AUTHOR=Dadashi Masoud , Sharifian Parastoo , Bostanshirin Nazila , Hajikhani Bahareh , Bostanghadiri Narjess , Khosravi-Dehaghi Nafiseh , van Belkum Alex , Darban-Sarokhalil Davood 

TITLE=The Global Prevalence of Daptomycin, Tigecycline, and Linezolid-Resistant Enterococcus faecalis and Enterococcus faecium Strains From Human Clinical Samples: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.720647

DOI=10.3389/fmed.2021.720647

ISSN=2296-858X

ABSTRACT=<p><bold>Background and Aim:</bold> The predominant species of the <italic>Enterococcus, Enterococcus faecalis</italic> (<italic>E. faecalis</italic>) and <italic>Enterococcus faecium</italic> (<italic>E. faecium</italic>) cause great variety of infections. Therefore, the expansion of antimicrobial resistance in the <italic>Enterococcus</italic> is one of the most important global concerns. This study was conducted to investigate the prevalence of resistance to linezolid, tigecycline, and daptomycin among enterococcal strains isolated from human clinical specimens worldwide.</p><p><bold>Methods:</bold> Several databases including Web of Science, EMBASE, and Medline (<italic>via</italic> PubMed), were carefully searched and reviewed for original research articles available in databases and published between 2000 and 2020. A total of 114 studies worldwide that address <italic>E. faecalis</italic> and <italic>E. faecium</italic> resistance to linezolid, tigecycline, and daptomycin were analyzed by STATA software.</p><p><bold>Results:</bold> The overall prevalence of antibiotic-resistant <italic>E. faecalis</italic> and <italic>E. faecium</italic> was reported to be 0.9 and 0.6%, respectively. <italic>E. faecalis</italic> and <italic>E. faecium</italic> were more resistant to the linezolid (2.2%) and daptomycin (9%), respectively. The prevalence of tigecyline-resistant <italic>E. facium</italic> (1%) strains was higher than <italic>E. faecalis</italic> strains (0.3%). Accordingly, the prevalence of linezolid-resistant <italic>E. faecalis</italic> was higher in Asia (2.8%), while linezolid-resistant <italic>E. faecium</italic> was higher in the America (3.4%). Regarding tigecycline-resistance, a higher prevalence of <italic>E. faecalis</italic> (0.4%) and <italic>E. faecium</italic> (3.9%) was reported in Europe.</p><p><bold>Conclusion:</bold> In conclusion, this meta-analysis shows that there is an emerging resistance in <italic>Enterococcus</italic> strains. Despite the rising resistance of enterococci to antibiotics, our results demonstrate that tigecycline, daptomycin, and linezolid can still be used for the treatment of enterococcal infections worldwide.</p>