Evidence map›Paper›PMID 41661521›Full record

SynthesisInfection2026

Emerging resistance to imipenem-relebactam among enterobacterales and non-fermenting gram-negative bacilli: a systematic review and meta-analysis.

Mengyu Ge, Weidong Qiang, Pengcheng Wang

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Mengyu GeDepartment of Pharmacy, Jinhua Hospital Affiliated to Zhejiang University, Jinhua, 321000, China.
Weidong QiangCollege of Medicine, Huanghuai University, Zhumadian, 463000, China.
Pengcheng WangDepartment of Pharmacy, Jinhua Hospital Affiliated to Zhejiang University, Jinhua, 321000, China. mycrazyoo@163.com.

Funding

Jinhua Science and Technology Plan Project 2023-4-080National Scientific Research Project Cultivation Fund Project of Huanghuai University XKPY-2024013Natural Science Foundation of Henan Province project 252300421674Zhumadian City Science and Technology Innovation Youth Project QNZX202302
6 · The paper itself

Abstract

backgroundMultidrug-resistant Gram-negative bacteria (GNB), including carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa, pose a growing global health threat with limited treatment options. Imipenem-relebactam (IMI/REL) is a promising therapy, but emerging resistance patterns remain poorly defined worldwide.

objectivesThis meta-analysis aimed to provide a comprehensive assessment of global IMI/REL resistance among Enterobacterales and non-fermenting GNB, highlighting species-specific, geographic, and temporal patterns.

methodsStudies were searched in Scopus, PubMed, and EMBASE (until October 23 2024), and all statistical analyses were conducted using R (ver. 4.2.1).

resultsA total of 149,396 Enterobacterales and non-fermenting GNB were included. Overall, IMI/REL resistance was low at 8.8% (95% CI 7.3-10.5), with Enterobacterales showing the lowest resistance (2.9%) and Pseudomonas the highest (30.7%). Resistance was higher in carbapenemase-producing Enterobacterales and non-fermenting species, and varied by infection source and geography. Temporal analysis indicated a rising trend in resistance over recent years, while data were mostly derived from the Americas, limiting global generalizability.

conclusionIMI/REL remains largely effective against Enterobacterales, including ESBL and MDR strains, but resistance is increasing in high-risk subgroups and non-fermenting bacteria. These findings underscore the need for local susceptibility testing, cautious empiric therapy, and robust antimicrobial stewardship to preserve the efficacy of IMI/REL.

Indexed as

Anti-Bacterial AgentsAzabicyclo CompoundsDrug Resistance, Multiple, BacterialEnterobacteriaceaeGram-Negative BacteriaImipenemHumansMicrobial Sensitivity TestsAnti-Bacterial AgentsAzabicyclo CompoundsImipenemrelebactamAntimicrobial resistanceEnterobacteralesGram negative bacteriaImipenem-relebactamPseudomonadsSystematic review and meta-analysis

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.