scholarly journals GENES CONFERRING ANTIMICROBIAL-RESISTANCE AMONG KLEBSIELLA PNEUMONIAE IN THE ARABIAN GULF COUNTRIES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author(s):  
KHALID MUBARAK BINDAYNA ◽  
RONNI MOL JOJI ◽  
HICHAM EZZAT ◽  
HAITHAM ALI JAHRAMI

Objective: The objective of the study was to look on the prevalence of six AMR genes (CTX-M, TEM, SHV, NDM-1, OXA-48, and VIM genes) in the province of the Arabian Gulf. We performed a systematic review and meta-analysis of the published studies from the Arabian Gulf countries and analyzed the antimicrobial resistance (AMR) genes pattern present in Klebsiella pneumoniae. Methods: The present study used the Meta-analysis Of Observational Studies in Epidemiology as a guideline for reporting findings. An electronic search was conducted in online databases such as PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, Science Direct, and Web of Science from January 2014 to June 2020 following the inclusion and exclusion criteria. Articles published were included in the study resistance pattern among 2036 isolates were analyzed. These isolates conferred the AMR genes including OXA-48 (n=500), CTX-M (n= 1796), SHV (n=1637), TEM (n=1492), NDM-1 (n=500), and VIM (n=302). Results: Of 160 initially searched studies, 28 entries met the inclusion criteria and were subjected to meta-analysis. Critical appraisal of studies or quality assessment revealed a mean quality score was 4.2, with an SD of 1.6. The analysis revealed predominant AMR genes wereOXA-48 followed by CTX-M, SHV, TEM, NDM-1, and VIM in the Arabian Gulf region. Conclusion: The Arabian Gulf countries share a high prevalence of OXA-48, CTX-M followed by SHV, TEM, NDM-1, and VIM genes. Antimicrobial-resistant in K. pneumoniae is a threat to public health and this needs strong surveillance to curb this threat.

2020 ◽  
Author(s):  
Khalid Mubarak Bindayna ◽  
Ronni Mol Joji ◽  
Hicham Ezzat ◽  
Haitham Ali Jahrami

Abstract Klebsiella is the common pathogen which causes pneumonia, UTI, and bloodstream infections. The vast majority of Klebsiella infections are hospital-acquired. Since the recognition of this as bacteria, it has always been a challenge for the clinicians to find effective treatment against their infections. Several studies are addressing increased antimicrobial resistance rates and different antimicrobial genes in various areas of the Arabian Gulf. Here we aimed to look upon the prevalence of six AMR genes (CTX M, TEM, SHV, NDM, OXA, VIM genes) in this province. We performed a systematic review and meta-analysis of the published studies from the Arabian Gulf countries and analysed the antimicrobial resistance genes pattern present in Klebsiella pneumoniae. Materials and methods The present study used the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) as a guideline for reporting findings. An electronic search was conducted in online databases such as PubMed/MEDLINE, EMBASE, Scopus, Cochrane, Google Scholar, Science Direct, and Web of Science from December 2017 to February 2019 following the inclusion and exclusion criteria. Results Of 160 initially searched studies, 28 entries met the inclusion criteria and were subjected to meta-analysis. Critical appraisal of studies or quality assessment revealed mean quality score was 4.2, with an SD of 1.6. The analysis revealed predominant antimicrobial resistance genes were OXA followed by CTX-M, SHV, TEM, NDM, and VIM in the Arabian Gulf region. Conclusion The antibiotic resistance gene prevalences in Klebsiella pneumoniae in countries of the Arabian Gulf have been reviewed in this study. These countries share a high prevalence of OXA, CTX-M followed by SHV, TEM, NDM, and VIM genes. Antimicrobial-resistant in K. pneumoniae is a threat to public health and this needs strong surveillance to curb this threat.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262597
Author(s):  
Tebelay Dilnessa ◽  
Alem Getaneh ◽  
Workagegnehu Hailu ◽  
Feleke Moges ◽  
Baye Gelaw

