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Antimicrobial Resistance and Infection... Dec 2023The rising prevalence of multidrug-resistant (MDR) and extended-spectrum beta lactamase-resistant (ESBL) Klebsiella pneumoniae (K. pneumoniae) is an important global... (Meta-Analysis)
Meta-Analysis Review
The rising prevalence of multidrug-resistant (MDR) and extended-spectrum beta lactamase-resistant (ESBL) Klebsiella pneumoniae (K. pneumoniae) is an important global public health challenge. This threat is even more pertinent in clinical settings. Morbidity and mortality associated with this condition are alarming particularly in the developing regions of the world. A comprehensive evaluation of the epidemiology of this phenomenon will assist towards the global effort of reducing its burden. So, this systematic review and meta-analysis was conducted to evaluate the epidemiology of MDR K. pneumoniae in South-Eastern Asia (SEA). The study was done under the PRISMA guidelines and was preceded by the development of a priori protocol. The protocol was then registered in PROSPERO-the public registry for systematic reviews. Seven important outcomes which include the assessment of the overall MDR K. pneumoniae prevalence were designed to be evaluated. A literature search was carried out in five selected electronic databases and 4389 were screened. Of these articles, 21 studies that met the eligibility criteria were included in the review. Relevant data were extracted from the included studies. By conducting a quality effect meta-analysis, the pooled prevalence for MDR and ESBL K. pneumoniae in SEA was estimated at 55% (CI 9-96) and 27% (CI 32-100) respectively. The review also identified ESBL genes types of allodemic situations occurring mostly in respiratory tract infections. The high prevalence of MDR and ESBL K. pneumoniae in this subregion is highly significant and of both public health and clinical relevance. Overall, the findings of this review will assist in the effective prevention and control of this threat in SEA.
Topics: Humans; Klebsiella pneumoniae; Anti-Bacterial Agents; beta-Lactamases; Klebsiella Infections; Drug Resistance, Multiple, Bacterial; Asia, Eastern
PubMed: 38062531
DOI: 10.1186/s13756-023-01346-5 -
Journal of Gastrointestinal and Liver... Sep 2023Traditional cardiovascular risk factors are established predictors of heart failure (HF). However, the human gut microbiota is suggested to potentially interact with the...
BACKGROUND AND AIMS
Traditional cardiovascular risk factors are established predictors of heart failure (HF). However, the human gut microbiota is suggested to potentially interact with the cardiovascular system through the "gut-heart axis", which induces inflammation and contributes to HF pathogenesis. This systematic review aims to confirm the interconnection between the gut microbiome in HF patients.
METHODS
Peer-reviewed human studies comparing the gut microbiota profile in adult patients with HF and healthy controls (HCs) up to April 18, 2022, were searched in Ovid MEDLINE, Ovid EMBASE, SCOPUS, and the Cochrane Library. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).
RESULTS
A total of nine studies, including 317 HF patients and 510 HCs, were included in the review. Decreased gut microbiota richness and similar microbial diversity (alpha diversity), and significantly different gut microbiota composition (beta diversity) were observed between HF patients and HCs. In comparison to HCs, HF patients had a greater abundance of Actinobacteria, Proteobacteria, and Synergistetes phyla; Enterococcus, Escherichia, Klebsiella, Lactobacillus, Streptococcus, and Veilonella genera and Ruminococcus gnavus, Streptococcus sp., and Veilonella sp. species. In contrast, there was decreased abundance of Firmicutes phylum; Blautia, Eubacterium, Faecalibacterium, and Lachnospiraceae FCS020 genera; and Dorea longicatena, Eubacterium rectale, Faecalibacterium prausnitzii, Oscillibacter sp., and Sutterella wadsworthensis species in HF patients.
CONCLUSIONS
Gut microbiota diversity, richness, and composition in HF patients differ significantly from the healthy population. Overall, short-chain fatty acid (SCFA)-producing gut microbiota was depleted in HF patients. However, different underlying comorbidities, environments, lifestyles, and dietary choices could affect gut microbiota heterogeneity.
