TY - JOUR
T1 - Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis
AU - Habibzadeh, Adrina
AU - Lankarani, Kamran B.
AU - Farjam, Mojtaba
AU - Akbari, Maryam
AU - Kashani, Seyyed Mohammad Amin
AU - Karimimoghadam, Zeinab
AU - Wang, Kan
AU - Imanieh, Mohammad Hossein
AU - Tabrizi, Reza
AU - Ahmadizar, Fariba
N1 - Funding Information:
This study was conducted at the Noncommunicable Diseases Research Center of Fasa University of Medical Sciences, Fars, Iran, with a grant number: IR.FUMS.REC.1400.056.
Funding Information:
No financial assistance was received in support of the study.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/8/15
Y1 - 2022/8/15
N2 - Purpose: Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane’s Q test and the I
2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients. Results: Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I
2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I
2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I
2 = 0%). Conclusion: Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment.
AB - Purpose: Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane’s Q test and the I
2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients. Results: Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I
2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I
2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I
2 = 0%). Conclusion: Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment.
KW - COVID-19
KW - Candidiasis
KW - Drug Resistance
KW - Fungi
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85136108187&partnerID=8YFLogxK
U2 - 10.1007/s12281-022-00439-9
DO - 10.1007/s12281-022-00439-9
M3 - Review article
C2 - 35990407
SN - 1936-3761
VL - 16
SP - 154
EP - 164
JO - Current fungal infection reports
JF - Current fungal infection reports
IS - 4
ER -