伊朗肺炎克雷伯菌分离株中多粘菌素耐药的流行情况：系统评价和荟萃分析。

Prevalence of colistin resistance of Klebsiella pneumoniae isolates in Iran: a systematic review and meta-analysis.

机构信息

Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

出版信息

Ann Clin Microbiol Antimicrob. 2022 Jun 28;21(1):29. doi: 10.1186/s12941-022-00520-8.

OBJECTIVE

Klebsiella pneumoniae is a gram-negative pathogen common cause of nosocomial infections. Colistin is a last resort antibiotic to treat infections caused by K. pneumoniae. In recent years, the resistance rate to colistin has increased in K. pneumoniae. This study evaluated the prevalence of colistin resistance of K. pneumoniae isolates in Iran using a systematic review and meta-analysis.

METHOD

A systematic search was performed for relevant articles until August 2021 in the following database: PubMed, Scopus, SID and Google Scholar. The pooled prevalence of colistin resistance in clinical K. pneumoniae isolates analyzed using Comprehensive Meta-Analysis Software (CMA).

RESULTS

Finally, 19 articles with appropriate criteria were included in the meta-analysis. Our results showed 6.9% of the pooled prevalence of colistin resistance in clinical K. pneumoniae isolates in Iran. The results of subgroup analysis demonstrated increase resistance of colistin from 4.8%; (95% CI 1.5-13.9%) in 2013-2018 to 8.2%; (95% CI 3.4-18.6%), in 2019-2021. Also, the results of our study showed a strong association between the carbapenem producing K. pneumoniae and increased resistance to colistin.

CONCLUSIONS

This study showed a high prevalence of colistin resistance in K. pneumoniae isolates. It is recommended that regular evaluation be performed to control colistin resistance.

目的

肺炎克雷伯菌是一种常见的革兰氏阴性病原体，是医院感染的常见病因。黏菌素是治疗肺炎克雷伯菌感染的最后一种抗生素。近年来，肺炎克雷伯菌对黏菌素的耐药率有所增加。本研究通过系统评价和荟萃分析评估了伊朗临床分离的肺炎克雷伯菌对黏菌素耐药的流行率。

方法

在 2021 年 8 月之前，我们在以下数据库中进行了相关文章的系统检索：PubMed、Scopus、SID 和 Google Scholar。使用 Comprehensive Meta-Analysis Software（CMA）对临床肺炎克雷伯菌分离株中黏菌素耐药的汇总流行率进行分析。

结果

最终，有 19 篇符合标准的文章纳入荟萃分析。我们的结果显示，伊朗临床肺炎克雷伯菌分离株中黏菌素耐药的总流行率为 6.9%。亚组分析的结果表明，黏菌素的耐药性从 2013-2018 年的 4.8%（95% CI 1.5-13.9%）增加到 2019-2021 年的 8.2%（95% CI 3.4-18.6%）。此外，我们的研究结果表明，产碳青霉烯的肺炎克雷伯菌与黏菌素耐药性增加之间存在很强的关联。