PDF(Pubmed)
Abstract：
BACKGROUND: Cystic fibrosis (CF) is a life-limiting disorder that is characterised by respiratory tract inflammation that is mediated by a range of microbial pathogens. Small colony variants (SCVs) of common respiratory pathogens are being increasingly recognised in CF. The aim of this systematic review is to investigate the prevalence of SCVs, clinical characteristics and health outcomes for patients with CF, and laboratory diagnostic features of SCVs compared to non-small colony variants (NCVs) for a range of Gram-positive and Gram-negative respiratory pathogens.
METHODS: A literature search was conducted (PubMed, Web of Science, Embase and Scopus) in April 2020 to identify articles of interest. Data pertaining to demographic characteristics of participants, diagnostic criteria of SCVs, SCV prevalence and impact on lung function were extracted from included studies for analysis.
RESULTS: Twenty-five of 673 studies were included in the systematic review. Individuals infected with SCVs of Staphylococcus aureus (S. aureus) were more likely to have had prior use of the broad-spectrum antibiotic trimethoprim sulfamethoxazole (p < 0.001), and the prevalence of SCVs in patients infected with S. aureus was estimated to be 19.3% (95% CI: 13.5% to 25.9%). Additionally, patients infected with SCVs of Gram-negative and Gram-positive pathogens were identified to have a lower forced expiratory volume in one second percentage predicted (-16.8, 95% CI: -23.2 to -10.4) than those infected by NCVs. Gram-positive SCVs were commonly described as small and non-haemolytic, grown on Mannitol salt or blood agar for 24 h at 35°C and confirmed using tube coagulase testing.
CONCLUSIONS: The findings of this systematic review demonstrate that SCVs of S. aureus have a high prevalence in the CF community, and that the occurrence of SCVs in Gram-positive and Gram-negative pathogens is linked to poorer respiratory function. Further investigation is necessary to determine the effect of infection by SCVs on the CF population.
METHODS: A literature search was conducted (PubMed, Web of Science, Embase and Scopus) in April 2020 to identify articles of interest. Data pertaining to demographic characteristics of participants, diagnostic criteria of SCVs, SCV prevalence and impact on lung function were extracted from included studies for analysis.
RESULTS: Twenty-five of 673 studies were included in the systematic review. Individuals infected with SCVs of Staphylococcus aureus (S. aureus) were more likely to have had prior use of the broad-spectrum antibiotic trimethoprim sulfamethoxazole (p < 0.001), and the prevalence of SCVs in patients infected with S. aureus was estimated to be 19.3% (95% CI: 13.5% to 25.9%). Additionally, patients infected with SCVs of Gram-negative and Gram-positive pathogens were identified to have a lower forced expiratory volume in one second percentage predicted (-16.8, 95% CI: -23.2 to -10.4) than those infected by NCVs. Gram-positive SCVs were commonly described as small and non-haemolytic, grown on Mannitol salt or blood agar for 24 h at 35°C and confirmed using tube coagulase testing.
CONCLUSIONS: The findings of this systematic review demonstrate that SCVs of S. aureus have a high prevalence in the CF community, and that the occurrence of SCVs in Gram-positive and Gram-negative pathogens is linked to poorer respiratory function. Further investigation is necessary to determine the effect of infection by SCVs on the CF population.
摘要：
背景：囊性纤维化（CF）是一种生命限制性疾病，其特征是由一系列微生物病原体介导的呼吸道炎症。在CF中越来越认识到常见呼吸道病原体的小菌落变体（SCV）。这项系统评价的目的是调查SCV的患病率，CF患者的临床特征和健康结局，与一系列革兰氏阳性和革兰氏阴性呼吸道病原体的非小菌落变体（NCV）相比，SCV的实验室诊断特征。
方法：进行了文献检索(PubMed，WebofScience,Embase和Scopus)于2020年4月确定感兴趣的文章。与参与者的人口统计学特征有关的数据，SCV的诊断标准，从纳入的研究中提取SCV患病率和对肺功能的影响进行分析。
结果：673项研究中有25项纳入了系统评价。感染金黄色葡萄球菌SCV的个体(S.金黄色葡萄球菌）更有可能先前使用过广谱抗生素甲氧苄啶磺胺甲恶唑（p<0.001），感染金黄色葡萄球菌的患者中SCV的患病率估计为19.3%(95%CI:13.5%~25.9%).此外,与接受NCV感染的患者相比,接受革兰氏阴性和革兰氏阳性病原体SCV感染的患者在1秒内的用力呼气量预测百分比(-16.8,95%CI:-23.2~-10.4)较低.革兰氏阳性SCV通常被描述为小而非溶血，在35°C下在甘露醇盐或血琼脂上生长24小时，并使用试管凝固酶测试进行确认。
结论：本系统综述的结果表明，金黄色葡萄球菌的SCV在CF社区中具有很高的患病率，并且在革兰氏阳性和革兰氏阴性病原体中SCV的发生与较差的呼吸功能有关。需要进一步研究以确定SCV感染对CF群体的影响。
方法：进行了文献检索(PubMed，WebofScience,Embase和Scopus)于2020年4月确定感兴趣的文章。与参与者的人口统计学特征有关的数据，SCV的诊断标准，从纳入的研究中提取SCV患病率和对肺功能的影响进行分析。
结果：673项研究中有25项纳入了系统评价。感染金黄色葡萄球菌SCV的个体(S.金黄色葡萄球菌）更有可能先前使用过广谱抗生素甲氧苄啶磺胺甲恶唑（p<0.001），感染金黄色葡萄球菌的患者中SCV的患病率估计为19.3%(95%CI:13.5%~25.9%).此外,与接受NCV感染的患者相比,接受革兰氏阴性和革兰氏阳性病原体SCV感染的患者在1秒内的用力呼气量预测百分比(-16.8,95%CI:-23.2~-10.4)较低.革兰氏阳性SCV通常被描述为小而非溶血，在35°C下在甘露醇盐或血琼脂上生长24小时，并使用试管凝固酶测试进行确认。
结论：本系统综述的结果表明，金黄色葡萄球菌的SCV在CF社区中具有很高的患病率，并且在革兰氏阳性和革兰氏阴性病原体中SCV的发生与较差的呼吸功能有关。需要进一步研究以确定SCV感染对CF群体的影响。
