Apramycin resistance in bacteria isolated from humans, a systematic review and meta-analysis
This article has been Reviewed by the following groups
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background Apramycin is an aminoglycoside that is used in animals but has not been authorized for use in humans. However, interest has been raised about repurposing it for us in humans because of its activity against Gram negative pathogens. Objective To systematically review and analyze data pertaining to apramycin resistance in bacteria isolated from humans and to identify knowledge gaps, to inform work evaluating the potential for re-purposing of apramycin for clinical use in humans. Methods A systematic review and meta-analysis was performed. Results The review identified 34 studies of apramycin susceptibility in humans. Pooled estimates for apramycin resistance were 6% (95% CI 1-12%) for E. coli, 1% (0-3%) for Acinetobacter spp, 2% (0-5%) for Enterobacter spp, 7% (2-15%) for Klebsiella spp, 4% (0-13%) for Pseudomonas and 0% (0-0%) for Salmonella spp. Conclusion Despite nearly 50 years of apramycin use in animals, apramycin resistance was identified in bacteria of human origin but was rare, supporting the potential value of re-purposing this drug for use in humans and suggesting that there is limited spillover of resistance from veterinary and agricultural use of apramycin.
