Alshehri Ahmad A, Irekeola Ahmad Adebayo
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, P.O. Box 1988, Najran, Saudi Arabia.
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia.
Saudi Pharm J. 2024 Nov;32(11):102186. doi: 10.1016/j.jsps.2024.102186. Epub 2024 Oct 14.
Antimicrobial resistance is a significant public health issue. In addressing the threat of multidrug resistant bacterial infections, carbapenems have been used. The carbapenem-resistant (CRE) are, however, rapidly expanding worldwide. Since the issue of CRE is also a problem in Saudi Arabia, the current meta-analysis was performed to comprehensively evaluate the resistance rates to the main carbapenem antibiotics and determine the actual prevalence of CRE in the country. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was followed. Different web databases including PubMed, Scopus, Web of Science, and ScienceDirect were searched for relevant records. Data were extracted, and summary estimates for resistance to carbapenems were calculated using DerSimonian-Laird method of meta-analysis and the random-effects model. From a total of 787 retrieved records, 69 studies were found fully eligible and were included in the final analyses. More than 50 % of all the studies were conducted after 2010, and the most frequently examined members of the were and . The pooled prevalence estimate for imipenem resistance was 6.6 % (95 % CI: 4.7-9.2), 9.1 % (95 % CI: 6.7-12.3) for meropenem, and 18.6 % (95 % CI: 11.9-27.9) for ertapenem. High heterogeneity ( > 97 %, < 0.001) was observed for all the estimates. Compared to other regions of the country, there was higher resistance rates in the Al-Qassim and Al-Jouf provinces. Additionally, resistance to ertapenem was as high as 34.2 % in the most recent study period (2021-2024). was the most prevalent CRE (26.2 %). This review highlights an increasing rate of carbapenem resistance among , emphasizing the need for collaborative efforts to implement strict infection control and prevention measures. Consistent surveillance is indispensable for safeguarding public health, guiding clinical decisions, and strengthening efforts to tackle the challenges of antibiotic resistance.
抗菌药物耐药性是一个重大的公共卫生问题。在应对多重耐药细菌感染的威胁时，碳青霉烯类药物被投入使用。然而，耐碳青霉烯类肠杆菌科细菌（CRE）在全球范围内正迅速蔓延。鉴于CRE问题在沙特阿拉伯也是一个难题，因此开展了本次荟萃分析，以全面评估对主要碳青霉烯类抗生素的耐药率，并确定该国CRE的实际流行情况。本研究遵循了系统评价与荟萃分析的首选报告项目（PRISMA）指南。通过搜索包括PubMed、Scopus、科学引文索引和ScienceDirect在内的不同网络数据库来查找相关记录。提取数据，并使用DerSimonian-Laird荟萃分析方法和随机效应模型计算对碳青霉烯类药物耐药性的汇总估计值。在总共检索到的787条记录中，发现69项研究完全符合条件并纳入最终分析。所有研究中超过50%是在2010年之后开展的，最常检测的肠杆菌科成员是大肠埃希菌和肺炎克雷伯菌。亚胺培南耐药性的汇总流行率估计为6.6%（95%置信区间：4.7 - 9.2），美罗培南为9.1%（95%置信区间：6.7 - 12.3），厄他培南为18.6%（95%置信区间：11.9 - 27.9）。所有估计值均观察到高度异质性（I² > 97%，P < 0.001）。与该国其他地区相比，卡西姆省和焦夫省的耐药率更高。此外，在最近的研究期间（2021 - 2024年），厄他培南耐药率高达34.2%。肺炎克雷伯菌是最常见的CRE（26.2%）。本综述强调了肠杆菌科细菌中碳青霉烯类耐药率的上升，强调需要共同努力实施严格的感染控制和预防措施。持续监测对于保障公众健康、指导临床决策以及加强应对抗生素耐药性挑战的努力不可或缺。
