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鲍曼不动杆菌对碳青霉烯类耐药的地理分布及时间趋势:一项综合荟萃分析。

Geographical mapping and temporal trends of Acinetobacter baumannii carbapenem resistance: A comprehensive meta-analysis.

作者信息

Beig Masoumeh, Parvizi Elnaz, Navidifar Tahereh, Bostanghadiri Narjes, Mofid Maryam, Golab Narges, Sholeh Mohammad

机构信息

Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.

Department of Microbiology, Science and Research Branch, Islamic Azad University, Fars, Iran.

出版信息

PLoS One. 2024 Dec 16;19(12):e0311124. doi: 10.1371/journal.pone.0311124. eCollection 2024.

Abstract

BACKGROUND

Carbapenem-resistant Acinetobacter baumannii (CRAB) is of critical concern in healthcare settings, leading to limited treatment options. In this study, we conducted a comprehensive meta-analysis to assess the prevalence of CRAB by examining temporal, geographic, and bias-related variations.

METHODS

We systematically searched prominent databases, including Scopus, PubMed, Web of Science, and EMBASE. Quality assessment was performed using the JBI checklist. Subgroup analyses were performed based on the COVID-19 timeframes, years, countries, continents, and bias levels, antimicrobial susceptivity test method and guidelines.

RESULTS

Our comprehensive meta-analysis, which included 795 studies across 80 countries from 1995 to 2023, revealed a surge in carbapenem resistance among A. baumannii, imipenem (76.1%), meropenem (73.5%), doripenem (73.0%), ertapenem (83.7%), and carbapenems (74.3%). Temporally, 2020-2023 witnessed significant peaks, particularly in carbapenems (81.0%) and meropenem (80.7%), as confirmed by meta-regression, indicating a steady upward trend.

CONCLUSION

This meta-analysis revealed an alarmingly high resistance rate to CRAB as a global challenge, emphasizing the urgent need for tailored interventions. Transparency, standardized methodologies, and collaboration are crucial for the accurate assessment and maintenance of carbapenem efficacy.

摘要

背景

耐碳青霉烯类鲍曼不动杆菌(CRAB)是医疗机构中极为关注的问题,导致治疗选择有限。在本研究中,我们进行了一项全面的荟萃分析,通过研究时间、地理和偏倚相关的变化来评估CRAB的流行情况。

方法

我们系统地检索了著名数据库,包括Scopus、PubMed、Web of Science和EMBASE。使用JBI清单进行质量评估。基于COVID-19时间框架、年份、国家、大洲和偏倚水平、抗菌药物敏感性试验方法和指南进行亚组分析。

结果

我们的全面荟萃分析纳入了1995年至2023年来自80个国家的795项研究,结果显示鲍曼不动杆菌对碳青霉烯类药物的耐药性激增,亚胺培南(76.1%)、美罗培南(73.5%)、多利培南(73.0%)、厄他培南(83.7%)和碳青霉烯类药物(74.3%)。从时间上看,2020年至2023年出现了显著峰值,尤其是碳青霉烯类药物(81.0%)和美罗培南(80.7%),荟萃回归证实了这一点,表明呈稳步上升趋势。

结论

这项荟萃分析揭示了CRAB的耐药率高得惊人,这是一个全球性挑战,强调迫切需要采取针对性干预措施。透明度、标准化方法和合作对于准确评估和维持碳青霉烯类药物的疗效至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/593f/11649148/17b95eff03cb/pone.0311124.g001.jpg

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