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

机译：多药抗性和扩展谱β-内酰胺酶（ESBL）的患病率 - 克隆阴性杆菌：埃塞俄比亚的Meta分析报告

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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.
机译：摘要多药抗性（MDR）扩展谱β-内酰胺酶（ESBL） - 发挥细菌分离产物作为对人体健康的全球威胁。关于埃塞俄比亚在埃塞俄比亚的多药抗性曲线和ESBL产生的革兰氏阴性杆菌（GNB）的总体患病率毫无少。因此，进行该荟萃分析以在埃塞俄比亚中产生多药耐药性和产生ESBL的GNB的比例估计。基于Web的搜索是在PubMed，Google Scholar，Research Gate，Scopus和其他数据库中进行的。研究中出版的文章纳入埃塞俄比亚ESBL生产GNB的患病率和抗微生物抗性概况被纳入该研究。提取相关数据并使用全面的Meta-Analysis 3.3.0软件进行统计分析。分析出版物偏见并用漏斗图呈现。在该荟萃分析中，ESBL制备GNB的总体比例估计为48.9％（95％置信区间[CI]：0.402,0.577）。 ESBL-生产Klebsiella肺炎，大肠杆菌和其他GNB的汇集比例估计分别为61.8％，41.2％和42.9％。关于针对选定药物的抗微生物抗性型材，抗性对抗氧化锆 - 克拉维酸的抗性的比例估计，Trimethoplim-磺胺甲氧唑，头孢噻肟，头孢唑胺，四环素，庆大霉素和环丙沙星为79.0％，78.4％，78.0％，72.4％，72.7％，58.9 ％和43.8％。发现MDR分离株的汇集比例估计为82.7％（95％CI：0.726,0.896），与其他国家相比相对较高。这突出了有必要有助于了解ESBL的实际流行病学的主动监测系统，帮助制定国家指南，以适当筛选ESBL，并支持制定用于管理与ESBL殖民殖民的患者的标准化方法。

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