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Microbial Pathogenesis Nov 2023Gram-negative bacteria are infectious and life-threatening agents after hematopoietic stem cell transplantation (HSCT). So, this study aimed to investigate the... (Review)
Review
Gram-negative bacteria are infectious and life-threatening agents after hematopoietic stem cell transplantation (HSCT). So, this study aimed to investigate the prevalence of Pseudomonas aeruginosa and its antibiotic resistance in patients who have received Hematopoietic Stem-Cell Transplantation through a systematic review. The systematic search was done with key words; Pseudomonas aeruginosa, hematopoietic stem cell transplantation from 2000 to the end of July 2023 in Google Scholar and PubMed/Medline, Scopus, and Web of Science. Twelve studies were able to include our study. Quality assessment of studies was done by Appraisal tool for Cross-Sectional Studies. The most of the included studies were conducted as allo-HSCT. Infections such as respiratory infection, urinary infection and bacteremia have occurred. The rate of prevalence with P. aeruginosa has varied between 3 and 100%. The average age of the participants was between 1 and 74 years. The rate of prevalence of P. aeruginosa resistant to several drugs has been reported to be variable, ranging from 20 to 100%. The highest antibiotic resistance was reported against cefotetan (100%), and the lowest was related to tobramycin (1.8%) followed by amikacin, levofloxacin and ciprofloxacin with the prevalence of 16.6%. Our findings showed a high prevalence and antibiotic resistance rate of P. aeruginosa in Hematopoietic stem cell transplantation. Therefore, more serious health measures should be taken in patients after transplantation.
Topics: Humans; Anti-Bacterial Agents; Cross-Sectional Studies; Drug Resistance, Multiple, Bacterial; Hematopoietic Stem Cell Transplantation; Prevalence; Pseudomonas aeruginosa; Pseudomonas Infections
PubMed: 37769854
DOI: 10.1016/j.micpath.2023.106368 -
Journal of Global Antimicrobial... Sep 2019This meta-analysis aimed to evaluate the current prevalence and trends over the past 10 years of Pseudomonas aeruginosa (P. aeruginosa) antimicrobial resistance. Two... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This meta-analysis aimed to evaluate the current prevalence and trends over the past 10 years of Pseudomonas aeruginosa (P. aeruginosa) antimicrobial resistance. Two researches independently searched two national (ULAKBİM, Türk Medline) and two international databases (PubMed, Web of Science) to identify studies on P. aeruginosa resistance to antimicrobials from 2007 to 2017.
METHODS
Homogeneity across studies was assessed using Cochrane guidelines, and total variability due to between-study variations was reflected in the I index. A random effects model was developed to estimate the antimicrobial resistance rates and their corresponding 95% CI. Pooled antibiotic resistance rates between 2007-2011 and 2012-2016 were compared to calculate the change in antibiotic resistance over time. Electronic searches with MeSH terms and text words identified 1017 papers. After applying exclusion and inclusion criteria, 45 articles were selected.
RESULTS
Pooled resistance prevalence of P. aeruginosa to piperacillin-tazobactam, ceftazidime, cefepime, meropenem, imipenem, ciprofloxacin, gentamicin, amikacin, tobramycin and colistin were 33.9%, 38.6%, 35.6%, 30.1%, 28.0%, 30.7%, 28.2%, 17.8%, 15.7% and 2.2%, respectively. The resistance rates of piperacillin, piperacillin-tazobactam, imipenem, meropenem, amikacin and colistin significantly increased in the second 5 years (P<0.05); however, gentamicin, tobramycin and ciprofloxacin resistance rates significantly decreased (P<0.05). Comparing the resistance rates between the isolates of intensive care unit (ICU) patients and non-ICU patients, meropenem and piperacillin-tazobactam resistance in ICU isolates were significantly higher than non-ICU (P<0.05).
CONCLUSIONS
These results suggest that antibiotic resistance is high in P. aeruginosa and the trends in antimicrobial resistance continue to increase, mainly in carbapenems and penicillins, in Turkey.
