绵羊附睾和牛型布鲁氏菌氨基糖苷类耐药株的流行率：系统评价和荟萃分析。
Prevalence of Brucella melitensis and Brucella abortus aminoglycoside-resistant isolates: a systematic review and meta-analysis.
机构信息
Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
出版信息
Braz J Microbiol. 2024 Mar;55(1):429-439. doi: 10.1007/s42770-023-01233-6. Epub 2024 Jan 16.
INTRODUCTION
Aminoglycosides are vital antibiotics for treating Brucella infections, because they interfere with bacterial protein production and are often combined with other antibiotics. They are cost-effective, have fewer side effects, and can penetrate biofilms. The prevalence of brucellosis has increased in recent years, increasing the need for effective treatments. In addition, the emergence of multidrug-resistant Brucella strains has highlighted the need for an updated and comprehensive understanding of aminoglycoside resistance. This systematic review aimed to provide a comprehensive overview of the global prevalence of aminoglycoside resistance in B. melitensis and B. abortus.
METHODS
A systematic search of online databases was conducted and eligible studies met certain criteria and were published in English. Quality assessment was performed using the JBI Checklist. A random-effects model was fitted to the data, and meta-regression, subgroup, and outlier/influential analyses were performed. The analysis was performed using R and the metafor package.
RESULTS
The results of this systematic review and meta-analysis suggested that the average prevalence rates of streptomycin, gentamicin, and amikacin resistance were 0.027 (95% confidence interval [CI], 0.015-0.049), 0.023 (95% CI, 0.017-0.032), and 0.008 (95% CI, 0.002-0.039), respectively. The prevalence of streptomycin resistance was higher in the unidentified Brucella group than in the B. abortus and B. melitensis groups (0.234, 0.046, and 0.017, respectively; p < 0.02). The prevalence of gentamicin resistance increased over time (r = 0.064; 95% CI, 0.018 to 0.111; p = 0.007). The prevalence of resistance did not correlate with the quality score for any antibiotic. Funnel plots showed a potential asymmetry for streptomycin and gentamicin. These results suggest a low prevalence of antibiotic resistance in the studied populations.
CONCLUSION
The prevalence of aminoglycoside resistance in B. melitensis and B. abortus was low. However, gentamicin resistance has increased in recent years. This review provides a comprehensive and updated understanding of aminoglycoside resistance in B. melitensis and B. abortus.
简介
氨基糖苷类抗生素是治疗布鲁氏菌感染的重要抗生素，因为它们干扰细菌蛋白质的产生，并且通常与其他抗生素联合使用。它们具有成本效益、副作用少且能穿透生物膜。近年来，布鲁氏菌病的流行有所增加，这增加了对有效治疗方法的需求。此外，多药耐药布鲁氏菌株的出现突出表明需要对氨基糖苷类耐药性有一个更新和全面的了解。本系统评价旨在全面概述全球贝氏疏螺旋体和流产布鲁氏菌中氨基糖苷类耐药的流行情况。
方法
对在线数据库进行了系统搜索，符合特定标准且以英文发表的研究均符合条件。使用 JBI 清单进行了质量评估。使用随机效应模型拟合数据，并进行了荟萃回归、亚组和离群值/有影响力分析。分析使用 R 和 metafor 包进行。
结果
本系统评价和荟萃分析的结果表明，链霉素、庆大霉素和阿米卡星耐药的平均流行率分别为 0.027（95%置信区间 [CI]，0.015-0.049）、0.023（95% CI，0.017-0.032）和 0.008（95% CI，0.002-0.039）。链霉素耐药率在未鉴定的布鲁氏菌组中高于流产布鲁氏菌和贝氏疏螺旋体组（分别为 0.234、0.046 和 0.017；p<0.02）。庆大霉素耐药率随时间增加（r=0.064；95% CI，0.018 至 0.111；p=0.007）。耐药率与任何抗生素的质量评分均无关。漏斗图显示链霉素和庆大霉素存在潜在的不对称性。这些结果表明研究人群中的抗生素耐药率较低。
结论
贝氏疏螺旋体和流产布鲁氏菌中氨基糖苷类耐药的流行率较低。然而，庆大霉素耐药性近年来有所增加。本综述提供了对贝氏疏螺旋体和流产布鲁氏菌中氨基糖苷类耐药性的全面和最新认识。
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