Rate of polymyxin resistance among Acinetobacter baumannii recovered from hospitalized patients: a systematic review and meta-analysis

Lima, William Gustavo; Brito, Júlio César Moreira; Cardoso, Bárbara Gatti; Cardoso, Valbert Nascimento; Paiva, Magna Cristina de; Lima, Maria Elena de; Fernandes, Simone Odília Antunes

doi:10.1007/s10096-020-03876-x

Cited by 20 publications

(20 citation statements)

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“…All pooled data were estimated using a random effect model (Lima, Silva Alves, Sanches, Antunes Fernandes, & de Paiva, 2019; Lima, Souza, Fernandes, Cardoso, & Godói, 2019). Heterogeneity of the primary data was analyzed using the I 2 statistic, in which I 2 > 50% was considered to have substantial heterogeneity (de Carvalho, Lima, Coelho, Cardoso, & Fernandes, 2020; Lima et al, 2020c). In all procedures, the significance level was 5%.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of supplementation with quercetin‐type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta‐analysis of preclinical studies

Brito

Lima

Cordeiro

et al. 2021

Phytotherapy Research

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Viral infections of the lower respiratory tract are considered a public health problem. They affect millions of people worldwide, causing thousands of deaths, and are treated with expensive medicines, such as antivirals or palliative measures. In this study, we conducted a systematic review to describe the use of quercetin‐type flavonols against lower respiratory tract viruses and discussed the preclinical impact of this approach on different signs and clinical mechanisms of infection. The systematic review was performed in PubMed/MEDLINE, Scopus, Scielo, and Biblioteca Virtual de Saúde (BVS). After the database search, 11 relevant studies were identified as eligible. The analysis of these studies showed evidence of antiviral activity of quercetin‐type flavonols with significantly reduced mortality rate (M‐H = 0.19, 95% CI: 0.05 to 0.65, p‐value = 0.008) of infected animals and a reduction in the average viral load (IV = −1.93, 95% CI: −3.54 to −0.31, p‐value = 0.02). Additionally, quercetin and its derivatives reduced the amount of proinflammatory cytokines, chemokines, reactive oxygen species, mucus production, and airway resistance in animals infected with a respiratory virus. Overall, supplementation with quercetin‐type flavonols is a promising strategy for treating viral‐induced lower respiratory tract infections.

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Section: Methodsmentioning

confidence: 99%

Effectiveness of supplementation with quercetin‐type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta‐analysis of preclinical studies

Brito

Lima

Cordeiro

et al. 2021

Phytotherapy Research

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“…To calculate the frequency of epilepsy in children with CZS, we applied the PEOS strategy, 25 as follow: “Population”: Children between 0 and 5 years old of both sexes; “Exposition”: ZIKV infection during pregnancy with a positive diagnosis of CSZ; “Outcomes (primary)”: Presence of epilepsy; “Study design”: Retrospective and prospective cohort and case‐control studies. The search was restricted to English, Spanish, and Portuguese studies, independent of the year of publication.…”

Section: Methodsmentioning

confidence: 99%

“…25,31 Heterogeneity of the primary data was analyzed using I 2 statistics, in which I 2 > 50% was considered as substantial heterogeneity. 25,31 In all procedures, the significance level was 5%. 32 Subgroup analysis was performed to evaluate the influence of the study design, duration of follow-up, CZS and epilepsy diagnosis criteria, the origin of the study population, publication date, and the study quality on the heterogeneity of the primary data.…”

Section: Meta-analysismentioning

confidence: 99%

“…Among the included studies, eight are prospective cohorts (8/15, 53.3%), 9,10,[16][17][18][19]21,22 four retrospective cohorts (4/15, 26.6%), 8,11,15,20 and three cross-sectional studies (3/15, 20%). [12][13][14] The selected studies were published between 2016 and 2020, conducted in Brazil (15/15, 100%) [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], and included children diagnosed with CSZ from 0 to 40 months of age (Table 1). Clinical evidence of CZS The author specifies that the patients are residents in the northeastern region of Brazil but do not report the city/state of origin of the patients.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Epilepsy in children with Congenital Zika Syndrome: A systematic review and meta‐analysis

et al. 2021

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Objectives: To estimate the overall frequency of epilepsy in children with congenital Zika syndrome (CZS) and describe the profile of seizures and the response rate to anti-epileptic treatment in this group of patients. Methods: A systematic review and meta-analysis were conducted following the Cochrane Handbook and preferred reporting items for systematic reviews and metaanalyses (PRISMA) guidelines. PubMed/MEDLINE, Scopus, Cochrane Library, SciELO, and LILACS were searched until June 23, 2020. Observational studies that evaluated the frequency of epilepsy in children diagnosed with CZS according to international criteria were included in the study. Results: Fourteen studies evaluating 903 patients diagnosed with CZS were pooled in a meta-analysis. All studies were conducted in Brazil, with reports published between 2016 and 2020, and included children diagnosed with CSZ from 0 to 40 months of age. The overall rate of epilepsy in children diagnosed with CZS was estimated at 60% (95% confidence interval [CI] 0.51-0.68). The studies included in this review show that the frequency of epilepsy in patients with CSZ varies with age, with higher rates in older children. Epileptic spasms was the primary type of seizure observed in this group, followed by focal and generalized crisis. The response rate to antiepileptic drugs was considerably low, ranging from 20% of seizure control in the first year and 30% in the second year. Significance: Children with CZS presented a high cumulative incidence of epilepsy episodes with increased severity and a low response to anti-epileptic therapy, which is associated with the extensive damage caused by the Zika virus on the cortical structures of patients. K E Y W O R D Santi-epileptic agents, congenital infection, cortical malformations, seizures, Zika virus (ZIKV) | METHODSA systematic review and meta-analysis were conducted following the Cochrane Handbook guidelines. 23 The searching, selection, extraction, and analysis of the data of interest were performed according to the Preferred Reporting Items Key points• The overall rate of epilepsy in children diagnosed with congenital Zika syndrome (CZS) was estimated at 60% (95% confidence interval [CI] 0.51-0.68) • The rate of epilepsy in children with CZS is considerably higher than that observed in congenital infections with syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex (STORCH) pathogens • Epileptic spasms were the primary type of seizure observed in this group, followed by focal and generalized crisis • The response rate to anti-epileptic drugs was considerably low (20% of seizure control in the first year and 30% in the second year)

