Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysis
ObjectivesStreptococcus agalactiae, or group B Streptococcus (GBS), is a significant pathogen associated with severe infections in neonates, particularly sepsis and meningitis. The increasing prevalence of antibiotic resistance among GBS strains is a growing public health concern, necessitating a co...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2025.1541524/full |
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| author | Chou-Yi Hsu Safoura Moradkasani Muath Suliman Subasini Uthirapathy Ahmed Hussein Zwamel Ahmed Hussein Zwamel Ahmed Hussein Zwamel Ahmed Hjazi Raghav Vashishth Masoumeh Beig |
| author_facet | Chou-Yi Hsu Safoura Moradkasani Muath Suliman Subasini Uthirapathy Ahmed Hussein Zwamel Ahmed Hussein Zwamel Ahmed Hussein Zwamel Ahmed Hjazi Raghav Vashishth Masoumeh Beig |
| author_sort | Chou-Yi Hsu |
| collection | DOAJ |
| description | ObjectivesStreptococcus agalactiae, or group B Streptococcus (GBS), is a significant pathogen associated with severe infections in neonates, particularly sepsis and meningitis. The increasing prevalence of antibiotic resistance among GBS strains is a growing public health concern, necessitating a comprehensive meta-analysis to evaluate the prevalence of this resistance globally.MethodsWe conducted a comprehensive systematic search across four major scientific databases: Scopus, PubMed, Web of Science, and EMBASE, targeting articles published until December 13, 2023. This meta-analysis focused on studies that examined antibiotic resistance in GBS strains. The Joanna Briggs Institute tool was employed to assess the quality of the included studies. This meta-analysis applied a random-effects model to synthesize data on antibiotic resistance in GBS, incorporating subgroup analyses and regression techniques to explore heterogeneity and trends in resistance rates over time. Outliers and influential studies were identified using statistical methods such as Cook’s distance, and funnel plot asymmetry was assessed to evaluate potential publication bias. All analyses were conducted using R software (version 4.2.1) and the metafor package (version 3.8.1).ResultsThis study included 266 studies from 57 countries, revealing significant variability in GBS antibiotic resistance rates. The highest resistance rates were observed for tetracycline (80.1, 95% CI: 77.1–82.8%), while tedizolid (0.1, 95% CI: 0.0–0.8%) showed the lowest resistance rates. Significant heterogeneity in resistance rates was observed, particularly for antibiotics such as azithromycin and gentamicin (I2 = 97.29%), variability across studies. On the other hand, tigecycline and ceftaroline exhibited no heterogeneity (I2 = 0%), suggesting consistent resistance patterns. Subgroup analyses revealed disparities in resistance rates based on country, continent, and methodological categories. Significant increase in resistance rates for several antibiotics over time, including clindamycin, erythromycin, ceftriaxone, cefuroxime, ciprofloxacin, levofloxacin, moxifloxacin, chloramphenicol, and ofloxacin. Ofloxacin and cefuroxime showed particularly steep trends. Conversely, a declining resistance trend was observed for oxacillin.ConclusionThis study emphasizes the growing issue of antibiotic resistance in GBS strains. Notable resistance to older and newer antibiotics, increasing resistance over time, regional disparities, and methodological variations are noted. Rising resistance trends for multiple antibiotics underscore the urgent need for global surveillance and improved antibiotic stewardship.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024566269, CRD42024566269. |
| format | Article |
| id | doaj-art-534beb4ef32b43d89aa32d92626643ba |
| institution | OA Journals |
| issn | 1664-302X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Microbiology |
| spelling | doaj-art-534beb4ef32b43d89aa32d92626643ba2025-08-20T02:24:54ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2025-04-011610.3389/fmicb.2025.15415241541524Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysisChou-Yi Hsu0Safoura Moradkasani1Muath Suliman2Subasini Uthirapathy3Ahmed Hussein Zwamel4Ahmed Hussein Zwamel5Ahmed Hussein Zwamel6Ahmed Hjazi7Raghav Vashishth8Masoumeh Beig9Thunderbird School of Global Management, Arizona State University Tempe Campus, Phoenix, AZ, United StatesDepartment of Bacteriology, Pasteur Institute of Iran, Tehran, IranDepartment of Laboratory Medicine, School of Medical Sciences, King Khalid University, Abha, Saudi ArabiaPharmacy Department Tishk International University Erbil, Kurdistan