Student Research Committee, Arak University of Medical Sciences, Arak, Iran.
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Pathog Glob Health. 2023 Oct;117(7):611-622. doi: 10.1080/20477724.2023.2179451. Epub 2023 Feb 16.
Shigellosis remains one of the global causes of morbidity and mortality. However, the global emergence of antibiotic resistance has become the leading cause of treatment failure in shigellosis. This review aimed to provide an updated picture of the antimicrobial resistance rates in species in Iranian pediatrics.
A comprehensive systematic search was performed on PubMed, Scopus, Embase, and Web of Science until 28 July 2021. The meta-analysis was performed by computing the pooled using a random-effects model with Stata/SE software, v.17.1. The discrepancy within articles was surveyed by the forest plot in addition to the I statistic. All statistical interpretations were reported on a 95% confidence interval (CI) basis.
Totally, of 28 eligible studies published between 2008 and 2021. The pooled prevalence rate of multidrug-resistant (MDR) was 63% (95% CI 50-76). Regarding suggested antimicrobial agents for species, the prevalence of resistance for ciprofloxacin, azithromycin, and ceftriaxone as first- and second-line treatments for shigellosis were 3%, 30%, and 28%, respectively. In contrast, resistance to cefotaxime, cefixime, and ceftazidime was 39%, 35%, and 20%. Importantly, subgroup analyses indicated that an increase in resistance rates during the periods (2008-2014, 2015-2021) was recognized for ciprofloxacin (0 % to 6%) and ceftriaxone (6% to 42%).
Our findings revealed that ciprofloxacin is an effective drug for shigellosis in Iranian children. The substantially high prevalence estimation proposes that the first- and second-line treatments for shigellosis are the major threat to public health and active antibiotic treatment policies are essential.
志贺菌病仍然是全球发病率和死亡率的原因之一。然而,抗生素耐药性的全球出现已成为志贺菌病治疗失败的主要原因。本综述旨在提供伊朗儿科志贺菌种抗菌药物耐药率的最新情况。
我们对 PubMed、Scopus、Embase 和 Web of Science 进行了全面的系统检索,检索截至 2021 年 7 月 28 日。采用 Stata/SE 软件 v.17.1 进行荟萃分析,采用随机效应模型计算合并率。采用森林图和 I 统计量调查文章内的差异。所有统计解释均以 95%置信区间(CI)为基础报告。
总共纳入了 2008 年至 2021 年期间发表的 28 项符合条件的研究。多药耐药(MDR)的合并患病率为 63%(95%CI 50-76)。关于建议用于志贺菌的抗菌药物,环丙沙星、阿奇霉素和头孢曲松作为志贺菌病一线和二线治疗药物的耐药率分别为 3%、30%和 28%。相比之下,头孢噻肟、头孢克肟和头孢他啶的耐药率分别为 39%、35%和 20%。重要的是,亚组分析表明,环丙沙星(0%至 6%)和头孢曲松(6%至 42%)的耐药率在研究期间(2008-2014 年,2015-2021 年)有所增加。
我们的研究结果表明,环丙沙星是伊朗儿童志贺菌病的有效药物。耐药率的显著升高表明,志贺菌病的一线和二线治疗方法对公共卫生构成重大威胁,需要积极采取抗生素治疗政策。