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“…No presente estudo, somente um isolado apresentou resistência às polimixinas, entretanto, há relatos publicados que mostram frequências extremamente alarmantes de A. baumannii resistente a estes antibióticos, como o realizado por Nowak e colaboradores (2017), o qual demonstrou frequência entre 32% e 62% em países europeus como Grécia, Itália e Espanha. Lima et al (2020) observaram que a América Latina é a região com maior incidência de A. baumannii resistente às polimixinas entre pacientes hospitalizados, o que está relacionado com o alto consumo de antibióticos nesta região. Especificamente, no Brasil, dados similares foram encontrados com frequências de 15% e 81%, respectivamente observadas nos estudos de Rodriguez et al (2019) e Genteluci et al (2016).…”

Section: Tabelaunclassified

Acinetobacter baumannii resistente aos carbapenêmicos em Minas Gerais: epidemiologia hospitalar, multirresistência e disseminação de clones de alto risco

Gonçalves¹

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Introduction:The spread of Acinetobacter baumannii associated with the emergence of resistance genotypes to carbapenems is of great concern worldwide. Aims: To understand hospital epidemiology as well as the current dissemination of high-risk clones in clinical strains of A. baumannii resistant to carbapenems. Materials and methods: The study was conducted in two stages. First, an epidemiological study was conducted using a cohort of 489 patients with carbapenem-resistant A. baumannii infection from 2013 to 2017 hospitalized at Hospital de Clínicas (HC-UFU), considering the first episode. Secondly, a molecular study of samples recovered from HC-UFU was carried out, along with isolates of A. baumannii recovered from other hospitals in Minas Gerais (MG) state, were selected to be typed by the MLST sequencing technique (Multilocus Sequence Typing, Pasteur scheme) and, of these, the whole-genome of one strain was sequenced using an Illumina Next-Seq 500 paired-end reads (150 bp). Polymerase chain reaction (PCR) were used to detect the oxacillinase genes (blaOXA-51, blaOXA-23, blaOXA-24, blaOXA-58 e blaOXA-143) and other carbapenemases (blaNDM-1, blaKPC, blaIMP-1, blaVIM-1, blaTEM). Results: In the epidemiological study, an incidence of carbapenemresistant A. baumannii infection of 0.7/1000 patient-days were found, with most patients with respiratory tract infections (54.7%), predominantly hospitalized in the intensive care (ICU). In November 2014, the infection rates exceeded the established limits, confirming an outbreak of multi-resistant A. baumannii infection. The frequency of mortality was high (39%) and the multivariate analysis showed that the related risk factors were the presence of sepsis and antimicrobial inappropriate therapy. It was found that 93.9% of the patients had infections with the multidrug resistant microorganism (MDR) and 41.5% with the extensively resistant microorganism (XDR). 94.5% of the 107 strains recovered and tested, recovered from the HC-UFU, were positive for the blaOXA-23 gene. On the molecular stage, 12 clinical strains of A. baumannii, obtained from different hospitals of MG state were selected. Seven strains (58.3%) were positive for the blaOXA-23 gene and one (8.3%) was positive for the blaNDM-1 gene. These 12 strains, along with two selected isolates from the HC-UFU, were typed by MLST, the result showed clonal dissemination of seven STs and four clonal complexes (CC), with predominance of ST/CC79 as well as the identification of two new STs, ST1465/CC216, and ST1466/CC79. Whole-genome sequencing of the positive sample for the blaNDM-1 gene was carried out, which was carried by an unusual plasmid (pAb17), in which some genes of the Tn125 transposon were lost. Besides, on the chromosome, the strain reported here presented blaOXA-106 gene, a variant of blaOXA-51 gene, and blaADC-25 with ISAba1 upstream. Conclusions: The study showed endemicity of A. baumannii MDR at HC-UFU, with a high frequency of the blaOXA-23 gene in recovered isolates, in addition to a higher risk of death in ...

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Rate of polymyxin resistance among Acinetobacter baumannii recovered from hospitalized patients: a systematic review and meta-analysis

Cited by 20 publications

References 50 publications

Effectiveness of supplementation with quercetin‐type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta‐analysis of preclinical studies

Effectiveness of supplementation with quercetin‐type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta‐analysis of preclinical studies

Epilepsy in children with Congenital Zika Syndrome: A systematic review and meta‐analysis

Acinetobacter baumannii resistente aos carbapenêmicos em Minas Gerais: epidemiologia hospitalar, multirresistência e disseminação de clones de alto risco

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