Topics: Adult; Humans; Gastrointestinal Microbiome; Diet; Bacteria; Heart Failure; Inflammation
PubMed: 37774217
DOI: 10.15403/jgld-4779 -
BMC Microbiology Dec 2023There is a link between Helicobacter pylori (HP) infection and small intestinal bacterial overgrowth (SIBO) with nonspecific digestive symptoms. Nonetheless, whether HP... (Meta-Analysis)
Meta-Analysis
BACKGROUND
There is a link between Helicobacter pylori (HP) infection and small intestinal bacterial overgrowth (SIBO) with nonspecific digestive symptoms. Nonetheless, whether HP infection is associated with SIBO in adults remains unclear. Based on a meta-analysis, we evaluated this relationship.
RESULTS
Observational studies relevant to our research were identified by searching PubMed, Embase, the Cochrane Library, and the Web of Science. We evaluated between-study heterogeneity using the Cochrane Q test and estimated the I statistic. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Ten datasets from eight studies, including 874 patients, were involved in the meta-analysis. It was shown that HP infection was related to a higher odds of SIBO (odds ratio [OR]: 1.82, 95% confidence interval: 1.29 to 2.58, p < 0.001) with mild heterogeneity (p for Cochrane Q test = 0.11, I = 7%). Subgroup analyses showed that HP infection was related to SIBO in young patients (mean age < 48 years, OR: 2.68, 95% CI: 1.67 to 4.28, p < 0.001; I = 15%) but not in older patients (mean age ≥ 48 years, OR: 1.15, 95% CI: 0.69 to 1.92, p < 0.60; I = 1%; p for subgroup difference = 0.02). Subgroup analyses further indicated that the association was not significantly affected by the country of study, comorbidities, exposure to proton pump inhibitors, or methods of evaluating HP infection and SIBO.
CONCLUSIONS
HP infection may be related to SIBO in adults, which supports the detection of SIBO in patients with digestive symptoms and HP infection.
Topics: Adult; Humans; Middle Aged; Intestine, Small; Helicobacter pylori; Helicobacter Infections; Proton Pump Inhibitors
PubMed: 38053022
DOI: 10.1186/s12866-023-03063-w -
Journal of Clinical Hypertension... Dec 2023Hypertension is a major public health issue worldwide. The imbalance of gut microbiota is thought to play an important role in the pathogenesis of hypertension. The... (Meta-Analysis)
Meta-Analysis
Hypertension is a major public health issue worldwide. The imbalance of gut microbiota is thought to play an important role in the pathogenesis of hypertension. The authors conducted the systematic review and meta-analysis to clarify the relationship between gut microbiota and hypertension through conducting an electronic search in six databases. Our meta-analysis included 19 studies and the results showed that compared with healthy controls, Shannon significantly decreased in hypertension [SMD = -0.13, 95%CI (-0.22, -0.04), p = .007]; however, Simpson [SMD = -0.01, 95%CI (-0.14, 0.12), p = .87], ACE [SMD = 0.18, 95%CI (-0.06, 0.43), p = .14], and Chao1 [SMD = 0.11, 95%CI (-0.01, 0.23), p = .08] did not differ significantly between hypertension and healthy controls. The F/B ratio significantly increased in hypertension [SMD = 0.84, 95%CI (0.10, 1.58), p = .03]. In addition, Shannon index was negatively correlated with hypertension [r = -0.12, 95%CI (-0.19, -0.05)], but had no significant correlation with SBP [r = 0.10, 95%CI (-0.19, 0.37)] and DBP [r = -0.39, 95%CI (-0.73, 0.12)]. At the phylum level, the relative abundance of Firmicutes [SMD = -0.01, 95%CI (-0.37, 0.34), p = .94], Bacteroidetes [SMD = -0.15, 95%CI (-0.44, 0.14), p = .30], Proteobacteria [SMD = 0.25, 95%CI (-0.01, 0.51), p = .06], and Actinobacteria [SMD = 0.21, 95%CI (-0.11, 0.53), p = .21] did not differ significantly between hypertension and healthy controls. At the genus level, compared with healthy controls, the relative abundance of Faecalibacterium decreased significantly [SMD = -0.16, 95%CI (-0.28, -0.04), p = .01], while the Streptococcus [SMD = 0.20, 95%CI (0.08, 0.32), p = .001] and Enterococcus [SMD = 0.20, 95%CI (0.08, 0.33), p = .002] significantly increased in hypertension. Available evidence suggests that hypertensive patients may have an imbalance of gut microbiota. However, it still needs further validation by large sample size studies of high quality.
