Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis

Adrina Habibzadeh; Kamran B. Lankarani; Mojtaba Farjam; Maryam Akbari; Seyyed Mohammad Amin Kashani; Zeinab Karimimoghadam; Kan Wang; Mohammad Hossein Imanieh; Reza Tabrizi; Fariba Ahmadizar

doi:10.1007/s12281-022-00439-9

Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis

Adrina Habibzadeh
, Kamran B. Lankarani
, Mojtaba Farjam
, Maryam Akbari
, Seyyed Mohammad Amin Kashani
, Zeinab Karimimoghadam
, Kan Wang
, Mohammad Hossein Imanieh
, Reza Tabrizi^*
, Fariba Ahmadizar

^*Corresponding author for this work

Epidemiology

Fasa Univ Med Sci, USERN Off
Shiraz University of Medical Science
Noncommunicable Diseases Research Center, Fasa University of Medical Sciences
Vali Asr Hospital
University Medical Centre Utrecht

Research output: Contribution to journal › Article › Academic › peer-review

23 Citations (Scopus)

Abstract

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 MultiCandida 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.

Original language	English
Pages (from-to)	154-164
Number of pages	11
Journal	Current Fungal Infection Reports
Volume	16
Issue number	4
Early online date	15 Aug 2022
DOIs	https://doi.org/10.1007/s12281-022-00439-9
Publication status	Published - Dec 2022

Bibliographical note

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.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1007/s12281-022-00439-9

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376562/

Cite this

@article{b3444fc604d8471281b131a48c00ab96,

title = "Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis",

abstract = "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 MultiCandida 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.",

author = "Adrina Habibzadeh and Lankarani, \{Kamran B.\} and Mojtaba Farjam and Maryam Akbari and Kashani, \{Seyyed Mohammad Amin\} and Zeinab Karimimoghadam and Kan Wang and Imanieh, \{Mohammad Hossein\} and Reza Tabrizi and Fariba Ahmadizar",

note = "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: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2022",

month = dec,

doi = "10.1007/s12281-022-00439-9",

language = "English",

volume = "16",

pages = "154--164",

journal = "Current Fungal Infection Reports",

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T1 - Prevalence of Fungal Drug Resistance in COVID-19 Infection

T2 - 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 - 2022/12

Y1 - 2022/12

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 MultiCandida 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 MultiCandida 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.

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U2 - 10.1007/s12281-022-00439-9

DO - 10.1007/s12281-022-00439-9

M3 - 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 -

Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis

Abstract

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