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Molecular epidemiology of fluoroquinolone resistant Salmonella in Africa: A systematic review and meta-analysis.

ABSTRACT: Wide-ranging evidence on the occurrence of fluoroquinolone (FQ) resistance genetic determinants in African Salmonella strains is not available. The main objectives of this study were to assess the heterogeneity, estimate pooled proportions and describe the preponderance of FQ-resistance determinants in typhoidal and non-typhoidal Salmonella (NTS) isolates of Africa.Genetic and phenotypic data on 6103 Salmonella isolates were considered. Meta- and frequency analyses were performed depending on the number of studies by category, number of isolates and risks of bias. A random effects model was used to assess heterogeneity and estimate pooled proportions. Relative and cumulative frequencies were calculated to describe the overall preponderance of FQ-resistance determinants in quinolone resistant isolates.The pooled proportion of gyrA mutants (Salmonella enterica serovar Typhi, Salmonella enterica serovar Typhimurium, and Salmonella enterica serovar Enteritidis) was estimated at 5.7% (95% Confidence interval (CI) = 2.6, 9.8; Tau squared (T2) = 0.1105), and was higher in S. Typhi than in S. Typhimurium (odds ratio (OR) = 3.3, 95%CI = 2, 5.7). The proportions of each of gyrB and parC mutants, and strains with Plasmid Mediated Quinolone Resistance genes (qnrA, qnrB and qnrS) were low (? 0.3%). Overall, 23 mutant serotypes were identified, and most strains had mutations at codons encoding Ser83 and Asp87 of gyrA (82%, 95%CI = 78, 86).Mutations at gyrA appear to account for ciprofloxacin non-susceptibility in most clinical Salmonella strains in Africa. The estimates could be harnessed to develop a mismatch-amplification mutation-assay for the detection of FQ-resistant strains in Africa.

SUBMITTER: Tadesse G

PROVIDER: S-EPMC5809059 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Molecular epidemiology of fluoroquinolone resistant Salmonella in Africa: A systematic review and meta-analysis.

Tadesse Getachew G Tessema Tesfaye S TS Beyene Getenet G Aseffa Abraham A

PloS one 20180212 2

<h4>Background</h4>Wide-ranging evidence on the occurrence of fluoroquinolone (FQ) resistance genetic determinants in African Salmonella strains is not available. The main objectives of this study were to assess the heterogeneity, estimate pooled proportions and describe the preponderance of FQ-resistance determinants in typhoidal and non-typhoidal Salmonella (NTS) isolates of Africa.<h4>Methods</h4>Genetic and phenotypic data on 6103 Salmonella isolates were considered. Meta- and frequency anal ...[more]

PMID: 29432492

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Project description:BackgroundStreptomycin is used as an epidemiological marker in monitoring programs for antimicrobial resistance in Salmonella serovars and indicates the presence of pentaresistance. However, comprehensive data on streptomycin resistant Salmonella among human, animal, and animal products is lacking in Ethiopia. In this review, we aimed to assess heterogeneity and pooled proportion of Salmonella serovars to streptomycin resistance among human, animal and animal products in Ethiopia.MethodsWe conducted a systematic review and meta-analysis of published literature from Ethiopia. We used the MEDLINE/ PubMed, Embase, Cochrane Library, and Google Scholar databases to identify genetic and phenotypic data on Salmonella isolates. To determine the heterogeneity and pooled proportion, we used metaprop commands and the random-effects model. Relative and cumulative frequencies were calculated to describe the overall preponderance of streptomycin resistance isolates after arcsine-transformed data. Metan funnel and meta-bias using a begg test were performed to check for publication bias.ResultsOverall, we included 1475 Salmonella serovars in this meta-analysis. The pooled proportion of streptomycin resistance was 47% (95% CI: 35-60%). Sub-group analysis by target population showed that the proportion of streptomycin resistance in Salmonella serovars was 54% (95% CI: 35-73%) in animal, 44% (95% Cl: 33-59%) in humans and 39% (95% CI: 24-55%) in animals products. The streptomycin resistant Salmonella serovars were statistically increasing from 0.35(95% CI: 0.12-0.58) in 2003 to 0.77(95% CI: 0.64-0.89) in 2018. The level of multidrug-resistant (MDR) Salmonella serovars was 50.1% in the meta-analysis.ConclusionWe found a high level of streptomycin resistance, including multidrug, Salmonella serovars among human, animals, and animal products. This resistance was significantly increasing in the last three decades (1985-2018). The resistance to streptomycin among Salmonella serovars isolated from animals was higher than humans. This mandates the continuous monitoring of streptomycin use and practicing one health approach to preventing further development of resistance in Ethiopia.RegistrationWe conducted a systematic review and meta-analysis after registration of the protocol in PROSPERO (CRD42019135116) following the MOOSE (Meta-Analysis of Observational Studies in Epidemiology).

Project description:Background and aimGlomerulonephritis (GN) is a leading cause of end-stage renal disease (ESRD) in Africa. Data on epidemiology and outcomes of glomerular diseases from Africa is still limited. We conducted a systematic review on the epidemiology of histologically proven glomerular diseases in Africa between 1980 and 2014.Materials and methodsWe searched literature using PubMed, AfricaWide, the Cumulative Index to Nursing and Allied Health Literature on EBSCO Host, Scopus, African Journals online databases, and the African Index Medicus, for relevant studies. The review was conducted using standard methods and frameworks using only biopsy-confirmed data.ResultsTwenty four (24) studies comprising 12,093 reported biopsies from 13 countries were included in this analysis. The median number of biopsies per study was 127.0 (50-4436), most of the studies (70.0%) originated from North Africa and the number of performed kidney biopsies varied from 5.2 to 617 biopsies/year. Nephrotic syndrome was the commonest indication of renal biopsy. The frequency of reported primary pathologic patterns included, minimal change disease (MCD); 16.5% (95%CI: 11.2-22.6), focal segmental glomerulosclerosis (FSGS); 15.9% (11.3-21.1), mesangiocapillary GN (MCGN); 11.8% (9.2-14.6), crescentic GN; 2.0% (0.9-3.5) and IgA nephropathy 2.8% (1.3-4.9). Glomerular diseases related to hepatitis B and systemic lupus erythematosus had the highest prevalence among assessed secondary diseases: 8.4% (2.0-18.4) and 7.7% (4.5-11.7) respectively. There was no evidence of publication bias and regional differences were seen mostly for secondary GNs.ConclusionsGlomerular diseases remain poorly characterized in sub-Saharan Africa due to declining renal biopsy rates and consequent paucity of data on pathologic patterns of key renal diseases. Development of renal biopsy registries in Africa is likely to enable adequate characterization of the prevalence and patterns of glomerular diseases; this could have a positive impact on chronic kidney disease evaluation and treatment in the African continent since most glomerulopathies are amenable to treatment.

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Dataset Information

Molecular epidemiology of fluoroquinolone resistant Salmonella in Africa: A systematic review and meta-analysis.

Publications

Molecular epidemiology of fluoroquinolone resistant Salmonella in Africa: A systematic review and meta-analysis.

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