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多重耐药全球流行情况的计算研究:一项系统评价与荟萃分析

Computational investigation of the global prevalence of multidrug resistant : A systematic review and meta-analysis.

作者信息

Zivarifar Hamidreza, Ahrari Forough, Karbalaei Mohsen

机构信息

Department of Internal Medicine, and Virology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.

出版信息

J Clin Tuberc Other Mycobact Dis. 2024 Nov 7;37:100495. doi: 10.1016/j.jctube.2024.100495. eCollection 2024 Dec.

Abstract

BACKGROUND

Leprosy is a chronic infectious disease caused by () However, the emergence of drug-resistant strains of this bacterium, especially multidrug-resistant (MDR) strains, is a serious concern. This study aimed to evaluate the global prevalence of MDR and its implications.

METHODS

Using PRISMA guidelines, we systematically reviewed ISI Web of Science, MEDLINE, and EMBASE up to August 2023 to assess the prevalence of MDR . We included human clinical trials on MDR , as well as excluded reviews, animal studies, and unavailable full texts. Data was analyzed using Comprehensive Meta-Analysis software, and publication bias was addressed using Egger's, Begg's tests, and the trim-fill method.

RESULTS

Overall, 861 articles were initially identified, of which 28 met the methodological criteria for inclusion in the quantitative synthesis. Statistically, the combined prevalence of drug resistant was approximated at 11.7 % (95 % CI: 7.7-17.3; : 90.79; value = 0.01). Specific drug resistance rates included 7.4 % to dapsone and 5.1 % to rifampin, among others. The global rate for MDR was measured at 2.2 % (95 % CI: 1.2-3.9; : 82.68; value = 0.01). Factors such as bacterial density and the lepromatous phase were associated with elevated DR risk (OR: 2.69; 95 % CI: 1.35-2.48). A systematic assessment of publication bias indicated a minimal impact on the general results.

CONCLUSIONS

The increasing prevalence of MDR globally requires urgent and strategic interventions to prevent further spread, which in turn is effective in treating leprosy patients.

摘要

背景

麻风病是一种由()引起的慢性传染病。然而,这种细菌耐药菌株的出现,尤其是多重耐药(MDR)菌株,令人严重担忧。本研究旨在评估全球MDR的流行情况及其影响。

方法

我们按照PRISMA指南,系统检索了截至2023年8月的ISI科学网、MEDLINE和EMBASE,以评估MDR的流行情况。我们纳入了关于MDR的人体临床试验,同时排除了综述、动物研究和无法获取的全文。使用综合Meta分析软件进行数据分析,并使用Egger检验、Begg检验和修剪填充法处理发表偏倚。

结果

总体而言,最初识别出861篇文章,其中28篇符合纳入定量综合分析的方法学标准。从统计学角度看,耐药的合并流行率约为11.7%(95%CI:7.7 - 17.3;:90.79;值 = 0.01)。具体的耐药率包括对氨苯砜为7.4%,对利福平为5.1%等。全球MDR的发生率为2.2%(95%CI:1.2 - 3.9;:82.68;值 = 0.01)。细菌密度和瘤型麻风期等因素与DR风险升高相关(OR:2.69;95%CI:1.35 - 2.48)。对发表偏倚的系统评估表明其对总体结果影响极小。

结论

全球MDR发生率不断上升,需要采取紧急且具有战略意义的干预措施以防止其进一步传播,这反过来对治疗麻风病患者是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/811f/11701851/de9492c7193b/gr1.jpg

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