大环内酯类耐药菌的全球流行率：一项全面的系统评价和荟萃分析。
Global prevalence of macrolide-resistant spp.: a comprehensive systematic review and meta-analysis.
作者信息
Navidifar Tahereh, Zare Banadkouki Abbas, Parvizi Elnaz, Mofid Maryam, Golab Narges, Beig Masoumeh, Sholeh Mohammad
机构信息
Department of Basic Sciences, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran.
Department of Microbiology, Shahid Beheshti University, Tehran, Iran.
出版信息
Front Microbiol. 2025 Mar 14;16:1524452. doi: 10.3389/fmicb.2025.1524452. eCollection 2025.
BACKGROUND
is a genus of bacteria responsible for various infections ranging from mild skin to severe systemic diseases. Methicillin-resistant (MRSA) and coagulase-negative staphylococci (CoNS) are significant challenges owing to their resistance to multiple antibiotics, including macrolides, such as erythromycin, clarithromycin, and azithromycin.
OBJECTIVE
This study aimed to systematically review and synthesize data on the prevalence of macrolide resistance in spp., identify trends and changes in resistance patterns over time, and assess how testing methods and guidelines affect reported resistance rates.
METHODS
The study conducted a systematic search of the Scopus, PubMed, Web of Science, and EMBASE databases. Studies have reported the proportion of macrolide-resistant spp. Two authors independently extracted and analyzed the data using a random-effects model. Heterogeneity was assessed, and subgroup analyses were performed based on country, continent, species, AST guidelines, methods, and period.
RESULTS
In total, 223 studies from 76 countries were included. The pooled prevalence of resistance to erythromycin, clarithromycin, and azithromycin were 57.3, 52.6, and 57.9%, respectively. Significant heterogeneity was observed across studies (I > 95%, < 0.001). Oceania (72%) had the highest erythromycin resistance, whereas Europe had the lowest (40.7%). Subgroup analyses revealed variations in resistance based on the species, with higher resistance in MRSA than in MSSA and CoNS than in other species. Over time, a slight decrease in erythromycin resistance has been observed (59.6% from 2015-2019 to 55% from 2020-2023).
CONCLUSION
This study emphasizes the high prevalence of macrolide resistance in spp. and its notable regional variation. These findings highlight the necessity for standardized methodologies and global surveillance to manage macrolide resistance effectively. Controlling antibiotic resistance should prioritize enhancing public health measures and updating treatment guidelines.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=557756, CRD42024557756.
背景
[具体细菌属名]是一类细菌，可引发从轻度皮肤感染到严重全身性疾病的各种感染。耐甲氧西林[具体细菌属名]（MRSA）和凝固酶阴性葡萄球菌（CoNS）是重大挑战，因为它们对多种抗生素耐药，包括大环内酯类抗生素，如红霉素、克拉霉素和阿奇霉素。
目的
本研究旨在系统回顾和综合关于[具体细菌属名]中大环内酯类耐药性流行情况的数据，确定耐药模式随时间的趋势和变化，并评估检测方法和指南如何影响报告的耐药率。
方法
该研究对Scopus、PubMed、科学网和EMBASE数据库进行了系统检索。研究报告了耐大环内酯类[具体细菌属名]的比例。两位作者使用随机效应模型独立提取和分析数据。评估了异质性，并根据国家、大洲、菌种、AST指南、方法和时间段进行了亚组分析。
结果
总共纳入了来自76个国家的223项研究。对红霉素、克拉霉素和阿奇霉素的合并耐药率分别为57.3%、52.6%和57.9%。各研究间观察到显著的异质性（I>95%，P<0.001）。大洋洲（72%）的红霉素耐药率最高，而欧洲最低（40.7%）。亚组分析显示，根据菌种不同耐药情况存在差异，MRSA的耐药率高于甲氧西林敏感金黄色葡萄球菌（MSSA），CoNS的耐药率高于其他菌种。随着时间的推移，观察到红霉素耐药率略有下降（从2015 - 2019年的59.6%降至2020 - 2023年的55%）。
结论
本研究强调了[具体细菌属名]中大环内酯类耐药性的高流行率及其显著的区域差异。这些发现凸显了采用标准化方法和全球监测以有效管理大环内酯类耐药性的必要性。控制抗生素耐药性应优先加强公共卫生措施并更新治疗指南。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=557756，CRD42024557756。
Zotero 插件