<>肺炎链球菌对抗生素的敏感性与患者性别:一项系统回顾和荟萃分析

Sergey A. Semenov, G. Khasanova
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引用次数: 0

摘要

背景:微生物抗生素耐药性的传播是最近出现的一个全球性问题,近年来在COVID-19大流行的背景下,由于抗生素消费量的显著增加,这一问题变得更加严重。肺炎球菌抗生素不敏感菌株传播的直接后果限制了这类患者的治疗选择,并导致预后恶化。目的:确定性别是否与肺炎链球菌耐药菌株引起的疾病发展相关。材料与方法:使用PubMed、ScienceDirect和谷歌Scholar电子数据库,检索1980年1月至2020年12月发表的文章,选择英文和俄文研究。文章的选择和荟萃分析是基于PRISMA小组和MOOSE的建议。合并资料后,以95%置信区间(95% CI)计算优势比(OR)。评估异质性。结果:应用排除标准后,选择41篇出版物,涵盖16635例侵袭性和非侵袭性肺炎球菌感染患者进行分析。其中,确定了36项病例对照研究和5项横断面研究。因此,患者性别不影响青霉素不敏感肺炎球菌菌株的分离频率(优势比[OR]=0.92, 95%可信区间[CI] 0.821.03, I2=7%)、青霉素耐药肺炎球菌菌株(OR=0.85, 95% CI 0.671.07, I2=1%)和红霉素不敏感肺炎球菌菌株(OR=0.80, 95% CI 0.511.24, I2=0%)。男性与肺炎球菌对左氧氟沙星的耐药性相关(OR=1.85, 95% CI 1.033.33, I2=0%)。结论:患者的性别与分离出对青霉素和红霉素不敏感和耐药的肺炎链球菌无关。此外,男性可能会增加侵袭性肺炎球菌感染成人中左氧氟沙星耐药肺炎球菌的分离机会。
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Sensitivity of <>iStreptococcus pneumoniae to antibiotics and the sex of the patient: A systematic review and meta-analysis
BACKGROUND: The spread of microbial resistance to antibiotics is a recent global problem, which has become more acute in recent years because of a significant increase in the consumption of antibiotics, against the background of the COVID-19 pandemic. A direct consequence of the spread of antibiotic-insensitive strains of pneumococci limits the treatment options for such patients and deterioration of the prognosis. AIM: To determine whether sex is a factor associated with the development of diseases caused by antibiotic-resistant strains of Streptococcus pneumoniae. MATERIALS AND METHODS: Using the electronic databases PubMed, ScienceDirect, and Google Scholar, a search was conducted for articles published from January 1980 to December 2020, and studies in English and Russian were selected. The selection of articles and meta-analysis was based on the recommendations of the PRISMA Group and MOOSE. After combining the data, the odds ratio (OR) was calculated with a 95% confidence interval (95% CI). Heterogeneity was assessed. RESULTS: After applying the exclusion criteria, 41 publications covering 16635 patients with invasive and non-invasive forms of pneumococcal infection were selected for analysis. Of these, 36 case-control studies and 5 cross-sectional studies were identified. Accordingly, the sex of the patient does not affect the frequency of isolation of pneumococcal strains insensitive to penicillin (odds ratio [OR]=0.92, 95% confidence interval [CI] 0.821.03, I2=7%), resistant to penicillin (OR=0.85, 95% CI 0.671.07, I2=1%), and insensitive to erythromycin (OR=0.80, 95% CI 0.511.24, I2=0%). Male sex is associated with pneumococcal resistance to levofloxacin (OR=1.85, 95% CI 1.033.33, I2=0%). CONCLUSIONS: The sex of the patient is not a factor associated with the isolation of S. pneumonia strains insensitive and resistant to penicillin and erythromycin. Moreover, the male sex probably increases the chance of isolation of levofloxacin-resistant pneumococci in adults with invasive pneumococcal infections.
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