As the only bactericidal drug in multidrug therapy is rifampicin, monitoring of antimicrobial resistance is important in leprosy patients. Therefore, we conducted a meta-analysis on the resistance of Mycobacterium leprae (M. leprae) to rifampicin and estimated drug resistance in different therapeutic states and regions.
Embase, Medline, PubMed, and Web of Science were searched to identify studies between January 1, 1993 and January 1, 2022. Two independent reviewers extracted study data. Pooled cumulative incidences were computed using the random-effects meta-analyses.
We included 32 papers and described the resistance of M. leprae to rifampicin (pooled cumulative incidences, 11% [95% CI, 7% to 15%]). Therapeutic states and regional distribution were obtained for subgroup analyses. A total of 51 of 1135 new cases (pooled incidence, 10% [95% CI, 5% to 16%]) and 81 of 733 relapsed cases (pooled incidence, 20% [95% CI, 13% to 27%]) had rifampicin resistance. A total of 139 participants, including 11 patients with rifampicin resistance (pooled incidence, 42% [95% CI, −21% to 105%]), were nonresponsive and intractable cases. The number of rifampicin resistance was highest in Western Pacific (pooled incidence, 21% [95% CI, 13% to 29%]) and lowest in Americas (pooled incidence, 4% [95% CI, 1% to 7%]).
It is recommended to carry out drug resistance testing in diagnosed leprosy patients and establish a robust and rigorous surveillance system to detect prevalence drug resistance in leprosy.
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