Prevalence of multidrug-resistant bacteria in Ethiopia: a systematic review and meta-analysis

Alemayehu, Tsegaye

doi:10.1016/j.jgar.2021.05.017

Cited by 19 publications

(15 citation statements)

References 66 publications

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“…In this study, among 1470 bacterial isolates 1104 (75.52%) with a pooled prevalence of 70.56%, were resistant to three or more antimicrobial agents (multidrug resistance) (MDR). In line with this finding, Alemayehu [85] reported that the pooled prevalence of multidrug resistance was PLOS ONE 70.5% among bacterial isolates in Ethiopia. Another, meta-analysis study on multidrug resistance by Abayneh et al [86] reported the pooled prevalence of 80.5% among Gram-negative bacteria.…”

Section: Plos Onesupporting

confidence: 58%

Prevalence and drug resistance patterns of Gram-negative enteric bacterial pathogens from diarrheic patients in Ethiopia: A systematic review and meta-analysis

et al. 2022

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Background Diarrhoea is the leading cause of morbidity and mortality in the world particularly in developing countries and among vulnerable groups of the population. Gram-negative enteric bacterial pathogens (GNEBPs) are a group of organisms that reside mainly in the intestine and induce diarrhoea. Antimicrobial agents are usually the part of their treatment regimen. The therapeutic effect of antimicrobials is hindered by the emergence and spread of drug-resistant strains. The information regarding the prevalence and antimicrobial resistance patterns of GNEBPs in Ethiopia is limited and found in a scattered form. Objectives This study was designed to determine the pooled prevalence and drug resistance patterns of GNEBPs by meta-analysis of data from diarrhoeic patients in Ethiopia. Method A comprehensive literature search was conducted through internet searches using Google Scholar, PubMed, Science Direct, HINARI databases, and reference lists of previous studies. Published articles were included in the study based on priorly set inclusion and exclusion criteria. Results were presented in the forest plot, tables, and figures with a 95% confidence interval (CI). The inconsistency index (I2) test statistics was used to assess heterogeneity across studies. The pooled prevalence estimate of GNEBPs and their drug resistance patterns were computed by a random-effects model. Software for Statistics and Data Science (STATA) version 14 statistical software was used for the analysis. Result After removing those articles which did not fulfil the inclusion criteria, 43 studies were included in the analysis. Studies were conducted in 8 regions of the country and most of the published articles were from the Amhara region (30.23%) followed by Oromia (18.60%) and Southern Nations, Nationalities, and Peoples’ region (SNNP) (18.60%). The pooled prevalence of GNEBPs was 15.81% (CI = 13.33–18.29). The funnel plot indicated the presence of publication bias. The pooled prevalence of GNEBPs in Addis Ababa, Amhara, SNNP, and Oromia regions were 20.08, 16.67, 12.12, and 11.61%, respectively. The pooled prevalence was 14.91, 18.03, and 13.46% among studies conducted from 2006–2010, 2011–2015, and 2016–2021, respectively and it was the highest (20.35%) in children having age less than or equal to 15 years. The pooled prevalence of Escherichia coli, Campylobacter spp., Shigella spp., and Salmonella enterica were 19.79, 10.76, 6.24, and 5.06%, respectively. Large proportions (60–90%) of the isolates were resistant to ampicillin, amoxicillin, tetracycline, and trimethoprim-sulphamethoxazole. The pooled prevalence of multidrug resistance (MDR) was 70.56% (CI = 64.56–76.77%) and MDR in Campylobacter spp., Shigella spp., E. coli, and S. enterica. were 80.78, 79.08, 78.20, and 59.46%, respectively. Conclusion The pooled estimate showed a high burden of GNEBPs infections and a high proportion of drug resistance characters to commonly used antimicrobial agents in Ethiopia. Therefore, performing drug susceptibility tests, establishing an antimicrobial surveillance system and confirmation by molecular techniques are needed.

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Section: Plos Onesupporting

confidence: 58%

Prevalence and drug resistance patterns of Gram-negative enteric bacterial pathogens from diarrheic patients in Ethiopia: A systematic review and meta-analysis

et al. 2022

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“…Still it was comparable to that of Addis Ababa (72.4%) but slightly lower than that of Harari (74.6%) and significantly lower than that of Sidama (81.7%). The differences in the MDR prevalence might be due to the differences in geography, client types, the types of bacteria, the methods used, and variations in the level of implementation of infection prevention protocols [49]. The findings showed the MDR prevalence in the present study was higher than the report from elsewhere in Ethiopia, 47.8% [23].…”

Section: Multidrug Resistance (Mdr)contrasting

confidence: 64%

Burden of Antibiotic Resistance at Wolaita Sodo University Comprehensive Specialized Hospital

