[Trends of antimicrobial resistance in Vibrio parahaemolyticus isolates in China from 2002 to 2022: a systematic review and meta-analysis].

Objective: To investigate the antimicrobial resistance trends of Vibrio parahaemolyticus isolates in China from 2002 to 2022, and to describe their overall profile and spatiotemporal dynamics. Methods: Two investigators independently searched research articles published between 2002 and 2022 on the antimicrobial resistance phenotypes of Vibrio parahaemolyticus isolates in China, from the China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Journal Service Platform, Web of Science, and PubMed medical literature databases. The pooled resistance rates for the 9 antimicrobial drugs were calculated using a random-effects model, and subgroup analyses were conducted stratified by isolation time, geographical location, and source. Results: A total of 98 studies were included altogether, involving 21 542 strains of Vibrio parahaemolyticus isolated in China. The pooled resistance rates (95%CI) for ampicillin, gentamicin, ciprofloxacin, Trimethoprim-Sulfamethoxazole, chloramphenicol, tetracycline, ceftazidime, imipenem, and amikacin were respectively 71.09% (64.49%-77.28%), 1.55% (0.85%-2.40%), 0.61% (0.18%-1.20%), 3.51% (2.16%-5.12%), 0.84% (0.33%-1.52%), 2.15% (1.28%-3.18%), 0.54% (0.21%-0.96%), 0.27% (0-0.94%), and 3.95% (1.66%-7.02%), respectively. In thetime-stratified subgroup analysis, the gentamicin resistance rate peaked during 2002-2006 (P<0.001), while resistance rates for both chloramphenicol (P=0.031) and ceftazidime (P=0.005) reached their highest levels in 2017-2022. Geographical subgroup analysis revealed that Northeast China had the highest resistance to amikacin (P<0.001), tetracycline (P=0.006), and ciprofloxacin (P=0.012) but the lowest ampicillin resistance (P<0.001); North China exhibited the highest ciprofloxacin resistance (P=0.044). In the strain source analysis, environmental strains had higher resistance rates to ciprofloxacin than aquatic product-derived strains (P<0.001), to chloramphenicol than clinical source strains (P<0.001) and aquatic product-derived strains (P<0.001), and to ceftazidime than both clinical source strains (P<0.001) and aquatic product-derived strains (P<0.001). Conclusions: Overall, Vibrio parahaemolyticus strains isolated in China show high resistance rates to ampicillin, while demonstrating low resistance rates to other antimicrobial drugs. Significant variations in resistance were observed according to isolation time, geographical region, and source. Targeted surveillance and control strategies should be implemented based on these variations.