Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

Antimicrobial resistance in Clostridioides (Clostridium) difficile derived from humans: a systematic review and meta-analysis

Wed Nov 30 06:35:36 2022

(2020) Antimicrobial resistance in Clostridioides (Clostridium) difficile derived from humans: a systematic review and meta-analysis. Antimicrobial resistance and infection control. p. 158. ISSN 2047-2994 (Electronic) 2047-2994 (Linking)

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Official URL: https://www.ncbi.nlm.nih.gov/pubmed/32977835

Abstract

BACKGROUND: Clostridioides (Clostridium) difficile is an important pathogen of healthcare- associated diarrhea, however, an increase in the occurrence of C. difficile infection (CDI) outside hospital settings has been reported. The accumulation of antimicrobial resistance in C. difficile can increase the risk of CDI development and/or its spread. The limited number of antimicrobials for the treatment of CDI is matter of some concern. OBJECTIVES: In order to summarize the data on antimicrobial resistance to C. difficile derived from humans, a systematic review and meta-analysis were performed. METHODS: We searched five bibliographic databases: (MEDLINE PubMed, Scopus, Embase, Cochrane Library and Web of Science) for studies that focused on antimicrobial susceptibility testing in C. difficile and were published between 1992 and 2019. The weighted pooled resistance (WPR) for each antimicrobial agent was calculated using a random- effects model. RESULTS: A total of 111 studies were included. The WPR for metronidazole and vancomycin was 1.0% (95% CI 0-3%) and 1% (95% CI 0-2%) for the breakpoint > 2 mg/L and 0% (95% CI 0%) for breakpoint >/=32 mug/ml. Rifampin and tigecycline had a WPRs of 37.0% (95% CI 18-58%) and 1% (95% CI 0-3%), respectively. The WPRs for the other antimicrobials were as follows: ciprofloxacin 95% (95% CI 85-100%), moxifloxacin 32% (95% CI 25-40%), clindamycin 59% (95% CI 53-65%), amoxicillin/clavulanate 0% (0-0%), piperacillin/tazobactam 0% (0-0%) and ceftriaxone 47% (95% CI 29-65%). Tetracycline had a WPR 20% (95% CI 14-27%) and meropenem showed 0% (95% CI 0-1%); resistance to fidaxomicin was reported in one isolate (0.08%). CONCLUSION: Resistance to metronidazole, vancomycin, fidaxomicin, meropenem and piperacillin/tazobactam is reported rarely. From the alternative CDI drug treatments, tigecycline had a lower resistance rate than rifampin. The high-risk antimicrobials for CDI development showed a high level of resistance, the highest was seen in the second generation of fluoroquinolones and clindamycin; amoxicillin/clavulanate showed almost no resistance. Tetracycline resistance was present in one fifth of human clinical C. difficile isolates.

Item Type: Article
Creators:
CreatorsEmail
Sholeh, M.UNSPECIFIED
Krutova, M.UNSPECIFIED
Forouzesh, M.UNSPECIFIED
Mironov, S.UNSPECIFIED
Sadeghifard, N.UNSPECIFIED
Molaeipour, L.UNSPECIFIED
Maleki, A.UNSPECIFIED
Kouhsari, E.UNSPECIFIED
Keywords: Antimicrobial resistance Clostridioides difficile Meta-analysis Metronidazole Vancomycin
Divisions:
Page Range: p. 158
Journal or Publication Title: Antimicrobial resistance and infection control
Journal Index: Pubmed
Volume: 9
Number: 1
Identification Number: https://doi.org/10.1186/s13756-020-00815-5
ISSN: 2047-2994 (Electronic) 2047-2994 (Linking)
Depositing User: مهندس مهدی شریفی
URI: http://eprints.medilam.ac.ir/id/eprint/3096

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