Ageru

Seid

Abiso

et al. 2022

BioMed Research International

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Background. Antibiotic resistance is a serious threat to the human population everywhere. However, less attention is given to its concern in sub-Saharan Africa including Ethiopia. There is an information gap concerning antibiotic resistance and its pattern in Wolaita Sodo University Teaching Referral Hospital. This study is aimed at investigating the prevalence of antimicrobial resistance in the study area. Methods. Five-year retrospective data of cultures and records of 581 patients were utilized to analyze the pattern of antibiotic resistance. The statistical software including SPSS version 25 and Microsoft excel 2013 were used. Laboratory records with incompletely registered age, sex, culture isolation, or drug susceptibility test data were excluded. Results. Out of the total of 581 samples extracted from the microbiology laboratory, 237 (40.8%) samples were culture positive for bacteria. From positive culture growth, 165 (69.6%) were gram-positive bacteria whereas 72 (30.4%) were gram negative. Staphylococcus aureus was the most prevalent isolate among gram-positive isolates as Escherichia coli was for gram-negative isolates. Overall antibiotic resistance of gram-positive isolates was 57.2% whereas that of gram-negative bacteria was 58.8%.Conclusion. S. aureus and E. coli were found to be the most prevalent pathogenic isolates among gram-positive and gram-negative bacteria, respectively. Most of the isolated pathogens showed high resistance towards the commonly prescribed antibiotic agents. The overall antibiotic resistance in this study was 57.7%, and the overall MDR prevalence was 72.2%.

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“…The overall proportion of MDR bacterial pathogens in the current study was 70.7%. In line with this, the overall pooled prevalence of MDR bacterial infection in Ethiopia was 70.5% [ 39 ]. Another study reported a high prevalence of MDR bacterial infection (81.1%) in poultry farms in Gondar City, Northwest part of Ethiopia [ 30 ].…”

Section: Discussionmentioning

confidence: 76%

Multidrug-resistance and extended-spectrum beta-lactamase-producing lactose-fermenting enterobacteriaceae in the human-dairy interface in northwest Ethiopia

Beyene,

Gizachew,

Yousef

et al. 2024

PLoS ONE

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Background Antimicrobial resistance (AMR) is among the top public health concerns in the globe. Estimating the prevalence of multidrug resistance (MDR), MDR index (MDR-I) and extended-spectrum beta-lactamase (ESBL)-producing lactose fermenting Enterobacteriaceae (LFE) is important in designing strategies to combat AMR. Thus, this study was designed to determine the status of MDR, MDR-I and ESBL-producing LFE isolated from the human-dairy interface in the northwestern part of Ethiopia, where such information is lacking. Methodology A cross-sectional study was conducted from June 2022 to August 2023 by analyzing 362 samples consisting of raw pooled milk (58), milk container swabs (58), milker’s hand swabs (58), farm sewage (57), milker’s stool (47), and cow’s feces (84). The samples were analyzed using standard bacteriological methods. The antimicrobial susceptibility patterns and ESBL production ability of the LFE isolates were screened using the Kirby-Bauer disk diffusion method, and candidate isolates passing the screening criteria were phenotypically confirmed by using cefotaxime (30 μg) and cefotaxime /clavulanic acid (30 μg/10 μg) combined-disk diffusion test. The isolates were further characterized genotypically using multiplex polymerase chain reaction targeting the three ESBL-encoding- genes namely blaTEM, blaSHV, and blaCTX-M. Results A total of 375 bacterial isolates were identified and the proportion of MDR and ESBL-producing bacterial isolates were 70.7 and 21.3%, respectively. The MDR-I varied from 0.0 to 0.81 with an average of 0.30. The ESBL production was detected in all sample types. Genotypically, the majority of the isolates (97.5%), which were positive on the phenotypic test, were carrying one or more of the three genes. Conclusion A high proportion of the bacterial isolates were MDR; had high MDR-I and were positive for ESBL production. The findings provide evidence that the human-dairy interface is one of the important reservoirs of AMR traits. Therefore, the implementation of AMR mitigation strategies is highly needed in the area.

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Prevalence of multidrug-resistant bacteria in Ethiopia: a systematic review and meta-analysis

Cited by 19 publications

References 66 publications

Prevalence and drug resistance patterns of Gram-negative enteric bacterial pathogens from diarrheic patients in Ethiopia: A systematic review and meta-analysis

Prevalence and drug resistance patterns of Gram-negative enteric bacterial pathogens from diarrheic patients in Ethiopia: A systematic review and meta-analysis

Burden of Antibiotic Resistance at Wolaita Sodo University Comprehensive Specialized Hospital

Multidrug-resistance and extended-spectrum beta-lactamase-producing lactose-fermenting enterobacteriaceae in the human-dairy interface in northwest Ethiopia

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