Menbari Shaho, Shahsavar Sara Kamal, Keikha Masoud, Karbalaei Mohsen
Department of Pathology and Medical Laboratory Sciences, Faculty of Para Medicine Kurdistan University of Medical Sciences Sanandaj Iran.
Antimicrobial Resistance Research Center, Bu-Ali Research Institute Mashhad University of Medical Sciences Mashhad Iran.
Health Sci Rep. 2025 Sep 14;8(9):e71238. doi: 10.1002/hsr2.71238. eCollection 2025 Sep.
The increasing prevalence of antibiotic-resistant () strains represents a critical impediment to successful eradication therapy in both pediatric and adult populations. This meta-analysis aimed to determine the current global landscape of primary antibiotic resistance in bacterial isolates obtained from children.
A systematic literature search was conducted across ISI Web of Science, PubMed, Scopus, and Google Scholar, encompassing the period from the inception of each database up to December 2021. Eligible studies reporting primary antibiotic resistance in isolates from children worldwide were included. Resistance rates were expressed as percentages with corresponding 95% confidence intervals. Statistical analysis was performed using Comprehensive Meta-Analysis 2.2.
One hundred eleven teens were included in this meta-analysis, and 36,021 isolates of this bacterium were evaluated. The resistance rate was reported 25.6%, 30.9%, 2.5%, 2.0%, 12.1%, 6.9%, 1.9%, 0.5%, and 9.1%, for clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, ciprofloxacin, furazolidone, nitrofurantoin, and rifampin respectively. Furthermore, the pooled prevalence of primary multidrug resistant isolates was 4.5%.
This meta-analysis reveals a significant global burden of primary resistance to clarithromycin and metronidazole in pediatric isolates, with evidence of increasing resistance over time. Conversely, resistance rates to amoxicillin, tetracycline, levofloxacin, ciprofloxacin, furazolidone, nitrofurantoin, and rifampin remained low. Consequently, therapeutic regimens incorporating clarithromycin and metronidazole should be carefully considered and potentially avoided in regions exhibiting resistance rates exceeding 20%.
抗生素耐药性（）菌株的患病率不断上升，这对儿童和成人人群的成功根除治疗构成了关键障碍。本荟萃分析旨在确定从儿童中分离出的细菌原发性抗生素耐药性的当前全球情况。
在科学网（ISI Web of Science）、PubMed、Scopus和谷歌学术上进行了系统的文献检索，涵盖每个数据库创建之初至2021年12月的时间段。纳入了报告全球儿童分离株原发性抗生素耐药性的合格研究。耐药率以百分比表示，并带有相应的95%置信区间。使用综合荟萃分析2.2进行统计分析。
本荟萃分析纳入了111名青少年，评估了36021株该细菌分离株。克拉霉素、甲硝唑、阿莫西林、四环素、左氧氟沙星、环丙沙星、呋喃唑酮、呋喃妥因和利福平的耐药率分别报告为25.6%、30.9%、2.5%、2.0%、12.1%、6.9%、1.9%、0.5%和9.1%。此外，原发性多重耐药分离株的合并患病率为4.5%。
本荟萃分析揭示了全球儿童分离株对克拉霉素和甲硝唑原发性耐药的重大负担，有证据表明耐药性随时间增加。相反，对阿莫西林、四环素、左氧氟沙星、环丙沙星、呋喃唑酮、呋喃妥因和利福平的耐药率仍然较低。因此，在耐药率超过20%的地区，应谨慎考虑并可能避免使用含克拉霉素和甲硝唑的治疗方案。