Topics: Anti-Bacterial Agents; Drug Resistance, Multiple, Bacterial; Humans; Intensive Care Units; Microbial Sensitivity Tests; Prevalence; Pseudomonas Infections; Pseudomonas aeruginosa; Turkey
PubMed: 30753904
DOI: 10.1016/j.jgar.2019.01.032 -
The Journal of Spinal Cord Medicine Jul 2023Despite a high urinary tract infection (UTI) rate in spinal cord injured patents in China, there is limited evidence on the epidemiological character of that. (Meta-Analysis)
Meta-Analysis
Epidemiology of pathogens and antimicrobial resistance of nosocomial urinary tract infections in patients with spinal cord injuries in China: A systematic review and meta-analysis.
CONTEXT
Despite a high urinary tract infection (UTI) rate in spinal cord injured patents in China, there is limited evidence on the epidemiological character of that.
OBJECTIVE
The purpose of our article was to characterize the distribution of pathogens of UTI patients with spinal cord injuries (SCI) and the resistance profile of pathogens.
METHODS
A literature search of six electronic databases was carried out to identify the incidence, pathogen distribution, and drug resistance of UTI after SCI based on our inclusion and exclusion criteria. Meta-analysis was carried out using R 4.0.2 software; a subgroup analysis was performed by the year 2012.
RESULTS
We screened 1110 eligible studies, 33 were included in our final review. A total of 7271 bacterial species were included in our studies; 6092 were gram-negative (81.13% [76.83-85.11]) and 1003 were gram-positive (14.89% [11.70-18.38]). Before 2012, (45.43%) was the predominant isolated pathogen, followed by Klebsiella (7.49%) and Enterococcus (6.01%). After 2012, (50.23%) was the main pathogen, followed by Klebsiella (12.47%) and Proteus (6.88%). was more likely to be resistant to Levofloxacin, Amikacin, sulfonamides, 4th-generation cephalosporins and Nitrofurantoin before 2012 (81.8% vs. 62.9%, 32.0% vs. 7.6%, 81.3% vs. 61.6%, 81.8% vs. 24.1%, 33.5% vs. 5.1%), whereas was more frequently resistant to Inhibitor-resistant β-lactamas after 2012 (56.3% vs. 34.0%). was more likely to be resistant to Aztreonam, Amikacin before 2012 (80.0% vs. 39.8%, 48.1% vs. 19.0%). presented a high resistance to Levofloxacin, Inhibitor-resistant β-lactamas after 2012 (61.8% vs. 35.6%, 59.1% vs. 5.7%).
CONCLUSIONS
UTI in patients with SCI in China were mainly caused by gram-negative bacteria. We observed a remarkable modification in resistance profiles of pathogen distribution before 2012 and after 2012, which suggests reasonable control of the use of antibiotics has a positive effectiveness on resistance profiles.
Topics: Humans; Anti-Bacterial Agents; Amikacin; Levofloxacin; Cross Infection; Escherichia coli; Drug Resistance, Bacterial; Spinal Cord Injuries; Urinary Tract Infections
PubMed: 36622339
DOI: 10.1080/10790268.2022.2129154 -
Prevalence of antibiotic resistance in clinical isolates of : a systematic review and meta-analysis.Expert Review of Anti-infective Therapy Jan 2024The prevalence of diseases caused by non-tuberculous mycobacteria (NTM), including , is increasing, necessitating further information to guide prevention, control, and... (Review)
Review
INTRODUCTION
The prevalence of diseases caused by non-tuberculous mycobacteria (NTM), including , is increasing, necessitating further information to guide prevention, control, and treatment strategies.
AREAS COVERED
A comprehensive analysis of articles published until February 2023 was conducted on PubMed, Web of Science, and Scopus databases to investigate antibiotic resistance in species. Stata software version 17 was employed for all analyses.
