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. 2024 Oct 9:15:1477836.
doi: 10.3389/fmicb.2024.1477836. eCollection 2024.

Prevalence of colistin resistance in clinical isolates of Pseudomonas aeruginosa: a systematic review and meta-analysis

Negar Narimisa  1   2 , Abbasali Keshtkar  3 , Leila Dadgar-Zankbar  2 , Narjess Bostanghadiri  1   2 , Yasaman Rouein Far  4 , Soheila Shahroodian  2 , Abed Zahedi Bialvaei  1 , Shabnam Razavi  1   2
Affiliations

Prevalence of colistin resistance in clinical isolates of Pseudomonas aeruginosa: a systematic review and meta-analysis

Negar Narimisa et al. Front Microbiol. .

Abstract

Objective: The emergence of resistance to colistin, the last resort for treating severe infections caused by Pseudomonas aeruginosa, poses a significant threat to public health. This meta-analysis aimed to investigate the prevalence of colistin resistance in clinical isolates of P. aeruginosa.

Method: A comprehensive search of MEDLINE (PubMed), Web of Science, and Scopus databases was conducted to identify relevant articles published until December 2023. Subsequently, a meta-analysis was performed using Stata software to examine the pooled prevalence of colistin resistance and to conduct subgroup analyses.

Results: A total of 619 studies were included in the meta-analysis, revealing a global prevalence of colistin resistance of 1% among all P. aeruginosa isolates. Furthermore, cystic fibrosis patients exhibited the highest resistance to colistin, with a prevalence of 7% among the examined diseases.

Conclusion: The increase in colistin resistance in P. aeruginosa in recent years from 2% (in the period of 2006-2010) to 5% (in the period of 2020-2023) underscores the need for implementing infection prevention programs, using appropriate treatment regimens, and disseminating comprehensive information on antimicrobial resistance patterns. These measures are crucial for addressing this growing public health concern.

Keywords: Pseudomonas aeruginosa; cystic fibrosis; infection prevention; public health; treatment regimens.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The study PRISMA flow diagram.
Figure 2
Figure 2
Funnel plot of the prevalence of colistin-resistant P. aeruginosa isolates.
Figure 3
Figure 3
Subgroup analysis for continents of colistin-resistant P. aeruginosa isolates.
Figure 4
Figure 4
Subgroup analysis for countries of the colistin-resistant P. aeruginosa isolates.
Figure 5
Figure 5
Subgroup analysis for year of publication of the colistin-resistant P. aeruginosa isolates.
Figure 6
Figure 6
Subgroup analysis for period of sample collection of the colistin-resistant P. aeruginosa isolates.
Figure 7
Figure 7
Subgroup meta-analysis for guidelines of colistin-resistant P. aeruginosa isolates.
Figure 8
Figure 8
Subgroup analysis for origin of samples of colistin-resistant P. aeruginosa isolates.
Figure 9
Figure 9
Subgroup analysis for infection of colistin-resistant P. aeruginosa isolates.
Figure 10
Figure 10
Subgroup meta-analysis for AST methods of colistin-resistant P. aeruginosa isolates.
Figure 11
Figure 11
Subgroup meta-analysis for different resistance categories of colistin-resistant P. aeruginosa isolates.
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