全球抗菌敏感性模式的黄金葡萄球菌在亚托匹性皮肤炎:一个系统的审查和元分析
Itzel Guadalupe Elizalde-Jiménez1, Fernando Gerardo Ruiz-Hernández2,3, Silvia Angélica Carmona-Cruz1,4
1Dermatology Department, Instituto Nacional de Pediatría, Mexico City, Mexico.
JAMA dermatology
|September 25, 2024
概括
在阿托皮性皮炎患者中,黄金葡萄球菌的抗微生物敏感性往往低于常见抗生素如甲素和红素的最佳水平. 易感性因国家收入水平而异,但随着时间的推移没有变化.
科学领域:
- 皮肤病学 皮肤病学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 亚托匹性皮肤炎患者经常经历金黄色葡萄球菌的殖民和感染.
- 经验性抗生素治疗是常见的,但在这个人群中S. aureus对抗菌素敏感性的数据在地理上是有限的.
- 了解抗菌素耐药性模式对于有效治疗亚托皮炎并发症至关重要.
研究的目的:
- 为了确定从阿托皮性皮肤炎患者中分离出来的Staphylococcus aureus菌株的抗微生物敏感性概况.
- 分析易感性模式如何根据原产国收入水平和数据收集期间不同.
主要方法:
- 从创立到2023年6月20日,使用主要科学数据库对文献进行系统审查和元分析.
- 纳入标准要求进行报告S. aureus皮肤分离物对抗生素敏感性的研究,这些分离物来自阿托皮性皮炎患者.
- 数据提取遵循了系统审查和元分析 (PRISMA) 准则的首选报告项目.
主要成果:
- 对包括4091个S. aureus分离物在内的61项研究的分析显示,对甲基西林,红红,酸和克林达米的抗微生物敏感性低于最佳 (≤85%).
- 大多数研究 (75.4%) 来自高收入国家.
- 与高收入国家相比,中低收入和中高收入国家对红红,甲基西林和trimethoprim/sulfamethoxazole的抗菌敏感性明显较低. 时间趋势显示,随着时间的推移,敏感性模式没有显著变化.
结论:
- 黄金菌对几种常用的抗生素的抗菌感受性,包括β-lactams,红红素,克林达胺素和酸,可能在阿托皮性皮炎患者的经验性使用中不理想.
- 在抗菌素敏感性模式方面存在显著的地理差异,特别是在高收入和中等收入国家之间.
- 这些发现凸显了需要更新的指导方针实证抗生素治疗在亚托皮炎,考虑到区域耐药性模式.
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