EXPERT OPINION
A total of 1647 articles were obtained through database search. After removing duplicates and unrelated studies, 17 cross-sectional studies that examined the breakpoints proposed by CLSI were included. The rates of resistance of to various antibiotics were as follows: clarithromycin (0%), rifampin (1%), amikacin (0%), ciprofloxacin (14%), linezolid (0%), moxifloxacin (0%), rifabutin (1%), doxycycline (96%), and SXT (49%). Our findings underscore the importance of managing and monitoring the use of these antibiotics, as well as the need for further studies to elucidate the exact mechanism of resistance to these antibiotics.
PubMed: 38294514
DOI: 10.1080/14787210.2024.2313051 -
Scientific Reports Mar 2021Treatment of ventilated patients with gram-negative pneumonia (GNP) is often unsuccessful. We aimed to assess the efficacy and safety of nebulized amikacin (NA) as... (Meta-Analysis)
Meta-Analysis
Amikacin nebulization for the adjunctive therapy of gram-negative pneumonia in mechanically ventilated patients: a systematic review and meta-analysis of randomized controlled trials.
Treatment of ventilated patients with gram-negative pneumonia (GNP) is often unsuccessful. We aimed to assess the efficacy and safety of nebulized amikacin (NA) as adjunctive therapy to systemic antibiotics in this patient population. PubMed, Embase, China national knowledge infrastructure, Wanfang, and the Cochrane database were searched for randomized controlled trials (RCTs) investigating the effect of NA as adjunctive therapy in ventilated adult patients with GNP. Heterogeneity was explored using subgroup analysis and sensitivity analysis. The Grading of recommendations assessment, development, and evaluation approach was used to assess the certainty of the evidence. Thirteen RCTs with 1733 adults were included. The pooled results showed NA had better microbiologic eradication (RR = 1.51, 95% CI 1.35 to 1.69, P < 0.0001) and improved clinical response (RR = 1.23; 95% CI 1.13 to 1.34; P < 0.0001) when compared with control. Meanwhile, overall mortality, pneumonia associated mortality, duration of mechanical ventilation, length of stay in ICU and change of clinical pneumonia infection scores were similar between NA and control groups. Additionally, NA did not add significant nephrotoxicity while could cause more bronchospasm. The use of NA adjunctive to systemic antibiotics therapy showed better benefits in ventilated patients with GNP. More well-designed RCTs are still needed to confirm our results.
Topics: Adult; Aged; Amikacin; Anti-Bacterial Agents; Critical Care; Gram-Negative Bacterial Infections; Humans; Intensive Care Units; Length of Stay; Middle Aged; Nebulizers and Vaporizers; Pneumonia, Bacterial; Pneumonia, Ventilator-Associated; Respiration, Artificial; Treatment Outcome
PubMed: 33772055
DOI: 10.1038/s41598-021-86342-8 -
Medicine Feb 2021Meropenem monotherapy vs ceftazidime plus amikacin have been approved for use against febrile neutropenia. To assess the effectiveness and safety of them for empirical... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Meropenem monotherapy vs ceftazidime plus amikacin have been approved for use against febrile neutropenia. To assess the effectiveness and safety of them for empirical treatment of cancer patients with febrile neutropenia, we conducted a meta-analysis of randomized controlled trial.
METHODS
Randomized controlled trials on ceftazidime plus amikacin, or/and monotherapy with meropenem for the treatment of cancer patients with febrile neutropenia were identified by searching Cochrane Library, PubMed, Science Direct, Wiley Online, Science Citation Index, Google (scholar), National Center for Biotechnology Information, and China National Knowledge Infrastructure. Data on interventions, participants' characteristics and the outcomes of therapy, were extracted for statistical analysis. Seven trials fulfilled the inclusion criteria.
RESULT
The treatment with ceftazidime plus amikacin was more effective than meropenem (OR = 1.17; 95% CI 0.93-1.46; 1270 participants). However, the treatment effects of the 2 therapy methods were almost parallel in adults (OR = 1.15; 95% CI 0.91-1.46; 1130 participants older than 16). Drug-related adverse effects afflicted more patients treated with ceftazidime plus amikacin (OR = 0.78; 95% CI 0.52-1.15; 1445 participants). The common responses were nausea, diarrhea, rash, and increased in serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase and bilirubin.
