Drug Resistance(Dapsone,Rifampicin,Ofloxacin) and Resistance-Related Gene Mutation Features in Leprosy Patients:A Systematic Review and Meta-Analysis
作者单位：Department of Epidemiology and Health StatisticsSchool of Public HealthSoutheast University Department of Chronic Infectious Disease Control and PreventionJiangsu Provincial Center for Disease Control and Prevention
会议名称：《2023年全国皮肤病防治学术年会》
会议日期：2023年
学科分类：1002[医学-临床医学] 100206[医学-皮肤病与性病学] 10[医学]
摘 要：Dapsone(DDS),Rifampicin(RIF) and Ofloxacin(OFL) are drugs recommended by the World Health Organization(WHO) for the treatment of *** the context of leprosy,resistance to these drugs occurs mainly due to mutations in the target genes(Folp1,RpoB and GyrA).It is important to monitor antimicrobial resistance in patients with ***,we performed a meta-analysis of drug resistance in Mycobacterium leprae and the mutational profile of the target *** this paper,we limited the study period to May 2022 and searched PubMed,Web of Science(WOS),Scopus,and Embase databases for identified *** independent reviewers extracted the study *** and drug-resistance rates were estimated in Stata *** results demonstrated that the drug-resistance rate was 10.18%(95% CI:7.85–12.51).Subgroup analysis showed the highest resistance rate was in the Western Pacific region(17.05%,95% CI:1.80 to 13.78),and it was higher after 2009 than before [(11.39%,7.46–15.33) vs.6.59%(3.66–9.53)].We can conclude that the rate among new cases(7.25%,95% CI:4.65–9.84) was lower than the relapsed(14.26%,95 CI%:9.82–18.71).Mutation rates of Folp1,RpoB and GyrA were 4.40%(95% CI:3.02–5.77),3.66%(95% CI:2.41–4.90) and 1.28%(95% CI:0.87–1.71) respectively,while the rate for polygenes mutation was1.73%(0.83–2.63).For further analysis,we used 368 drug-resistant strains as research subjects and found that codons(Ser,Pro,Ala) on RpoB,Folp1 and GyrA are the most common mutation sites in the determining region(DRDR).In addition,the most common substitution patterns of Folp1,RpoB,and GyrA are Pro→Leu,Ser→Leu,and Ala→*** study found that a higher proportion of patients has developed resistance to these drugs,and the rate has increased since 2009,which continue to pose a challenge to *** addition,the amino acid alterations in the sequence of the DRDR regions and the substitution patterns mentioned in the study also provide new ideas for clinical treatment options.