不同质的黄金葡萄球菌菌株的全球分布 - - 中介性万科米辛菌株 (1997-2021):系统性审查和元分析
Masoud Keikha1, Mohsen Karbalaei2
1Department of Microbiology and Virology, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Journal of global antimicrobial resistance
|February 9, 2024
概括
全球异质菌素中间体黄金葡萄球菌 (hVISA) 的流行率正在增加,特别是在血液感染中. 这种增加威胁到万科米辛治疗的有效性,并需要对这些耐药菌株进行普遍控制计划.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 异质的米素中间体黄金葡萄球菌 (hVISA) 显著导致米素治疗失败和不良临床结果.
- 了解hVISA的全球流行,趋势和遗传特征对于有效管理至关重要.
研究的目的:
- 为了全面评估全球流行,趋势和hVISA菌株的遗传背景.
- 评估hVISA对治疗结果的影响,并确定风险因素.
主要方法:
- 根据PRISMA 2020检查清单进行了一项元分析.
- 在全球数据库中搜索了关于hVISA在抗甲基黄金葡萄球菌 (MRSA) 临床分离物中患病率的研究.
- 使用事件率和95%置信区间分析了流行率和趋势变化.
主要成果:
- 分析包括了124项研究,其中有114,801个MRSA分离体,显示hVISA的总流行率为64%.
- 虽然hVISA感染频率正在上升,但亚洲和欧洲/美国之间没有明显的地理差异 (6.1%和6.8%).
- 与其他感染 (5.5%) 相比,hVISA感染在细菌性患者中更为普遍 (9.4%),导致住院,成本和死亡率增加. SCCmec II和III类型是最常见的基因型.
结论:
- 越来越多的hVISA患病率对万科米辛治疗疗效构成重大威胁.
- 血液样本中更高的患病率凸显了对细菌病患者的危险性.
- 需要一个通用的战略来识别和控制hVISA在医疗机构的传播.
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