Prevalence of multidrug-resistant and extended-spectrum beta-lactamase (ESBL)-producing gram-negative bacilli: A meta-analysis report in Ethiopia

Abstract

Multidrug-resistant (MDR) extended-spectrum beta-lactamase (ESBL)-producing bacterial isolates have emerged as a global threat to human health. Little is known about the overall prevalence of multidrug resistance profile and ESBL-producing gram-negative bacilli (GNB) in Ethiopia. Therefore, this meta-analysis was performed to produce proportional estimates of multidrug resistance and ESBL-producing GNB in Ethiopia.
 A web-based search was conducted in PubMed, Google Scholar, Research Gate, Scopus and other databases. Articles published till 2019 on the prevalence and antimicrobial resistance profiles of ESBL-producing GNB in Ethiopia were included in the study. Relevant data were extracted and statistical analysis was performed using comprehensive meta-analysis version 3.3.0 software. Publication bias was analyzed and presented with funnel plots.
 In this meta-analysis, the overall proportional estimate of ESBL-producing GNB was 48.9% (95% confidence interval [CI]: 0.402, 0.577). The pooled proportional estimates of ESBL-producing Klebsiella pneumoniae, Escherichia coli and other GNB were 61.8%, 41.2% and 42.9%, respectively. Regarding antimicrobial resistance profiles against selected drugs, the pooled proportional estimates of resistance against amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole, cefotaxime, ceftazidime, tetracycline, gentamicin and ciprofloxacin was 79.0%, 78.4%, 78.0%, 72.4%, 72.7%, 58.9% and 43.8%, respectively. The pooled proportional estimates of MDR isolates were found to be 82.7% (95% CI: 0.726, 0.896), which are relatively high as compared to other countries. This highlights a need for active surveillance systems which can help understand the actual epidemiology of ESBL, aid in formulating national guidelines for proper screening of ESBL and support developing standardized approaches for managing patients colonized with ESBL

Global Prevalence of Nosocomial Multidrug-Resistant Klebsiella pneumoniae: A Systematic Review and Meta-Analysis

“…While in Ethiopia, the pooled proportional estimates of ESBL-producing K. pneumoniae were 61.8% (95% CI, 48.7–73.4) and the pooled proportion estimates of MDR isolates for both K. pneumoniae and E. coli were 82.7% (95% CI, 72.6–89.6), which was higher when compared with the current study, 45.9% (95% CI, 38.9–53.2). Ethiopia is a resource-limited country where it can be a considerable reason for the high prevalence of K. pneumoniae [ 52 ].…”

Bacterial Etiologies of Ear Infection and Their Antimicrobial Susceptibility Pattern at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia: A Six-Year Retrospective Study

“… 56 According to a recent meta-analysis report, an estimated 48.9% of Gram-negative (Enterobacteriaceae) clinical isolates in Ethiopia are ESβL producers, most of them are classified as MDR because they usually carry genes encoding resistance to antibiotics other than beta-lactams. 57 …”

High Magnitude of Fecal Carriage of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at Debre Berhan Comprehensive Specialized Hospital, Ethiopia

“…Researches have been undertaken in the context of infection caused by ESBL-PE in Ethiopia. 15 However, little is known regarding the gastrointestinal carriage rate of ESBL-PE in hospitalized patients. 16 , 17 Local epidemiological data on the carriage of ESBL-PE is very important to prevent and control nosocomial infection and the spread of antimicrobial resistance in hospitals.…”