Dadashi Masoud, Hajikhani Bahareh, Nazarinejad Nooshin, Noorisepehr Negin, Yazdani Shahrooz, Hashemi Ali, Hashemizadeh Zahra, Goudarzi Mehdi, Fatemeh Sameni
Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Glob Antimicrob Resist. 2023 Sep;34:253-267. doi: 10.1016/j.jgar.2023.02.018. Epub 2023 Mar 9.
Stenotrophomonas maltophilia (S. maltophilia), an opportunistic pathogen, causes infection in patients undergoing immunosuppressive therapy, mechanical ventilation, or catheters and in long-term hospitalized patients. Due to its extensive resistance to various antibiotics and chemotherapeutic agents, S. maltophilia is challenging to treat. Using case reports, case series, and prevalence studies, the current study provides a systematic review and meta-analysis of antibiotic resistance profiles across clinical isolates of S. maltophilia.
A systematic literature search was performed for original research articles published in Medline, Web of Science, and Embase databases from 2000 to 2022. Statistical analysis was performed using STATA 14 software to report antibiotic resistance of S. maltophilia clinical isolates worldwide.
223 studies (39 case reports/case series and 184 prevalence studies) were collected for analysis. A meta-analysis of prevalence studies demonstrated that the most antibiotic resistance worldwide was to levofloxacin, trimethoprim-sulfamethoxazole (TMP/SMX), and minocycline (14.4%, 9.2%, and 1.4%, respectively). Resistance to TMP/SMX (36.84%), levofloxacin (19.29%), and minocycline (1.75%) were the most prevalent antibiotic resistance types found in evaluated case reports/case series studies. The highest resistance rate to TMP/SMX was reported in Asia (19.29%), Europe (10.52%), and America (7.01%), respectively.
Considering the high resistance to TMP/SMX, more attention should be paid to patients' drug regimens to prevent the emergence of multidrug-resistant S. maltophilia isolates.
嗜麦芽窄食单胞菌是一种机会致病菌，可在接受免疫抑制治疗、机械通气或使用导管的患者以及长期住院患者中引起感染。由于其对多种抗生素和化疗药物具有广泛耐药性，嗜麦芽窄食单胞菌的治疗具有挑战性。本研究通过病例报告、病例系列和患病率研究，对嗜麦芽窄食单胞菌临床分离株的抗生素耐药谱进行了系统综述和荟萃分析。
对2000年至2022年发表在Medline、Web of Science和Embase数据库中的原始研究文章进行系统文献检索。使用STATA 14软件进行统计分析，以报告全球嗜麦芽窄食单胞菌临床分离株的抗生素耐药情况。
收集了223项研究（39项病例报告/病例系列和184项患病率研究）进行分析。患病率研究的荟萃分析表明，全球最常见的抗生素耐药情况是对左氧氟沙星、甲氧苄啶-磺胺甲恶唑（TMP/SMX）和米诺环素耐药（分别为14.4%、9.2%和1.4%）。在评估的病例报告/病例系列研究中，对TMP/SMX（36.84%）、左氧氟沙星（19.29%）和米诺环素（1.75%）的耐药是最常见的抗生素耐药类型。亚洲、欧洲和美洲报告的TMP/SMX耐药率最高，分别为19.29%、10.52%和7.01%。
鉴于对TMP/SMX的高耐药性，应更加关注患者的用药方案，以防止多重耐药嗜麦芽窄食单胞菌分离株的出现。