CONCLUSION
Ceftazidime plus amikacin should be the first choice for empirical treatment of cancer patients with febrile neutropenia, and meropenem may be chosen as a last defense against pathogenic bacteria.
Topics: Amikacin; Anti-Bacterial Agents; Ceftazidime; Drug Therapy, Combination; Febrile Neutropenia; Humans; Meropenem; Neoplasms
PubMed: 33663117
DOI: 10.1097/MD.0000000000024883 -
International Journal of Microbiology 2022Carbapenems are the last-line therapy for multidrug-resistant (MDR) infections caused by including those caused by species. However, the recent emergence of...
BACKGROUND
Carbapenems are the last-line therapy for multidrug-resistant (MDR) infections caused by including those caused by species. However, the recent emergence of carbapenem-resistant (CR) and extended-spectrum -lactamase (ESBL)-producing pathogens, which are resistant to nearly all antibiotics, has raised concerns among international healthcare organizations. Hence, because there is no comprehensive data in Iran, the current study aimed to evaluate the prevalence of antibiotic resistance among species, especially CR and ESBL-producing strains, in Iran.
METHODS
The literature search was performed up to June 21, 2021, in national and international databases using MeSH-extracted keywords, i.e., , antibiotic resistance, carbapenem, ESBL, and Iran. Study selection was done based on the predefined inclusion and exclusion criteria, and data analysis was carried out using the Comprehensive Meta-Analysis (CMA) software.
RESULTS
The pooled prevalence of species resistant to various antibiotics is as follows: imipenem 16.6%, meropenem 16.2%, aztreonam 40.9%, ciprofloxacin 35.3%, norfloxacin 31%, levofloxacin 48%, gentamicin 42.1%, amikacin 30.3%, tobramycin 37.2%, tetracycline 50.1%, chloramphenicol 25.7%, trimethoprim/sulfamethoxazole 52%, nalidixic acid 49.1%, nitrofurantoin 43%, ceftriaxone 49.3%, cefixime 52.4%, cefotaxime 52.7%, ceftazidime 47.9%, cefepime 43.6%, and ceftizoxime 45.5%. The prevalence rates of MDR and ESBL-producing species in Iran were 63.1% and 32.8%, respectively.
CONCLUSION
In accordance with the warning of international organizations, our results revealed a high prevalence of ESBL-producing species in Iran, which is probably associated with the high prevalence of species resistant to most of the assessed antibiotics, especially MDR strains. However, the resistance rate to carbapenems was relatively low, and these drugs can still be considered as drugs of choice for the treatment of infections in Iran. Nevertheless, continuous monitoring of drug resistance along with antibiotic therapy based on the local data and evaluation of the therapeutic efficacy of new antibiotics or combination therapeutic strategies, such as ceftazidime/avibactam, meropenem/vaborbactam, plazomicin, and eravacycline, is recommended.
PubMed: 36312785
DOI: 10.1155/2022/8367365 -
Frontiers in Medicine 2024Corynebacterium, Nocardia, Rhodococcus, Mycobacterium, as well as Gordonia genera belongs to the genus Gordonia, Actinomycetia class. is a nitrate-reducing,...
BACKGROUND
Corynebacterium, Nocardia, Rhodococcus, Mycobacterium, as well as Gordonia genera belongs to the genus Gordonia, Actinomycetia class. is a nitrate-reducing, urease-producing, non-motile, force aerobe with a rod-like figure that is known to arrangement into sessile, cord-like groups. This systematic review aimed to establish whether and what invasive infections in humans were caused by , and to evaluate outcomes of administered antibiotic treatment.
METHODS
We have registered this systematic review in PROSPERO database of systematic reviews and meta-analyses with the number CRD42022369974.