Background Clostridium difficile is the leading cause of infectious diarrhea that develops in patients after hospitalization during antibiotic administration. It has also become a big issue in community-acquired diarrhea. The emergence of hypervirulent strains of C. difficile poses a major problem in hospital-associated diarrhea outbreaks and it is difficult to treat. The antimicrobial resistance in C. difficile has worsened due to the inappropriate use of broad-spectrum antibiotics including cephalosporins, clindamycin, tetracycline, and fluoroquinolones together with the emergence of hypervirulent strains. Objective To estimate the pooled prevalence and antimicrobial resistance pattern of C. difficile derived from hospitalized diarrheal patients, a systematic review and meta-analysis was performed. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review published studies conducted. We searched bibliographic databases from PubMed, Scopus, Google Scholar, and Cochrane Library for studies on the prevalence and antimicrobial susceptibility testing on C. difficile. The weighted pooled prevalence and resistance for each antimicrobial agent was calculated using a random-effects model. A funnel plot and Egger’s regression test were used to see publication bias. Results A total of 15 studies were included. Ten articles for prevalence study and 5 additional studies for antimicrobial susceptibility testing of C. difficile were included. A total of 1967/7852 (25%) C. difficile were isolated from 10 included studies for prevalence study. The overall weighted pooled proportion (WPP) of C. difficile was 30% (95% CI: 10.0–49.0; p<0.001). The analysis showed substantial heterogeneity among studies (Cochran’s test = 7038.73, I2 = 99.87%; p<0.001). The weighed pooled antimicrobial resistance (WPR) were: vancomycin 3%(95% CI: 1.0–4.0, p<0.001); metronidazole 5%(95% CI: 3.0–7.0, p<0.001); clindamycin 61%(95% CI: 52.0–69.0, p<0.001); moxifloxacin 42%(95% CI: 29–54, p<0.001); tetracycline 35%(95% CI: 22–49, p<0.001); erythromycin 61%(95% CI: 48–75, p<0.001) and ciprofloxacin 64%(95% CI: 48–80; p< 0.001) using the random effect model. Conclusions A higher weighted pooled prevalence of C. difficile was observed. It needs a great deal of attention to decrease the prevailing prevalence. The resistance of C. difficile to metronidazole and vancomycin was low compared to other drugs used to treat C. difficile infection. Periodic antimicrobial resistance monitoring is vital for appropriate therapy of C. difficile infection.


2021 ◽  
Author(s):  
Mei Zeng ◽  
Yue Qiu ◽  
Daojiong Lin ◽  
Yi Xu ◽  
Yibing Cheng ◽  
...  

Abstract Background:High prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a serious clinical concern in China. This study first described the risk factors, outcomes and antimicrobial resistance pattern of healthcare-associated KP infections in Chinese pediatric patients.Methods:This retrospective study was conducted in the nine tertiary hospitals during 2016-2018. The 324 pediatric inpatients who had KP isolated from blood and cerebrospinal fluid and had complete medical records reviewed were included. We analyzed the risk factors, outcomes and antimicrobial resistance pattern of KP-infected patients based on comparison between healthcare-associated KP infections (HAI) and community-acquired infections.Result:Of the 324 enrolled patients, 275 (84.9%) were clinically defined as HAI, including 175 (63.6%) neonates and 100 (36.4%) aged >28 days. The overall prevalence of CRKP was 35.8% (40.4% in HAI verse 10.2% in CAI, P <0.05). Prematurity (odds ratio (OR):37.07, 95% CI:8.29-165.84), hematologic malignancies (OR:15.52, 95% CI:1.89-127.14) and invasive mechanical ventilation (OR:13.09, 95% CI: 1.66-103.56) were independent risk factors for HAI. Patients from rural area (OR: 1.78, 95% CI:1.06-2.99), invasive mechanical ventilation (OR:1.79, 95% CI: 1.01-3.19), antibiotic therapy prior to admission (OR: 1.88, 95% CI:1.07-3.29) and prior hospital stay in the past 30 days (OR: 2.17, 95% CI:1.26-3.73) were associated with healthcare-associated CRKP infections. Organ dysfunction was independently correlated with poor outcomes (OR:2.92, 95% CI: 1.23-6.95)Conclusions:Pediatric invasive KP infections and high prevalence of CRKP infections largely occurred in health-care settings in China. The adequate and intensified infection control measures should be focused on high-risk hematologic patients, neonatal patients and intubated patients.


