Antibiotic resistance pattern of Pseudomonas aeruginosa wound isolates among Chinese burn patients: A systematic review and meta analysis

Abstract

Objective: To investigate the resistance profiles to antimicrobial agents of wound-isolated Pseudomonas (P.) aeruginosa among Chinese burn patients. Methods: Electronic databases and manual search were used to identify eligible studies published since 2010. The objectives were pooled resistance rates for eleven common antimicrobial agents, estimated by a random-effects model. Subgroup analyses were conducted by stratifying the studies into three four-year periods based on year of isolation. Results: A total of 35 studies were included. Gentamicin had the highest pooled resistance rate (56%, 95% CI 48%-64%), while meropenem had the lowest pooled resistance rate (29%, 95% CI 20%-40%). There was an increasing trend of resistance to common antimicrobial agents of wound-isolated P. aeruginosa over a span of twelve years (2009-2020). There remained the highest risk of gentamicin resistance over time in China. Subgroup analyses indicated significantly higher resistances to ceftazidime and levofloxacin from 2017 to 2020. Conclusions: Enhanced resistance to common antimicrobial agents in wound-isolated P. aeruginosa presents a challenge in burn wound management in mainland China. Effective stewardship programs should be established based on corresponding resistance profiles, thereby optimizing treatment options for hospitalized burn patients.

Keywords

• antibiotic resistance; burn; nosocomial infection; pseudomonas aeruginosa