RESULTS
A total of 24 publications were included (22 case reports and two case series) with 28 individual cases. The oldest patients had 92 years, and the youngest patients had 13 years. Clinical signs of infection were present in six patients (21%). All isolates were susceptible to ciprofloxacin, imipenem, and amikacin. Vancomycin was the most frequently used antibiotic with nine cases followed by ciprofloxacin, ceftriaxone, and amoxicillin/clavulanic acid.
CONCLUSION
Although there are no standardized recommendations to date, successful treatment with a favorable outcome has most often been carried out with fluoroquinolones, vancomycin with or without aminoglycosides, as well as carbapenems.
PubMed: 38515988
DOI: 10.3389/fmed.2024.1333663 -
Expert Review of Anti-infective Therapy Jul 2022(), a non-tuberculous mycobacterium (NTM), rare causes infection including localized pulmonary to disseminated disease in immunocompromised patients. An optimal...
INTRODUCTION
(), a non-tuberculous mycobacterium (NTM), rare causes infection including localized pulmonary to disseminated disease in immunocompromised patients. An optimal pharmacological management practice has not yet been defined for this infection. This study investigates drug regimens and treatment outcomes in patients with M. simiae to describe different drug regimen with the therapeutic response.
AREAS COVERED
The three databases PubMed, Scopus, and Web of science were systematically searched from June 1994 to June 2021 to retrieve relevant articles. The inclusion criterion included studies, which reported treatment outcomes in patients with infections. Treatment success was defined as the achievement of culture conversion, and the improvement of the symptoms and radiologic signs among the patients.
EXPERT OPINION
Data of 223 patients were retrieved from 40 studies. Duration of the treatment regimens used in different studies ranged from 2 to 12 months. The most common treatment regimens administered for infection were as follows: clarithromycin, rifampin, ethambutol, moxifloxacin, or ciprofloxacin and amikacin plus cotrimoxazole or pyrazinamide in some regimens. Macrolides, such as clarithromycin, combined with quinolones (such as moxifloxacin) and TMP/SMX, which are used in combination, had the most significant effect on eliminating the pulmonary signs of .
Topics: Clarithromycin; Humans; Moxifloxacin; Mycobacterium; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination
PubMed: 35306950
DOI: 10.1080/14787210.2022.2056019 -
APMIS : Acta Pathologica,... Feb 2024The objectives of this study were to perform a systematic review of publications between 2010 and 2021 on the antibiotic resistance of Pseudomonas aeruginosa and...
The objectives of this study were to perform a systematic review of publications between 2010 and 2021 on the antibiotic resistance of Pseudomonas aeruginosa and Acinetobacter baumannii from urinary tract infections and to analyze changes over time in hospital urine cultures from 2016 through 2021. The literature was searched, and a retrospective cross-sectional descriptive study was performed in the hospital. Out of 21 838 positive urine cultures, 3.86% were due to P. aeruginosa and 0.44% were due to A. baumannii. For P. aeruginosa, lower resistance rates were observed to virtually all tested antibiotics than were obtained in the systematic review, and the present series of hospital samples showed an in vitro resistance rate <10% to ceftazidime, cefepime, meropenem, piperacillin-tazobactam, amikacin, tobramycin, and colistin. For A. baumannii, the resistance rates to almost all antibiotics were higher in the present series than in the systematic review, being lowest to colistin (10%). Both microorganisms show reduced in vitro susceptibility to some antibiotics during the years of the COVID-19 pandemic in comparison to previous years. In our setting, both piperacillin-tazobactam and meropenem can be recommended for the empirical treatment of UTIs by P. aeruginosa, whereas only colistin can be recommended for UTIs by A. baumannii.
Topics: Humans; Pseudomonas aeruginosa; Meropenem; Acinetobacter baumannii; Spain; Colistin; Cross-Sectional Studies; Retrospective Studies; Pandemics; Anti-Bacterial Agents; Pseudomonas Infections; Piperacillin, Tazobactam Drug Combination; Urinary Tract Infections; Drug Resistance, Multiple, Bacterial; Hospitals; Microbial Sensitivity Tests
PubMed: 37971152
DOI: 10.1111/apm.13360