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Hyperammonemia syndrome associated with Ureaplasma spp. Infections in immunocompromised patients and transplant recipients: A systematic review and meta‐analysis
Author(s) -
Tantengco Ourlad Alzeus G.,
De Jesus Federico Cristobal C.,
Gampoy Eloina Faye S.,
Ornos Eric David B.,
Vidal Manuel S.,
Abad Cybele Lara R.
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14334
Subject(s) - ureaplasma , medicine , meta analysis , incidence (geometry) , relative risk , pediatrics , gastroenterology , confidence interval , microbiology and biotechnology , mycoplasma , biology , physics , optics
Abstract Background Hyperammonemia syndrome (HS) is reported to occur in patients with Ureaplasma spp. infections. We performed a systematic review and meta‐analysis of studies reporting HS in patients with Ureaplasma spp. infection. Methods We searched several databases (CINAHL, OVID, ProQuest, and Scopus) from inception to January 2021. We described case reports and series, and performed a meta‐analysis for all cohort studies. The pooled risk ratio (RR) for the association between HS and Ureaplasma spp. infections was derived using a random‐effects model. Results The systematic review yielded 18 studies. HS was reported in 53 patients with Ureaplasma spp. infections. The most common clinical manifestations were neurologic. Meta‐analysis showed a higher incidence of HS (41.67%) and peak ammonia concentration among Ureaplasma spp.–infected lung transplant recipients compared with Ureaplasma spp.–negative recipients (2.84%). The risk of HS was significantly increased in Ureaplasma spp.–infected recipients compared with Ureaplasma spp.–negative recipients (RR: 14.64; CI: 2.85–75.24). Mortality from Ureaplasma‐associated HS was 27.27% compared with 5.24% in those with HS from other causes. Conclusions The risk of developing HS is higher among Ureaplasma‐infected patients compared with uninfected patients. Lung transplant recipients appear to be disproportionally affected, and HS should be suspected in those who present with neurologic symptoms.