鲍曼不动杆菌
医学
荟萃分析
置信区间
多重耐药
肺炎
抗生素耐药性
死亡率
入射(几何)
呼吸机相关性肺炎
内科学
抗药性
人口学
抗生素
生物
微生物学
铜绿假单胞菌
物理
光学
社会学
细菌
遗传学
作者
Sazlyna Mohd Sazlly Lim,A. Zainal Abidin,Su May Liew,Jason A. Roberts,Fekade Bruck Sime
标识
DOI:10.1016/j.jinf.2019.09.012
摘要
Objective The objective of this works was to assess the global prevalence of multidrug-resistance among A. baumannii causing hospital-acquired (HAP) and ventilator-associated pneumonia (VAP), and describe its associated mortality. Methods We performed a systematic search of four databases for relevant studies. Meta-analysis was done based on United Nations geoscheme regions, individual countries and study period. We used a random-effects model to calculate pooled prevalence and mortality estimates with 95% confidence intervals (CIs), weighted by study size. Results Among 6445 reports screened, we identified 126 relevant studies, comprising data from 29 countries. The overall prevalence of multidrug-resistance among A. baumannii causing HAP and VAP pooled from 114 studies was 79.9% (95% CI 73.9–85.4%). Central America (100%) and Latin America and the Caribbean (100%) had the highest prevalence, whereas Eastern Asia had the lowest (64.6%; 95% CI, 50.2–77.6%). The overall mortality estimate pooled from 27 studies was 42.6% (95% CI, 37.2–48.1%). Conclusions We observed large amounts of variation in the prevalence of multidrug-resistance among A. baumannii causing HAP and VAP and its mortality rate among regions and lack of data from many countries. Data from this review can be used in the development of customized strategies for infection control and antimicrobial stewardship.
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