Abstract：
UNASSIGNED: Carbapenem-resistant Enterobacterales (CRE) due to Metallo-β-lactamase (MBL) production are treated with either polymyxins or the novel combination of ceftazidime-avibactam and aztreonam (AA). This study aims to evaluate the 30-day mortality of AA in patients with BSI caused by MBL-CRE infections.
UNASSIGNED: In this systematic review and meta-analysis, all articles up to June 2023 were screened using search terms like \'CRE\', \'MBL\', \'AA\' and \'polymyxins\'. The risk ratio for AA vs polymyxins was pooled using a random-effect model, and the results were represented by a point estimate with a 95% confidence interval.
UNASSIGNED: After removing the duplicates, the titles and abstracts of 455 articles were screened, followed by a full-text screening of 50 articles. A total of 24 articles were included for systematic review, and four comparative studies were included in the meta-analysis. All four studies had a moderate or serious risk of bias. The pooled risk ratio for 30-day mortality for AA vs. polymyxins was 0.51 (95%CI: 0.34-0.76), p < 0.001. There was no significant heterogeneity.
UNASSIGNED: The meta-analysis from studies with a high risk of bias shows that AA is associated with lesser 30-day mortality when compared to polymyxins in patients with MBL-producing CRE BSI. Registration with PROSPERO- CRD42023433608.
UNASSIGNED: In this systematic review and meta-analysis, all articles up to June 2023 were screened using search terms like \'CRE\', \'MBL\', \'AA\' and \'polymyxins\'. The risk ratio for AA vs polymyxins was pooled using a random-effect model, and the results were represented by a point estimate with a 95% confidence interval.
UNASSIGNED: After removing the duplicates, the titles and abstracts of 455 articles were screened, followed by a full-text screening of 50 articles. A total of 24 articles were included for systematic review, and four comparative studies were included in the meta-analysis. All four studies had a moderate or serious risk of bias. The pooled risk ratio for 30-day mortality for AA vs. polymyxins was 0.51 (95%CI: 0.34-0.76), p < 0.001. There was no significant heterogeneity.
UNASSIGNED: The meta-analysis from studies with a high risk of bias shows that AA is associated with lesser 30-day mortality when compared to polymyxins in patients with MBL-producing CRE BSI. Registration with PROSPERO- CRD42023433608.
摘要：
■用多粘菌素或头孢他啶-阿维巴坦和氨曲南的新组合(AA)处理由于金属-β-内酰胺酶(MBL)产生的碳青霉烯类抗性肠杆菌(CRE)。本研究旨在评估由MBL-CRE感染引起的BSI患者中AA的30天死亡率。
■在本系统综述和荟萃分析中，截至2023年6月的所有文章都使用“CRE”等搜索词进行了筛选，\'MBL\',\'AA\'和\'多粘菌素\'。AA与多粘菌素的风险比使用随机效应模型进行汇总，结果由点估计代表,置信区间为95%.
■删除重复项之后，筛选了455篇文章的标题和摘要，其次是全文筛选50篇文章。共纳入24篇文章进行系统评价，4项比较研究纳入荟萃分析.所有四项研究都有中度或严重的偏倚风险。AA与30天死亡率的合并风险比多粘菌素为0.51（95CI：0.34-0.76），p<0.001。没有显著的异质性。
■来自具有高偏倚风险的研究的荟萃分析显示，与产生MBL的CREBSI的患者相比，AA与30天死亡率较低相关。注册与PROSPERO-CRD42023433608。
■在本系统综述和荟萃分析中，截至2023年6月的所有文章都使用“CRE”等搜索词进行了筛选，\'MBL\',\'AA\'和\'多粘菌素\'。AA与多粘菌素的风险比使用随机效应模型进行汇总，结果由点估计代表,置信区间为95%.
■删除重复项之后，筛选了455篇文章的标题和摘要，其次是全文筛选50篇文章。共纳入24篇文章进行系统评价，4项比较研究纳入荟萃分析.所有四项研究都有中度或严重的偏倚风险。AA与30天死亡率的合并风险比多粘菌素为0.51（95CI：0.34-0.76），p<0.001。没有显著的异质性。
■来自具有高偏倚风险的研究的荟萃分析显示，与产生MBL的CREBSI的患者相比，AA与30天死亡率较低相关。注册与PROSPERO-CRD42023433608。