Topics: Humans; Hypertension; Gastrointestinal Microbiome
PubMed: 37853925
DOI: 10.1111/jch.14722 -
Helicobacter Dec 2023The question of whether eradication of Helicobacter pylori (Hp) can reverse gastric precancerous lesions, including intestinal metaplasia, remains uncertain, leading to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The question of whether eradication of Helicobacter pylori (Hp) can reverse gastric precancerous lesions, including intestinal metaplasia, remains uncertain, leading to ongoing debate. Therefore, a meta-analysis was performed to evaluate the effect of Hp eradication on gastric precancerous lesions.
MATERIALS AND METHODS
PubMed, Embase, Cochrane Library, Web of Science, Scopus database, and ClinicalTrials.gov were systematically searched from inception to April 2023 for studies that explored the impact of Hp eradication on gastric precancerous lesions. Risk ratios (RRs) and their 95% confidence intervals (95% CIs) were selected as the effect size. We used the random-effects model to assess pooled data. We also performed quality assessments, subgroup analyses, and sensitivity analyses.
RESULTS
Fifteen studies were included. Compared with placebo, Hp eradication could significantly prevent the progression of gastric precancerous lesions (RR = 0.87, 95% CI: 0.81-0.94, p < 0.01) and reverse them (RR = 1.32, 95% CI: 1.17-1.50, p < 0.01). Then, specific precancerous lesions were further explored. The progression of intestinal metaplasia was significantly prevented by Hp eradication compared to placebo or no treatment (RR = 0.80, 95% CI: 0.69-0.94, p < 0.01). Moreover, compared with placebo or no treatment, Hp eradication also improved chronic atrophic gastritis (RR = 1.84, 95% CI: 1.30-2.61, p < 0.01) and intestinal metaplasia (RR = 1.41, 95% CI: 1.15-1.73, p < 0.01). However, in terms of preventing dysplasia progression (RR = 0.86, 95% CI: 0.37-2.00) and improving dysplasia (RR = 0.89, 95% CI: 0.47-1.70), Hp eradication had no advantage compared to placebo or no treatment.
CONCLUSIONS
Hp eradication therapy could prevent the progression of gastric precancerous lesions and reverse them. Notably, intestinal metaplasia can be reversed, but this may only be appropriate for patients with epigenetic alterations and milder lesions.
Topics: Humans; Helicobacter pylori; Helicobacter Infections; Stomach; Stomach Neoplasms; Precancerous Conditions; Metaplasia
PubMed: 37602719
DOI: 10.1111/hel.13013 -
BMC Oral Health Jul 2023Various studies have examined the association between periodontitis and helicobacter pylori and reported conflicting results. The aimed of this systematic review and... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Various studies have examined the association between periodontitis and helicobacter pylori and reported conflicting results. The aimed of this systematic review and meta-analysis estimating the association between these two variables.
METHODS
Electronic databases including PubMed (Medline), Scopus, Web of Sciences and Medline (Elsevier) were searched using the relevant keywords. All observational studies comparing the association between periodontitis and helicobacter pylori were considered. The Newcastle - Ottawa Quality Assessment Scale (NOS) checklist was used for assessing quality of included studies. All statistical analyses were completed using STATA (Version 16).
RESULTS
Twenty-three studies with 8,638 patients (15 case-control with 2,366 patients and 8 cross-sectional with 6,272 patients) were included in this meta-analysis. After combining the selected studies, the odds of presence the Helicobacter pylori infection in patients with the periodontal disease was 2.47 (OR: 2.47; 95% CI: 2.01, 3.03; I: 50.87%; P: 0.001). Also, the odds after combining case-control studies was 2.77 (OR: 2.77; % 95 CI: 2.11, 3.66; I: 37.16%; P: 0.049) and after combining cross-sectional analytical ones, it was equal to 2.07 (OR: 2.07; 95% CI: 1.62, 2.65; I: 43.25%; P: 0.050).
CONCLUSION
Based on the results of this meta-analysis, the association between Helicobacter pylori infection and the periodontal disease is evident.
Topics: Humans; Helicobacter pylori; Helicobacter Infections; Cross-Sectional Studies; Periodontal Diseases; Periodontitis
PubMed: 37496045
DOI: 10.1186/s12903-023-03232-3 -
Clinical Laboratory Oct 2023Acinetobacter baumannii produce biofilm and efflux pumps. This systematic review study aimed to provide new strategies to inhibit the efflux pumps and biofilm in A.... (Review)
Review
BACKGROUND
Acinetobacter baumannii produce biofilm and efflux pumps. This systematic review study aimed to provide new strategies to inhibit the efflux pumps and biofilm in A. baumannii using nanoparticles.
