Emerg Infect Dis. 2023 Nov;29(11):2335-2344. doi: 10.3201/eid2911.230753.
Antimicrobial resistance is a pressing global health concern, leading to 4.95 million deaths in 2019. We conducted a systematic review and meta-analysis to assess the lethality attributed to infections caused by multidrug-resistant organisms (MDROs) in Latin America and the Caribbean. A comprehensive search of major databases retrieved relevant studies from 2000-2022. We included 54 observational studies, primarily from Brazil, Argentina, and Colombia. The most commonly studied organism was methicillin-resistant Staphylococcus aureus. The overall unadjusted case fatality rate related to MDROs was 45.0%; higher adjusted lethality was observed in persons infected with MDROs than in those infected with other pathogens (adjusted odds ratio 1.93, 95% CI 1.58-2.37). A higher lethality rate was seen in patients who did not receive appropriate empirical treatment (odds ratio 2.27, 95% CI 1.44-3.56). These findings underscore the increased lethality associated with antimicrobial resistance in Latin America and the Caribbean.
抗菌药物耐药性是一个紧迫的全球健康问题,导致 2019 年有 495 万人死亡。我们进行了系统评价和荟萃分析,以评估拉丁美洲和加勒比地区多药耐药生物体(MDRO)引起的感染的致命性。我们从 2000 年至 2022 年对主要数据库进行了全面搜索,以检索相关研究。我们纳入了 54 项观察性研究,主要来自巴西、阿根廷和哥伦比亚。研究最多的生物体是耐甲氧西林金黄色葡萄球菌。与 MDRO 相关的未调整病例死亡率总体为 45.0%;与感染其他病原体的患者相比,感染 MDRO 的患者的死亡率更高(调整后的优势比 1.93,95%置信区间 1.58-2.37)。未接受适当经验性治疗的患者的死亡率更高(比值比 2.27,95%置信区间 1.44-3.56)。这些发现强调了拉丁美洲和加勒比地区与抗菌药物耐药性相关的更高的致死率。