Ann Clin Microbiol Antimicrob. 2021 Oct 13;20(1):73. doi: 10.1186/s12941-021-00478-z.
Mycobacterium tuberculosis (MTB) is responsible for tuberculosis; that continues to be a public health threat across the globe. Furthermore, increasing heteroresistance (HR)-the presence of resistant and susceptible isolates among MTB strains- has been reported from around the world. This phenomenon can lead to full resistance development and treatment failure.
We systematically searched the relevant studies in PubMed, Scopus, and Embase (Until October 21, 2020). The study outcomes revealed the weighted pooled prevalence of antibiotic HR in MTB isolates with subgroup analysis by year, quality of study, and heteroresistance detection method.
A total of 38 studies which had investigated MTB isolates were included in the meta-analysis. Geographically, the highest number of studies were reported from Asia (n = 24), followed by Africa (n = 5). Nineteen studies reported HR to isoniazid, with a weighted pooled prevalence of 5% (95% CI 0-12) among 11,761 MTB isolates. Also, there is no important trend for the subgroup analysis by the study period (2001-2014 vs 2015-2017 vs 2018-2020). HR to rifampin was reported in 17 studies, with a weighted pooled prevalence of 7% (95% CI 2-14) among 3782 MTB isolates. HR to fluoroquinolone and ethambutol were reported in 12 and 4 studies, respectively, with weighted pooled prevalence of 10% and 1% among 2153 and 1509 MTB isolates, correspondingly.
Based on our analysis, HR in MTB isolates with different frequency rate is present worldwide. Thus, the selection of appropriate and reliable methods for HR detection is crucial for TB eradication.
结核分枝杆菌（MTB）是导致结核病的原因，在全球范围内仍是一个公共卫生威胁。此外，世界各地都有报道称异质性耐药（HR）——MTB 菌株中存在耐药和敏感分离株的存在——不断增加。这种现象可能导致完全耐药的发展和治疗失败。
我们系统地在 PubMed、Scopus 和 Embase 中搜索了相关研究（截至 2020 年 10 月 21 日）。研究结果显示了 MTB 分离株中抗生素 HR 的加权汇总患病率，并按年份、研究质量和异质性耐药检测方法进行了亚组分析。
共有 38 项研究调查了 MTB 分离株，纳入了荟萃分析。从地理上看，来自亚洲的研究最多（n=24），其次是非洲（n=5）。19 项研究报告了异烟肼的 HR，在 11761 株 MTB 分离株中，加权汇总患病率为 5%（95%CI 0-12）。此外，按研究期间（2001-2014 年、2015-2017 年和 2018-2020 年）进行的亚组分析也没有重要趋势。17 项研究报告了利福平的 HR，在 3782 株 MTB 分离株中，加权汇总患病率为 7%（95%CI 2-14）。12 项和 4 项研究分别报告了氟喹诺酮类和乙胺丁醇的 HR，在 2153 株和 1509 株 MTB 分离株中，加权汇总患病率分别为 10%和 1%。
根据我们的分析，具有不同频率的 MTB 分离株中的 HR 普遍存在于世界各地。因此，选择适当和可靠的 HR 检测方法对于结核病的消除至关重要。
