This meta-analysis aimed to evaluate the weighted pooled resistance (WPR) rates in V. cholerae O1/O139 isolates obtained from environmental samples.
We systematically searched the articles in PubMed, Scopus, and Embase (until January 2020). Subgroup analyses were then employed by publication year, geographic areas, and the quality of studies. Statistical analyses were conducted using STATA software (ver. 14.0).
A total of 20 studies investigating 648 environmental V. cholerae O1/O139 isolates were analysed. The majority of the studies were originated from Asia (n = 9). In addition, a large number of studies (n = 15 i.e. 71.4%) included in the meta-analysis revealed the resistance to cotrimoxazole and ciprofloxacin. The WPR rates were as follows: cotrimoxazole 59%, erythromycin 28%, tetracycline 14%, doxycycline 5%, and ciprofloxacin 0%. There was increased resistance to nalidixic acid, cotrimoxazole, furazolidone, and tetracycline while a decreased resistance to amoxicillin, ciprofloxacin, erythromycin, chloramphenicol, ampicillin, streptomycin, and ceftriaxone was observed during the years 2000-2020. A significant decrease in the doxycycline and ciprofloxacin-resistance rates in V. cholerae O1/O139 isolates was reported over the years 2011-2020 which represents a decrease in 2001-2010 (p < 0.05).
Fluoroquinolones, gentamicin, ceftriaxone, doxycycline, kanamycin, and cefotaxime showed the highest effectiveness and the lowest resistance rate. However, the main interest is the rise of antimicrobial resistance in V. cholerae strains especially in low-income countries or endemic areas, and therefore, continuous surveillance, careful appropriate AST, and limitation on improper antibiotic usage are crucial.
本荟萃分析旨在评估从环境样本中获得的霍乱弧菌O1/O139分离株的加权合并耐药率(WPR)。
我们系统地搜索了PubMed中的文章,Scopus,和Embase(至2020年1月)。然后按出版年采用亚组分析,地理区域,和研究的质量。使用STATA软件(ver。14.0)。
共分析了20项研究,调查了648个环境霍乱弧菌O1/O139分离株。大多数研究来自亚洲(n=9)。此外,荟萃分析中包含的大量研究(n=15,即71.4%)揭示了对复方新诺明和环丙沙星的耐药性。WPR率如下:复方新诺明59%,红霉素28%,四环素14%,强力霉素5%,和环丙沙星0%。对萘啶酸的抗性增加,复方新诺明,呋喃唑酮,和四环素,同时对阿莫西林的耐药性降低,环丙沙星,红霉素,氯霉素,氨苄青霉素,链霉素,头孢曲松在2000-2020年间被观察到。据报道,2011-2020年霍乱弧菌O1/O139分离株的强力霉素和环丙沙星耐药率显着下降,这代表2001-2010年下降(p<0.05)。
氟喹诺酮类药物,庆大霉素,头孢曲松,多西环素,卡那霉素,头孢噻肟的疗效最高,耐药率最低。然而,主要兴趣是霍乱弧菌菌株的抗菌素耐药性上升,特别是在低收入国家或流行地区,因此,持续监测,小心适当的AST,限制抗生素的不当使用至关重要。