在Acinetobacter baumannii中出现的卡巴尼姆耐药性是否会增加病例死亡率? 系统性审查和元分析
Jale Boral1,2, Fatihan Pınarlık1,2, Güz Ekinci1,2
1Graduate School of Health Sciences, Koç University, Istanbul 34010, Türkiye.
Infectious disease reports
|October 27, 2023
概括
2007年至2018年,Acinetobacter baumannii的碳烯耐药性增加了,但死亡率并没有与之并行上升. 这表明,改善医疗护理或细菌适应可能正在减轻抗药性增加的影响.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 在Acinetobacter baumannii中,碳烯耐药性的增加构成了全球健康的重大威胁.
- 了解耐药性和死亡率的趋势对于有效的感染控制至关重要.
研究的目的:
- 调查土耳其Acinetobacter baumannii血流感染中死亡率和卡巴酶基因阳性的变化.
- 分析卡巴胺耐药性和死亡率之间的时间关联.
主要方法:
- 系统审查遵循系统审查优先报告项目 (PRISMA) 准则.
- 从2003年到2023年,在多个数据库 (科克兰图书馆,Pubmed,Scopus,科学网,Medline,Tubitak TR Dizin,Harman) 中进行全面的文献搜索.
- 简单的线性回归分析来评估阻力,死亡率和时间之间的关系.
主要成果:
- 从1717项已识别的研究中选择了21篇文章,重点关注土耳其的Acinetobacter baumannii血流感染.
- 在2007年至2018年期间 (p = 0.025) 观察到卡巴胺耐药率的显著增加.
- 对OXA-23和OXA-58基因的阳性显示出反向相关性 (p = 0.025).
结论:
- 尽管卡巴胺耐药性增加,但死亡率并没有比例上升.
- 潜在的因素包括医疗保健的进步和与长时间抗微生物药物暴露相关的细菌健康成本.
- 建议进行进一步的全球研究,以探索影响卡巴胺耐药率的克隆相关性.
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