Global prevalence and antibiotic resistance profiles of carbapenem-resistant Pseudomonas aeruginosa reported from 2014 to 2024: a systematic review and meta-analysis
Abstract
Introduction: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) represents a global threat, but the global distribution of carbapenem resistant bacteria remains a critical issue in public health.
Methods: We conducted a systematic review and meta-analysis on the global pooled prevalence estimate (PPE) of CRPA and their antibiotic resistance. The systematic review protocol was registered with PROSPERO (CRD42024579654). This study was carried out following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. Comprehensive meta-analysis software v4.0 was used to analyze the pooled prevalence of CRPA.
Results: A total of 163 studies (both clinical and screening samples) containing a total of 58,344 cases from 39 countries were included in this study. The overall PPE of CRPA was 34.7% (95% CI: 0.316-0.37.8) for both clinical and screening samples. Meropenem had a PPE of 31.2% (95% CI: 0.272-0.352) and imipenem had the lowest PPE of 27.7% (95% CI: 0.238-0.319). Japan had the highest PPE at 98.2% (95% CI: 0.482-0.100) of CRPA, and the lowest was observed for Saudi Arabia at 13.9% (95% CI: 0. 064-0. 277). CRPA is widespread on five continents except Australia and Antarctica, while the highest PPE is in Europe at 47.6% (95% CI: 0.359-0.595) and the lowest in Asia at 32, 8% (95% CI: 0.293-0.364). The relatively higher PPE of…
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