摘要
Resistance/sensitivity to polymyxin-B(PB)antibiotic has been employed as one among other epidemiologically relevant biotyping-scheme for Vibrio cholerae into Classical/El Tor biotypes.However,recent studies have re-vealed some pitfalls bordering on PB-sensitivity/resistance(PBR/S)necessitating study.Current study assesses the PBR/S cosmopolitan prevalence,epidemiology/distribution among O1/O139 and nonO1/nonO139 V.cholerae strains.Relevant databases(Web of Science,Scopus and PubMed)were searched to retrieve data from environ-mental and clinical samples employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA).Random-effect-model(REM)and common-effect-model(CEM)of meta-analysis was performed to de-termine prevalence of PBR/S V.cholerae strains,describe the cosmopolitan epidemiological potentials and biotype relevance.Heterogeneity was determined by meta-regression and subgroup analyses.The pooled analyzed iso-lates from articles(7290),with sensitive and resistance are 2219(30.44%)and 5028(69.56%).Among these PB-sensitive strains,more than 1944(26.67%)were O1 strains,132(1.81%)were nonO1 strains while mis-reported Classical biotype were 2080(28.53)respectively indicating potential spread of variant/dual biotype.A significant PB-resistance was observed in the models(CEM=0.66,95%CI[0.65;0.68],p-value=0.001;REM=0.83[0.74;0.90],p=0.001)as both models had a high level of heterogeneity(I^(2)=98.0%;^(2)_(df=33)=1755.09,Qp=2.4932).Egger test(z=5.4017,p<0.0001)reveal publication bias by funnel plot asymmetry.The subgroup analysis for continents(Asia,Africa)and sources(acute diarrhea)revealed(98%CI(0.73;0.93);55%CI(0.20;0.86)),and 92%CI(0.67;0.98).The Epidemiological prevalence for El tor/variant/dual biotype showed 88%CI(0.78;0.94)with O1 strains at 88%CI(0.78;0.94).Such global prevalence,distribution/spread of phenotypes/genotypes ne-cessitates updating the decades-long biotype classification scheme.An antibiotic stewardship in the post antibiotic era is suggestive/recommended.Also,there is need for holistic monitoring/evaluation of clinical/epidemiological relevance of the disseminating strains in endemic localities.
基金
funds provided by African German Network of Excellence in Science 2022 (AGNES-2022).
