Prevalence and Risk Factors of Fluoroquinolone Resistance in Major Bacterial Pathogens: A Systematic Review and Meta-Analysis
Abstract
Background: The widespread use of fluoroquinolones for the treatment of Gram-negative bacterial infections has contributed to the rising prevalence of antimicrobial resistance. However, limited studies have systematically analyzed the prevalence of fluoroquinolone resistance (FQR) and its associated risk factors.
Methods: A systematic review and meta-analysis were conducted, screening studies published between January 1, 2014, and October 31, 2024, from the PubMed, Medline, Embase, and CINAHL databases. Studies were included based on the following criteria: observational designs, evaluation of Gram-negative bacteria for FQR in human subjects, and investigation of FQR and associated risk factors. Data analysis, including pooled prevalence estimation and odds ratio calculation, was performed using R Studio (Version 4.2.3) with the metafor package. Heterogeneity among studies was assessed using Q and I 2 statistics. A funnel plot was used to assess potential publication bias among the included studies.
Results: A total of 24 studies were included in the systematic review and meta-analysis. The pooled prevalence of FQR across pathogens was 35% (95% CI: 30%-40%), with species-specific rates of Campylobacter spp. (49%), Escherichia coli (35%), Klebsiella spp. (23%), Mycobacterium tuberculosis (40%), Pseudomonas aeruginosa (34%), Proteus spp. (45%), and others (26%). Subgroup analyses showed variation by fluoroquinolone generation and year of publication, with E. coli displaying…
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Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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