A meta-analysis of the correlation between carbapenem antibiotic use and the incidence of carbapenem-resistant Pseudomonas aeruginosa

Abstract

Introduction: This meta-analysis evaluates the correlation between carbapenem antibiotic use and the incidence of carbapenem-resistant Pseudomonas aeruginosa (CRPA).

Methodology: A comprehensive literature search conducted across multiple databases yielded seven clinical experimental studies involving 4,417 patients. The primary outcomes assessed were the risk factors associated with CRPA infection, drug resistance rates, and the comparison of resistance rates between meropenem (MEM) and imipenem (IPM). The Newcastle-Ottawa Scale (NOS) was used to assess study quality, and Egger’s test and funnel plots were used to assess publication bias. 

Results: The NOS scores for the included studies ranged between 6 and 8, indicating their generally high quality. The analysis indicated that prior carbapenem use significantly increased the risk of CRPA infection (OR = 1.866, 95% confidence interval [CI]: 1.164–2.993, p = 0.010). The drug resistance rates of P. aeruginosa to carbapenems ranged between 21.07% and 37.90%. There was no significant difference in drug resistance rates between MEM and IPM (risk ratio = 1.09, 95% CI: 0.99-1.21, p = 0.517).

Conclusions: With drug resistance rates between 21.07% and 37.90%, these findings suggest that carbapenem use is associated with an increased risk of CRPA infection, highlighting the need for the judicious use of these antibiotics in clinical practice.