Region, IraqMedical Laboratory Technique College, The Islamic University, Najaf, IraqMedical Laboratory Technique College, The Islamic University of Al Diwaniyah, Al Diwaniyah, IraqMedical Laboratory Technique College, The Islamic University of Babylon, Babylon, IraqDepartment of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi ArabiaDepartment of Surgery, National Institute of Medical Sciences, NIMS University Rajasthan, Jaipur, IndiaDepartment of Bacteriology, Pasteur Institute of Iran, Tehran, IranObjectivesStreptococcus agalactiae, or group B Streptococcus (GBS), is a significant pathogen associated with severe infections in neonates, particularly sepsis and meningitis. The increasing prevalence of antibiotic resistance among GBS strains is a growing public health concern, necessitating a comprehensive meta-analysis to evaluate the prevalence of this resistance globally.MethodsWe conducted a comprehensive systematic search across four major scientific databases: Scopus, PubMed, Web of Science, and EMBASE, targeting articles published until December 13, 2023. This meta-analysis focused on studies that examined antibiotic resistance in GBS strains. The Joanna Briggs Institute tool was employed to assess the quality of the included studies. This meta-analysis applied a random-effects model to synthesize data on antibiotic resistance in GBS, incorporating subgroup analyses and regression techniques to explore heterogeneity and trends in resistance rates over time. Outliers and influential studies were identified using statistical methods such as Cook’s distance, and funnel plot asymmetry was assessed to evaluate potential publication bias. All analyses were conducted using R software (version 4.2.1) and the metafor package (version 3.8.1).ResultsThis study included 266 studies from 57 countries, revealing significant variability in GBS antibiotic resistance rates. The highest resistance rates were observed for tetracycline (80.1, 95% CI: 77.1–82.8%), while tedizolid (0.1, 95% CI: 0.0–0.8%) showed the lowest resistance rates. Significant heterogeneity in resistance rates was observed, particularly for antibiotics such as azithromycin and gentamicin (I2 = 97.29%), variability across studies. On the other hand, tigecycline and ceftaroline exhibited no heterogeneity (I2 = 0%), suggesting consistent resistance patterns. Subgroup analyses revealed disparities in resistance rates based on country, continent, and methodological categories. Significant increase in resistance rates for several antibiotics over time, including clindamycin, erythromycin, ceftriaxone, cefuroxime, ciprofloxacin, levofloxacin, moxifloxacin, chloramphenicol, and ofloxacin. Ofloxacin and cefuroxime showed particularly steep trends. Conversely, a declining resistance trend was observed for oxacillin.ConclusionThis study emphasizes the growing issue of antibiotic resistance in GBS strains. Notable resistance to older and newer antibiotics, increasing resistance over time, regional disparities, and methodological variations are noted. Rising resistance trends for multiple antibiotics underscore the urgent need for global surveillance and improved antibiotic stewardship.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024566269, CRD42024566269.https://www.frontiersin.org/articles/10.3389/fmicb.2025.1541524/fullantibiotic resistancegroup B Streptococcusmeta-analysisantibiotic susceptibilityJoanna Briggs Institute tool |
| spellingShingle | Chou-Yi Hsu Safoura Moradkasani Muath Suliman Subasini Uthirapathy Ahmed Hussein Zwamel Ahmed Hussein Zwamel Ahmed Hussein Zwamel Ahmed Hjazi Raghav Vashishth Masoumeh Beig Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysis Frontiers in Microbiology antibiotic resistance group B Streptococcus meta-analysis antibiotic susceptibility Joanna Briggs Institute tool |
| title | Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysis |
| title_full | Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysis |
| title_fullStr | Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysis |
| title_full_unstemmed | Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysis |
| title_short | Global patterns of antibiotic resistance in group B Streptococcus: a systematic review and meta-analysis |
| title_sort | global patterns of antibiotic resistance in group b streptococcus a systematic review and meta analysis |
| topic | antibiotic resistance group B Streptococcus meta-analysis antibiotic susceptibility Joanna Briggs Institute tool |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2025.1541524/full |
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