背景:支原体和脲原体。尤其是人马,U.parvum,和解脲支原体被认为是泌尿生殖道感染的重要原因。由于抗生素耐药性的存在和耐药性的持续上升,治疗选择有限,治疗变得更具挑战性和成本。
目标:因此,这项荟萃分析旨在评估全球生殖器支原体和脲原体对氟喹诺酮类(环丙沙星,氧氟沙星,莫西沙星,和左氧氟沙星)药剂。
方法:我们搜索了PubMed上发表的相关研究,Scopus,和Embase从2022年3月3日。所有统计分析均使用统计软件包R进行。
结果:分析中包括的30项研究在16个国家进行。在元数据中,环丙沙星的比例,氧氟沙星,莫西沙星,支原体和泌尿生殖道支原体分离株的左氧氟沙星耐药率报告为59.8%(95%CI49.6,69.1),31.2%(95%CI23,40),7.3%(95%CI1,31),和5.3%(95%CI1,2),分别。根据元回归,环丙沙星,氧氟沙星,莫西沙星,左氧氟沙星的比率随着时间的推移而增加。不同大洲/国家间氟喹诺酮类药物耐药率差异有统计学意义(P<0.05)。
结论:根据本系统评价和荟萃分析的结果,我们建议使用较新的氟喹诺酮类药物,特别是左氧氟沙星作为治疗生殖器支原体病的首选药物。以及氧氟沙星用于治疗由小阴囊引起的生殖器感染。
BACKGROUND: Mycoplasma and Ureaplasma spp. especially M. hominis, U. parvum, and U. urealyticum recognized as an important cause of urogenital infections. Sake of the presence of antibiotic resistance and a continuous rise in resistance, the treatment options are limited, and treatment has become more challenging and costlier.
OBJECTIVE: Therefore, this meta-analysis aimed to estimate worldwide resistance rates of genital Mycoplasmas and Ureaplasma to fluoroquinolones (ciprofloxacin, ofloxacin,
moxifloxacin, and levofloxacin) agents.
METHODS: We searched the relevant published studies in PubMed, Scopus, and Embase from until 3, March 2022. All statistical analyses were carried out using the statistical package R.
RESULTS: The 30 studies included in the analysis were performed in 16 countries. In the metadata, the proportions of ciprofloxacin, ofloxacin,
moxifloxacin, and levofloxacin resistance in Mycoplasma and Ureaplasma urogenital isolates were reported 59.8% (95% CI 49.6, 69.1), 31.2% (95% CI 23, 40), 7.3% (95% CI 1, 31), and 5.3% (95% CI 1, 2), respectively. According to the meta-regression, the ciprofloxacin, ofloxacin,
moxifloxacin, and levofloxacin rate increased over time. There was a statistically significant difference in the fluoroquinolones resistance rates between different continents/countries (P < 0.05).
CONCLUSIONS: Based on the results obtained in this systematic
review and meta-analysis we recommend the use of the newer group of fluoroquinolones especially levofloxacin as the first choice for the treatment of genital mycoplasmosis, as well as ofloxacin for the treatment of genital infections caused by U. parvum.