AUTHOR=Khoshbayan Amin , Narimisa Negar , Elahi Zahra , Bostanghadiri Narjess , Razavi Shabnam , Shariati Aref 

TITLE=Global prevalence of mutation in the mgrB gene among clinical isolates of colistin-resistant Klebsiella pneumoniae: a systematic review and meta-analysis

JOURNAL=Frontiers in Microbiology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2024.1386478

DOI=10.3389/fmicb.2024.1386478

ISSN=1664-302X

ABSTRACT=<sec id="sec1"><title>Background</title><p>Colistin is used as a last resort for managing infections caused by multidrug-resistant bacteria. However, the high emergence of colistin-resistant strains has restricted the clinical use of this antibiotic in the clinical setting. In the present study, we evaluated the global prevalence of the mutation in the <italic>mgrB</italic> gene, one of the most important mechanisms of colistin resistance in <italic>Klebsiella pneumoniae</italic>.</p></sec><sec id="sec2"><title>Methods</title><p>Several databases, including Scopus, Medline (via PubMed), and Web of Science, were searched (until August 2023) to identify those studies that address the <italic>mgrB</italic> mutation in clinical isolates of <italic>K. pneumoniae</italic>. Using Stata software, the pooled prevalence of <italic>mgrB</italic> mutation and subgroup analyses for the year of publication, country, continent, <italic>mgrB</italic> mutation types, and detection methods of <italic>mgrB</italic> mutation were analyzed.</p></sec><sec id="sec3"><title>Results</title><p>Out of the 115 studies included in the analysis, the prevalence of <italic>mgrB</italic> mutations in colistin-resistant <italic>K. pneumoniae</italic> isolates was estimated at 65% of isolates, and <italic>mgrB</italic> variations with insertional inactivation had the highest prevalence among the five investigated mutations with 69%. The year subgroup analysis indicated an increase in mutated <italic>mgrB</italic> from 46% in 2014 to 61% in 2022. Europe had the highest prevalence of mutated <italic>mgrB</italic> at 73%, while Africa had the lowest at 54%.</p></sec><sec id="sec4"><title>Conclusion</title><p>Mutations in the <italic>mgrB</italic> gene are reported as one of the most common mechanisms of colistin resistance in <italic>K. pneumoniae,</italic> and the results of the present study showed that 65% of the reported colistin-resistant <italic>K. pneumoniae</italic> had a mutation in this gene.</p></sec>