沙特阿拉伯耐碳青霉烯类肠杆菌(CRE)的流行情况:系统回顾和荟萃分析

IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Saudi Pharmaceutical Journal Pub Date : 2024-10-14 DOI:10.1016/j.jsps.2024.102186
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引用次数: 0

摘要

抗菌药耐药性是一个重大的公共卫生问题。为应对耐多药细菌感染的威胁,人们一直在使用碳青霉烯类药物。然而,耐碳青霉烯类肠杆菌(CRE)正在全球迅速蔓延。由于 CRE 在沙特阿拉伯也是一个问题,因此本研究进行了荟萃分析,以全面评估主要碳青霉烯类抗生素的耐药率,并确定 CRE 在该国的实际流行率。研究遵循了《系统综述和荟萃分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-analyses,PRISMA)指南。在不同的网络数据库(包括 PubMed、Scopus、Web of Science 和 ScienceDirect)中搜索相关记录。提取数据后,使用DerSimonian-Laird荟萃分析法和随机效应模型计算碳青霉烯类耐药性的汇总估计值。在检索到的总共 787 条记录中,有 69 项研究完全符合条件并被纳入最终分析。在所有研究中,50% 以上的研究是在 2010 年之后进行的,最常见的肠杆菌科细菌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值为 6.6%(95 % CI:4.7-9.2),美罗培南为 9.1%(95 % CI:6.7-12.3),厄他培南为 18.6%(95 % CI:11.9-27.9)。所有估计值均存在高度异质性(I2 > 97 %, p < 0.001)。与该国其他地区相比,卡西姆省和朱夫省的耐药率较高。此外,在最近的研究期间(2021-2024 年),对厄他培南的耐药性高达 34.2%。变形杆菌是最常见的 CRE(26.2%)。本综述强调了肠杆菌科细菌对碳青霉烯类耐药率的不断上升,强调需要共同努力实施严格的感染控制和预防措施。持续的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工作都是不可或缺的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Prevalence of carbapenem-resistant Enterobacterales (CRE) in Saudi Arabia: A systematic review and meta-analysis
Antimicrobial resistance is a significant public health issue. In addressing the threat of multidrug resistant bacterial infections, carbapenems have been used. The carbapenem-resistant Enterobacterales (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 Enterobacterales were Escherichia coli and Klebsiella pneumoniae. 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 (I2 > 97 %, p < 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). Proteus spp was the most prevalent CRE (26.2 %). This review highlights an increasing rate of carbapenem resistance among Enterobacterales, 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.
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来源期刊
Saudi Pharmaceutical Journal
Saudi Pharmaceutical Journal PHARMACOLOGY & PHARMACY-
CiteScore
6.10
自引率
2.40%
发文量
194
审稿时长
67 days
期刊介绍: The Saudi Pharmaceutical Journal (SPJ) is the official journal of the Saudi Pharmaceutical Society (SPS) publishing high quality clinically oriented submissions which encompass the various disciplines of pharmaceutical sciences and related subjects. SPJ publishes 8 issues per year by the Saudi Pharmaceutical Society, with the cooperation of the College of Pharmacy, King Saud University.
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