METHODS
In this research, analyses from 2000 to February 24, 2022, were performed by the Statement of Preferred Reporting Items for Systematic Reviews (PRISMA). Keywords include Acinetobacter baumannii (A. baumannii) AND (biofilm) AND (anti-biofilm activity) AND (nanoparticles) AND (solid lipid NPS) AND (lipid nanocarriers), and in other searches include Acinetobacter baumannii (A. baumanni) AND (efflux pumps) AND (nanoparticles) AND (solid lipid NPS) AND (lipid nanocarriers). Searches were conducted in English databases, including Science Direct, PubMed, Scopus, Ovid, and Cochrane.
RESULTS
At first, 136 studies were extracted, but after removing duplicates, 116 cases remained for further analysis. After evaluating the title and abstract of each study, 95 unrelated studies were excluded. The remaining 25 studies were reviewed based on full texts. Considering the inclusion/exclusion criteria, 19 studies were selected. In this study, metal nanoparticles were the most used nanoparticles for anti-biofilm and efflux pump purposes, and among these nanoparticles, silver nanoparticles (AgNPs) contributed the most.
CONCLUSIONS
The present study shows that nanoparticles have potential and significant effects in inhibiting biofilm and efflux pumps in A. baumannii isolates, which researchers can consider in light of the increasing prevalence of antibiotic resistance.
Topics: Humans; Anti-Bacterial Agents; Membrane Transport Proteins; Acinetobacter baumannii; Metal Nanoparticles; Silver; Biofilms; Lipids; Microbial Sensitivity Tests; Drug Resistance, Multiple, Bacterial; Bacterial Proteins
PubMed: 37844038
DOI: 10.7754/Clin.Lab.2023.230227 -
World Journal of Microbiology &... Jul 2023This research aimed to analyze scientific information regarding the prevalence of generic and pathogenic E. coli in the production and supply chain of pork meat,... (Meta-Analysis)
Meta-Analysis Review
This research aimed to analyze scientific information regarding the prevalence of generic and pathogenic E. coli in the production and supply chain of pork meat, considering different types of samples, places of sampling, and pathotypes using a systematic review and meta-analysis tools. The meta-analysis for the prevalence of generic and pathogenic E. coli was conducted by estimating the effects within subgroups. Data subsets were analyzed using the DerSimonian-Laird method for binary random effects. The average prevalence of generic E. coli in different types of pork meat samples was determined to be 35.6% (95% CI 19.3-51.8), with no significant differences observed between pork meat and carcasses. Conversely, the average prevalence of E. coli pathotypes in samples related to the supply chain of pork meat was found to be 4.7% (95% CI 3.7-5.7). In conclusion, these findings suggest the possibility of establishing an objective threshold for E. coli prevalence as a benchmark for comparison within the meat industry. By utilizing this data, it becomes possible to propose a standardized limit that can serve as a reference point for evaluating and improving processes in the industry.
Topics: Animals; Swine; Escherichia coli; Red Meat; Pork Meat; Prevalence; Meat; Food Microbiology
PubMed: 37428340
DOI: 10.1007/s11274-023-03687-0 -
Clinical Infectious Diseases : An... Jan 2024Tularemia is caused by the gram-negative bacterium Francisella tularensis. Although rare, tularemia during pregnancy has been associated with pregnancy complications;...
BACKGROUND
Tularemia is caused by the gram-negative bacterium Francisella tularensis. Although rare, tularemia during pregnancy has been associated with pregnancy complications; data on efficacy of recommended antimicrobials for treatment are limited. We performed a systematic literature review to characterize clinical manifestations of tularemia during pregnancy and examine maternal, fetal, and neonatal outcomes with and without antimicrobial treatment.
METHODS
We searched 9 databases, including Medline, Embase, Global Health, and PubMed Central, using terms related to tularemia and pregnancy. Articles reporting cases of tularemia with ≥1 maternal or fetal outcome were included.
