Adrina Habibzadeh, Kamran B Lankarani, Mojtaba Farjam, Maryam Akbari, Seyyed Mohammad Amin Kashani, Zeinab Karimimoghadam, Kan Wang, Mohammad Hossein Imanieh, Reza Tabrizi, Fariba Ahmadizar
{"title":"COVID-19感染中真菌耐药流行情况:一项全球荟萃分析","authors":"Adrina Habibzadeh, Kamran B Lankarani, Mojtaba Farjam, Maryam Akbari, Seyyed Mohammad Amin Kashani, Zeinab Karimimoghadam, Kan Wang, Mohammad Hossein Imanieh, Reza Tabrizi, Fariba Ahmadizar","doi":"10.1007/s12281-022-00439-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane's Q test and the I<sup>2</sup> index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients.</p><p><strong>Results: </strong>Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I<sup>2</sup> = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I<sup>2</sup> = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I<sup>2</sup> = 0%).</p><p><strong>Conclusion: </strong>Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12281-022-00439-9.</p>","PeriodicalId":10813,"journal":{"name":"Current Fungal Infection Reports","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376562/pdf/","citationCount":"9","resultStr":"{\"title\":\"Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis.\",\"authors\":\"Adrina Habibzadeh, Kamran B Lankarani, Mojtaba Farjam, Maryam Akbari, Seyyed Mohammad Amin Kashani, Zeinab Karimimoghadam, Kan Wang, Mohammad Hossein Imanieh, Reza Tabrizi, Fariba Ahmadizar\",\"doi\":\"10.1007/s12281-022-00439-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane's Q test and the I<sup>2</sup> index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients.</p><p><strong>Results: </strong>Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I<sup>2</sup> = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I<sup>2</sup> = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I<sup>2</sup> = 0%).</p><p><strong>Conclusion: </strong>Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12281-022-00439-9.</p>\",\"PeriodicalId\":10813,\"journal\":{\"name\":\"Current Fungal Infection Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376562/pdf/\",\"citationCount\":\"9\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Fungal Infection Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12281-022-00439-9\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/8/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Fungal Infection Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12281-022-00439-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/15 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis.
Purpose: Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients.
Methods: PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane's Q test and the I2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients.
Results: Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I2 = 0%).
Conclusion: Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment.
Supplementary information: The online version contains supplementary material available at 10.1007/s12281-022-00439-9.
期刊介绍：
This journal intends to provide clear, insightful, balanced contributions that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of fungal infections. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as advances in diagnosis, current and emerging management approaches, and genomics and pathogenesis. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. Commentaries from well-known figures in the field are also provided, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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