Igere Bright E, Onohuean Hope, Iwu Declan C, Igbinosa Etinosa O
Department of Biological Sciences, Microbiology Unit, Dennis Osadebay University, Asaba 320242, Nigeria.
Biotechnology and Emerging Environmental Infections Pathogens Research Group (BEEIPREG), Department of Biological Sciences, Microbiology Unit, Dennis Osadebay University, Asaba 320242, Nigeria.
Infect Med (Beijing). 2023 Nov 21;2(4):283-293. doi: 10.1016/j.imj.2023.11.004. eCollection 2023 Dec.
Resistance/sensitivity to polymyxin-B (PB) antibiotic has been employed as one among other epidemiologically relevant biotyping-scheme for into Classical/El Tor biotypes. However, recent studies have revealed some pitfalls bordering on PB-sensitivity/resistance (PBR/S) necessitating study. Current study assesses the PBR/S cosmopolitan prevalence, epidemiology/distribution among O1/O139 and nonO1/nonO139 strains. Relevant databases (Web of Science, Scopus and PubMed) were searched to retrieve data from environmental and clinical samples employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effect-model (REM) and common-effect-model (CEM) of meta-analysis was performed to determine prevalence of PBR/S strains, describe the cosmopolitan epidemiological potentials and biotype relevance. Heterogeneity was determined by meta-regression and subgroup analyses. The pooled analyzed isolates from articles (7290), with sensitive and resistance are 2219 (30.44%) and 5028 (69.56%). Among these PB-sensitive strains, more than 1944 (26.67%) were O1 strains, 132 (1.81%) were nonO1 strains while mis-reported Classical biotype were 2080 (28.53) respectively indicating potential spread of variant/dual biotype. A significant PB-resistance was observed in the models (CEM = 0.66, 95% CI [0.65; 0.68], -value = 0.001; REM = 0.83 [0.74; 0.90], = 0.001) as both models had a high level of heterogeneity ( = 98.0%; ). Egger test ( = 5.4017, < 0.0001) reveal publication bias by funnel plot asymmetry. The subgroup analysis for continents (Asia, Africa) and sources (acute diarrhea) revealed (98% CI (0.73; 0.93); 55% CI (0.20; 0.86)), and 92% CI (0.67; 0.98). The Epidemiological prevalence for El tor/variant/dual biotype showed 88% CI (0.78; 0.94) with O1 strains at 88% CI (0.78; 0.94). Such global prevalence, distribution/spread of phenotypes/genotypes necessitates updating the decades-long biotype classification scheme. An antibiotic stewardship in the post antibiotic era is suggestive/recommended. Also, there is need for holistic monitoring/evaluation of clinical/epidemiological relevance of the disseminating strains in endemic localities.
对多粘菌素B（PB）抗生素的耐药性/敏感性已被用作与经典/埃尔托生物型相关的其他流行病学生物分型方案之一。然而，最近的研究揭示了一些与PB敏感性/耐药性（PBR/S）相关的缺陷，因此有必要进行研究。本研究评估了PBR/S在全球的流行情况、在O1/O139和非O1/非O139菌株中的流行病学/分布情况。检索了相关数据库（科学网、Scopus和PubMed），以使用系统评价和Meta分析的首选报告项目（PRISMA）从环境和临床样本中检索数据。进行了Meta分析的随机效应模型（REM）和共同效应模型（CEM），以确定PBR/S菌株的流行率，描述全球流行病学潜力和生物型相关性。通过Meta回归和亚组分析确定异质性。汇总分析文章中的分离株（7290株），敏感和耐药的分别为2219株（30.44%）和5028株（69.56%）。在这些PB敏感菌株中，超过1944株（26.67%）为O1菌株，132株（1.81%）为非O1菌株，而错误报告的经典生物型分别为2080株（28.53%），这表明变异/双生物型可能传播。在模型中观察到显著的PB耐药性（CEM = 0.66，95% CI [0.65；0.68]，P值 = 0.001；REM = 0.83 [0.74；0.90]，P = 0.001），因为两个模型都有很高的异质性（I² = 98.0%；P < 0.0001）。Egger检验（t = 5.4017，P < 0.0001）通过漏斗图不对称揭示了发表偏倚。对各大洲（亚洲、非洲）和来源（急性腹泻）的亚组分析显示（98% CI（0.73；0.93）；55% CI（0.20；0.86）），以及92% CI（0.67；0.98）。埃尔托/变异/双生物型的流行病学流行率显示为88% CI（0.78；0.94），O1菌株为88% CI（0.78；
