Abstract
BackgroundThere has been an increasing resistance rate to tetracyclines, the first line treatment for cholera disease caused by V. cholera strains, worldwide. The aim of the present study was to determine the global status of resistance to this class of antibiotic among V. cholera isolates.MethodsFor the study, electronic databases were searched using the appropriate keywords including: ‘Vibrio’, ‘cholera’, ‘Vibrio cholerae’, ‘V. cholerae’, ‘resistance’, ‘antibiotic resistance’, ‘antibiotic susceptibility’, ‘antimicrobial resistance’, ‘antimicrobial susceptibility’, ‘tetracycline’, and ‘doxycycline’. Finally, after some exclusion, 52 studies from different countries were selected and included in the study and meta-analysis was performed on the collected data.ResultsThe average resistance rate for serogroup O1 to tetracycline and doxycycline was 50% and 28%, respectively (95% CI). A high level of heterogeneity (I2 > 50%, p-value < 0.05) was observed in the studies representing resistance to tetracycline and doxycycline in O1 and non-O1, non-O139 serogroups. The Begg’s tests did not indicate the publication bias (p-value > 0.05). However, the Egger’s tests showed some evidence of publication bias in the studies conducted on serogroup O1.ConclusionsThe results of the present study show that the overall resistance to tetracyclines is relatively high and prevalent among V. cholerae isolates, throughout the world. This highlights the necessity of performing standard antimicrobial susceptibility testing prior to treatment choice along with monitoring and management of antibiotic resistance patterns of V. cholerae strains in order to reduce the emergence and propagation of antibiotic resistant strains as well as the failure of treatment.
Highlights
Cholera is an ancient infectious disease mainly affecting developing countries
Search strategies The electronic databases, including OVID databases, PubMed, Web of Science, Scopus, MEDLINE, EMBASE, Cochrane Library, as well as Google Scholar, were searched for papers reporting the resistance rate for different Vibrio cholerae isolates to the antibiotics of tetracyclines family from December 1980 to April 2020
The search was restricted to original research articles throughout the world, published in English using the following keywords with the help of Boolean operators (AND, OR): ‘Vibrio’, ‘cholera’, ‘Vibrio cholerae’, ‘V. cholerae’, ‘resistance’, ‘antibiotic resistance’, ‘antibiotic susceptibility’, ‘antimicrobial resistance’, ‘antimicrobial susceptibility’, ‘tetracycline’, and ‘doxycycline’
Summary
The disease is capable to spread across many countries leading to vast pandemics and becoming a major public health concern throughout the world [1]. The causative agent of this life threatening diarrheal disease is Vibrio cholerae secreting the cholera toxin. Two major cholera toxin-producing serogroups of this bacterial pathogen, O1 and O139, have potential to spread and cause epidemic as well as pandemic disease [2]. The main stay of management of cholera (acute gastroenteritis) is urgent fluid replacement; the use of an appropriate antibiotic is necessary to eliminate the Ahmadi Antimicrob Resist Infect Control (2021) 10:115 bacteria, lessen the duration of illness, and control the disease [4]. There has been an increasing resistance rate to tetracyclines, the first line treatment for cholera disease caused by V. cholera strains, worldwide. The aim of the present study was to determine the global status of resistance to this class of antibiotic among V. cholera isolates
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