Background

Commensal Neisseria species (spp). represent an important reservoir of antimicrobial resistance genes for pathogenic Neisseria spp. In this systematic review, we aimed to assess the antimicrobial susceptibility of commensal Neisseria spp. and how this has evolved over time. We also aimed to assess if commensal Neisseria spp. showed intrinsic resistance to four antimicrobials - penicillin, azithromycin, ceftriaxone and ciprofloxacin.

Methods

Pubmed and Google Scholar were searched following the PRISMA guidelines. Articles reporting MICs of commensal Neisseria spp. were included according to inclusion/exclusion criteria, and the quality of the articles was assessed using a pre-designed tool. Individual and summary measures of penicillin, azithromycin, ceftriaxone and ciprofloxacin MICs were collected. Additional data was sought to perform a comparison between the MICs of pathogenic and commensal Neisseria spp.

Results

A total of 15 studies met our criteria.We found no evidence of intrinsic AMR in commensal Neisseria spp. We did find evidence of an increasing trend in MICs of commensal Neisseria spp. over time for all antimicrobials assessed. These findings were similar in various countries. Eight additional studies were included to compare pathogenic and commensal Neisseria spp.

Conclusion

The MICs of commensal Neisseria spp. appear to be increasing in multiple countries. Surveillance of MICs in commensals could be used as an early warning system for antimicrobial resistance emergence in pathogens. Our findings underline the need for antibiotic stewardship interventions, particularly in populations with high antimicrobial consumption.

中文翻译：

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全球共生奈瑟菌耐药性流行病学：系统评价

背景

共生奈瑟氏球菌(spp)。代表致病性奈瑟氏菌的重要抗菌素耐药基因库。在本系统评价中，我们旨在评估共生奈瑟菌的抗菌敏感性。以及随着时间的推移这是如何演变的。我们还旨在评估是否共生奈瑟氏球菌。对四种抗菌药物——青霉素、阿奇霉素、头孢曲松和环丙沙星显示出内在耐药性。

方法

Pubmed 和 Google Scholar 是按照 PRISMA 指南进行搜索的。报道共生奈瑟菌MIC 的文章。根据纳入/排除标准纳入，并使用预先设计的工具评估文章的质量。收集了青霉素、阿奇霉素、头孢曲松和环丙沙星 MIC 的单独和汇总测量值。寻求额外的数据来比较致病性和共生奈瑟氏球菌的 MIC 。

结果

共有 15 项研究符合我们的标准。我们在共生奈瑟菌中没有发现内在 AMR 的证据。我们确实发现了共生奈瑟菌 MIC 呈上升趋势的证据。随着时间的推移评估所有抗菌药物。这些发现在不同的国家是相似的。纳入另外八项研究以比较致病性和共生奈瑟菌属。

结论

共生奈瑟菌的 MIC 。似乎在多个国家都在增加。对共生体中 MIC 的监测可用作病原体出现抗菌素耐药性的早期预警系统。我们的研究结果强调了抗生素管理干预的必要性，特别是在抗生素消耗量高的人群中。