RESULTS
Of 5891 articles identified, 30 articles describing 52 cases of tularemia in pregnant patients met inclusion criteria. Cases were reported from 9 countries, and oropharyngeal and ulceroglandular tularemia were the most common presenting forms. A plurality (46%) of infections occurred in the second trimester. Six complications were observed: lymph node aspiration, lymph node excision, maternal bleeding, spontaneous abortion, intrauterine fetal demise, and preterm birth. No deaths among mothers were reported. Of 28 patients who received antimicrobial treatment, 1 pregnancy loss and 1 fetal death were reported. Among 24 untreated patients, 1 pregnancy loss and 3 fetal deaths were reported, including one where F. tularensis was detected in placental and fetal tissues.
CONCLUSIONS
Pregnancy loss and other complications have been reported among cases of tularemia during pregnancy. However, risk of adverse outcomes may be lower when antimicrobials known to be effective are used. Without treatment, transplacental transmission appears possible. These data underscore the importance of prompt recognition and treatment of tularemia during pregnancy.
Topics: Humans; Female; Infant, Newborn; Pregnancy; Tularemia; Premature Birth; Placenta; Francisella tularensis; Abortion, Spontaneous; Anti-Infective Agents
PubMed: 38294114
DOI: 10.1093/cid/ciad686 -
World Journal of Gastroenterology Mar 2024() infects over half the global population, causing gastrointestinal diseases like dyspepsia, gastritis, duodenitis, peptic ulcers, G-MALT lymphoma, and gastric... (Meta-Analysis)
Meta-Analysis
BACKGROUND
() infects over half the global population, causing gastrointestinal diseases like dyspepsia, gastritis, duodenitis, peptic ulcers, G-MALT lymphoma, and gastric adenocarcinoma. Eradicating is crucial for treating and preventing these conditions. While conventional proton pump inhibitor (PPI)-based triple therapy is effective, there's growing interest in longer acid suppression therapies. Potassium competitive acid blocker (P-CAB) triple and dual therapy are new regimens for eradication. Initially used in Asian populations, vonoprazan (VPZ) has been recently Food and Drug Administration-approved for eradication.
AIM
To assess the efficacy of regimens containing P-CABs in eradicating infection.
METHODS
This study, following PRISMA 2020 guidelines, conducted a systematic review and meta-analysis by searching MEDLINE and Scopus libraries for randomized clinical trials (RCTs) or observational studies with the following command: [("" OR "H pylori") AND ("Treatment" OR "Therapy" OR "Eradication") AND ("Vonaprazan" OR "Potassium-Competitive Acid Blocker" OR "P-CAB" OR "PCAB" OR "Revaprazan" OR "Linaprazan" OR "Soraprazan" OR "Tegoprazan")]. Studies comparing the efficacy of P-CABs-based treatment to classical PPIs in eradicating were included. Exclusion criteria included case reports, case series, unpublished trials, or conference abstracts. Data variables encompassed age, diagnosis method, sample sizes, study duration, intervention and control, and eradication method were gathered by two independent reviewers. Meta-analysis was performed in R software, and forest plots were generated.
RESULTS
A total of 256 references were initially retrieved through the search command. Ultimately, fifteen studies (7 RCTs, 7 retrospective observational studies, and 1 comparative unique study) were included, comparing P-CAB triple therapy to PPI triple therapy. The intention-to-treat analysis involved 8049 patients, with 4471 in the P-CAB intervention group and 3578 in the PPI control group across these studies. The analysis revealed a significant difference in eradication between VPZ triple therapy and PPI triple therapy in both RCTs and observational studies [risk ratio (RR) = 1.17, 95% confidence interval (CI): 1.11-1.22, < 0.0001] and (RR = 1.13, 95%CI: 1.09-1.17, < 0.0001], respectively. However, no significant difference was found between tegoprazan (TPZ) triple therapy and PPI triple therapy in both RCTs and observational studies (RR = 1.04, 95%CI: 0.93-1.16, = 0.5) and (RR = 1.03, 95%CI: 0.97-1.10, = 0.3), respectively.
CONCLUSION
VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating , positioning it as a highly effective first-line regimen. Additionally, TPZ-based triple therapy was non-inferior to classical PPI triple therapy.
Topics: Humans; Anti-Bacterial Agents; Clarithromycin; Helicobacter pylori; Proton Pump Inhibitors; Drug Therapy, Combination; Helicobacter Infections; Pyrroles; Amoxicillin; Treatment Outcome; Randomized Controlled Trials as Topic; Observational Studies as Topic; Benzene Derivatives; Imidazoles; Sulfonamides
PubMed: 38577188
DOI: 10.3748/wjg.v30.i9.1213