One Health ◽  
2021 ◽  
pp. 100286
Author(s):  
Biruk Alemu Gemeda ◽  
Ayalew Assefa ◽  
Megarsa Bedasa Jaleta ◽  
Kebede Amenu ◽  
Barbara Wieland

2021 ◽  
Vol 22 (9) ◽  
pp. 4480
Author(s):  
Maria Tziastoudi ◽  
Georgios Pissas ◽  
Georgios Raptis ◽  
Christos Cholevas ◽  
Theodoros Eleftheriadis ◽  
...  

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the ABCB1, IL-10, ITPA, MIF, and TNF genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.


2019 ◽  
Vol 95 (5) ◽  
pp. 328-335 ◽  
Author(s):  
Manuel Cina ◽  
Lukas Baumann ◽  
Dianne Egli-Gany ◽  
Florian S Halbeisen ◽  
Hammad Ali ◽  
...  

BackgroundMycoplasma genitalium is increasingly seen as an emerging sexually transmitted pathogen, and has been likened to Chlamydia trachomatis, but its natural history is poorly understood. The objectives of this systematic review were to determine M. genitalium incidence, persistence, concordance between sexual partners and the risk of pelvic inflammatory disease (PID).MethodsWe searched Medline, EMBASE, LILACS, IndMed and African Index Medicus from 1 January 1981 until 17 March 2018. Two independent researchers screened studies for inclusion and extracted data. We examined results in forest plots, assessed heterogeneity and conducted meta-analysis where appropriate. Risk of bias was assessed for all studies.ResultsWe screened 4634 records and included 18 studies; six (4201 women) reported on incidence, five (636 women) on persistence, 10 (1346 women and men) on concordance and three (5139 women) on PID. Incidence in women in two very highly developed countries was 1.07 per 100 person-years (95% CI 0.61 to 1.53, I2 0%). Median persistence of M. genitalium was estimated from one to three months in four studies but 15 months in one study. In 10 studies measuring M. genitalium infection status in couples, 39%–50% of male or female sexual partners of infected participants also had M. genitalium detected. In prospective studies, PID incidence was higher in women with M. genitalium than those without (risk ratio 1.73, 95% CI 0.92 to 3.28, I2 0%, two studies).DiscussionIncidence of M. genitalium in very highly developed countries is similar to that for C. trachomatis, but concordance might be lower. Taken together with other evidence about age distribution and antimicrobial resistance in the two infections, M. genitalium is not the new chlamydia. Synthesised data about prevalence, incidence and persistence of M. genitalium infection are inconsistent. These findings can be used for mathematical modelling to investigate the dynamics of M. genitalium.Registration numbersCRD42015020420, CRD42015020405


Author(s):  
Marília de Oliveira Crispim ◽  
Cândida Maria Rodrigues dos Santos ◽  
Iracema da Silva Frazão ◽  
Cecília Maria Farias de Queiroz Frazão ◽  
Rossana Carla Rameh de Albuquerque ◽  
...  

Objective: to identify the prevalence of suicidal behavior in young university students. Method: a systematic review with meta-analysis of cross-sectional studies based on the Joanna Briggs Institute proposal, and carried out in the PubMed, Web of Science, Scopus, PsycINFO and LILACS databases and in the Brazilian Digital Library of Theses and Dissertations, with no language or year restrictions. A total of 2,942 publications were identified. Selection, data extraction and methodological evaluation of the studies were performed by two independent researchers. The meta-analysis was performed considering the random effects model. Results: eleven articles were included in this review. The prevalence variation for suicidal ideation was from 9.7% to 58.3% and, for attempted suicide, it was from 0.7% to 14.7%. The meta-analysis showed a 27.1% prevalence for suicidal ideation in life, 14.1% for ideation in the last year, and 3.1% for attempted suicide in life. Conclusion: the high prevalence of suicidal behavior, even with the considerable heterogeneity of the studies, raises the need to implement interventions aimed at preventing suicide and promoting mental health, especially in the academic environment.


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