Bacterial Pathogens and Their Antimicrobial Resistance Patterns of Inanimate Surfaces and Equipment in Ethiopia: A Systematic Review and Meta-analysis

Abstract

Background. Hospital-acquired infections have remained a serious cause of mortality, morbidity, and extended hospitalization. Bacterial contamination of inanimate surfaces of the hospital environment and equipment is considered a major contributing factor to the development of several nosocomial infections worldwide. The hospital environment and many devices are an important reservoir of many clinically important bacterial agents including multidrug-resistant pathogens. Therefore, this systematic review and meta-analysis are aimed at investigating bacterial pathogens and their antimicrobial resistance patterns of inanimate surfaces and equipment in Ethiopia. Methods. An exhaustive literature search was carried out using the major electronic databases including PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, Google Scholar, Cochrane Library, Scopus, and Wiley online library to identify potentially relevant studies without date restriction. Original articles which address the research question were identified, screened, and included using the PRISMA flow diagram. Data extraction was prepared in Microsoft Excel, and data quality was assessed by using 9-point Joanna Briggs Institute critical appraisal tools. Then, data were exported to STATA 16.0 software for analyses of pooled estimation of outcome measures. Estimation of outcome measures at a 95% confidence interval was performed using DerSimonian-Laird’s random-effects model. Finally, results were presented via text, figures, and tables. Results. A total of 18 studies with 3058 bacterial isolates recovered from 3423 swab specimens were included for systematic review and meta-analysis. The pooled prevalence of bacterial contamination of inanimate surfaces and equipment was found 70% (95% CI: 59, 82). Among the Gram-negative bacterial species, the prevalence of ampicillin-resistant K. pneumoniae was the highest 80% (95% CI: 78, 92) followed by Citrobacter species 78% (95% CI: 57, 83). Conclusion. This study has shown a high prevalence of bacterial contamination of inanimate surfaces and equipment in Ethiopia.

Hospital-Based Air-Borne and Surface-Borne Bacterial Pathogens and Their Antimicrobial Profiles in Wolaita Sodo, Southern Ethiopia

“…However, this fnding was higher than previous studies done in Morocco (26.8%) [35], Palestine (24.7%) [36], and Egypt (25.6%) [37]. In contrast, this fnding was lower than previous studies conducted in Ethiopia (70%) [31], Northern Ethiopia [15], Jimma (66%) [16], Eastern Ethiopia (53.8%), Addis Ababa (86%) [38], Zimbabwe (86.21%) [39], and Nigeria (56.7%) [40]. Tis variation could be due to differences in the infection management systems of hospitals within or in diferent countries, hygiene practices of the population in the hospital environment, architecture characteristics, sample size, and microbial characteristics.…”

“…The sample size was calculated using a single population proportion formula considering the 95% level taking the prevalence of 70% from a previous study [ 31 ] and degree of allowable error 0.05. The sample size is therefore calculated as follows: where N = sample size.…”

Multidrug-resistant and carbapenemase-producing critical gram-negative bacteria isolated from the intensive care unit environment in Amhara region, Ethiopia

“…In contrast to the present study, Acinetobacter species, A. baumannni was the most persistently detected isolate in ICUs [25,26]. Moreover, a systematic review and meta-analysis that estimated the overall prevalence of bacterial contamination on inanimate surfaces and equipment in Ethiopia reported that E. coli was the most commonly detected isolate, followed by P. aeruginosa and K. pneumoniae [27]. This inconsistency with the results of other studies on the number and type of isolates may be due to differences in the number of people in the environment, amount of activity, amount of moisture, presence of material capable of supporting microbial growth, and type of environmental surface (for example, rough or smooth), and orientation in ICUs [11].…”

“…aeruginosa and K . pneumoniae [ 27 ]. This inconsistency with the results of other studies on the number and type of isolates may be due to differences in the number of people in the environment, amount of activity, amount of moisture, presence of material capable of supporting microbial growth, and type of environmental surface (for example, rough or smooth), and orientation in ICUs [ 11 ].…”

Gram-Negative Rods on Inanimate Surfaces of Selected Hospital Facilities and Their Nosocomial Significance

“…The results of Ahmed et al [28] and Kiros et al [41] point out that strains of Klebsiella pneumoniae are relatively common on inanimate surfaces. However, in our study, only two strains of K. pneumoniae (DAIC, n = 1; DIM, n = 1) were identified from inanimate surfaces.…”