Comprehensive analysis of Burkholderia species head and neck infections: A systematic review.

Autor: Nanu DP; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; Elson S. Floyd College of Medicine at Washington State University, Spokane, WA, United States of America., Marrero-Gonzalez AR; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; University of Puerto Rico School of Medicine, San Juan, Puerto Rico., Nguyen SA; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America. Electronic address: nguyensh@musc.edu., Newman JG; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America.
Jazyk: angličtina
Zdroj: American journal of otolaryngology [Am J Otolaryngol] 2024 Dec 04; Vol. 46 (1), pp. 104544. Date of Electronic Publication: 2024 Dec 04.
DOI: 10.1016/j.amjoto.2024.104544
Abstrakt: Objective: To report the first systematic review and meta-analysis of Burkholderia species infections of the head and neck to facilitate understanding of the disease's demographics, mortality rate, comorbidities associated, symptoms, and antibiotic treatments utilized.
Data Sources: COCHRANE Library, CINAHL, PubMed, and Scopus.
Review Methods: A systematic review and meta-analysis were performed using PRISMA reporting guidelines. Inclusion criteria included non-surgical patients who were diagnosed with any head and neck Burkholderia infection. Demographics included, patient age and gender. Symptoms, antibiotics given, bacteriology, comorbidities and mortality were analyzed. Meta-analysis of continuous measures (mean), and proportions (%) with a 95 % confidence interval (CI) was conducted. Studies were accessed for bias via the JBI appraisal tool.
Results: There were 740 studies screened with 45 studies (N = 132) being included. In total, 50.1 % were females (95 % CI: 43-57) with a mean patient age of 28.7 years (95 % CI: 25.9 to 31.5). Overall survival rate was 83.4 % (95 % CI: 77.5 to 88.4) and predominant localized symptoms were neck swelling at 38.4 % (95 % CI: 27.5 to 49.9), followed by neck abscess at 34.1 % (27.5 to 41.2) and head and neck suppurative lymphadenitis at 22.9 % (17.3 to 29.4). Main antibiotic treatments included: trimethoprim-sulfamethoxazole at 63.0 % (95 % CI: 55.9 to 69.8), ceftazidime at 47.9 % (40.7 to 55.1), and doxycycline at 26.7 % (10.7 to 33.5).
Conclusion: Burkholderia infections exhibit diverse symptoms, which pose a challenge in diagnosis. Additionally, prescription of non-guideline antibiotics highlights the initial difficulty in identifying these organisms as the primary culprit of infection causing delayed treatment.
Competing Interests: Declaration of competing interest Authors state that there are no conflicts of interest.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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