Dataset Information

Drug Resistance Patterns of Escherichia coli in Ethiopia: A Meta-Analysis.

ABSTRACT: Background:Antimicrobial drug resistance is a global threat for treatment of infectious diseases and costs life and money and threatens health delivery system's effectiveness. The resistance of E. coli to frequently utilized antimicrobial drugs is becoming a major challenge in Ethiopia. However, there is no inclusive countrywide study. Therefore, this study intended to assess the prevalence of E. coli resistance and antimicrobial-specific resistance pattern among E. coli clinical isolates in Ethiopia. Methods:Articles were retrieved from PubMed, Embase, and grey literature from 2007 to 2017. The main outcome measures were overall E. coli and drug-specific resistance patterns. A random-effects model was used to determine pooled prevalence with 95% confidence interval (CI), using DerSimonian and Laird method. In addition, subgroup analysis was conducted to improve the outcome. The study bias was assessed by Begg's funnel plot. This study was registered in PROSPERO as follows: PROSPERO 2017: CRD42017070106. Results:Of 164 articles retrieved, 35 articles were included. A total of 19,235 study samples participated in the studies and 2,635 E. coli strains were isolated. Overall, E. coli antibacterial resistance was 45.38% (95% confidence interval (CI): 33.50 to 57.27). The resistance pattern ranges from 62.55% in Addis Ababa to 27.51% in Tigray region. The highest resistance of E. coli reported was to ampicillin (83.81%) and amoxicillin (75.79%), whereas only 13.55% of E. coli isolates showed resistance to nitrofurantoin. Conclusion:E. coli antimicrobial resistance remains high with disparities observed among regions. The bacterium was found to be highly resistant to aminopenicillins. The finding implies the need for effective prevention strategies for the E. coli drug resistance and calls for multifaceted approaches with full involvement of all stakeholders.

SUBMITTER: Tuem KB

PROVIDER: S-EPMC5960519 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Drug Resistance Patterns of <i>Escherichia coli</i> in Ethiopia: A Meta-Analysis.

Tuem Kald Beshir KB Gebre Abadi Kahsu AK Atey Tesfay Mehari TM Bitew Helen H Yimer Ebrahim M EM Berhe Derbew Fikadu DF

BioMed research international 20180506

<h4>Background</h4>Antimicrobial drug resistance is a global threat for treatment of infectious diseases and costs life and money and threatens health delivery system's effectiveness. The resistance of <i>E. coli</i> to frequently utilized antimicrobial drugs is becoming a major challenge in Ethiopia. However, there is no inclusive countrywide study. Therefore, this study intended to assess the prevalence of <i>E. coli</i> resistance and antimicrobial-specific resistance pattern among <i>E. coli ...[more]

PMID: 29854757

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Project description:BackgroundAntimicrobial resistance is a serious public health problem. Fecal carriage of drug-resistant bacteria has been suggested as an important source of antimicrobial resistant genes (ARGs). We aimed to identify risk factors associated with fecal carriage of drug-resistant commensal Escherichia coli among healthy adult population.MethodsWe conducted a systematic review and meta-analysis following the PRISMA guideline. We identified observational studies published from 2014 to 2019 through PubMed, Embase, and Web of Science. Studies were eligible if they investigated and reported risk factors and accompanying measure of associations for fecal carriage of drug-resistant E. coli for healthy population aged 18-65. Data on risk factors assessed in three or more studies were extracted.ResultsFifteen of 395 studies involving 11480 healthy individuals were included. The pooled prevalence of drug-resistant Enterobacteriaceae was 14% (95% confidence interval [CI] 8-23%). Antimicrobial use within the 12 months prior to stool culture (odds ratio [OR] 1.84 [95%CI 1.35-2.51]), diarrhea symptoms (OR 1.56 [95%CI 1.09-2.25]), travel to India (OR 4.15 [95%CI 2.54-6.78]), and vegetarian diet (OR 1.60 [95%CI 1.00(1.0043)-2.56(2.5587)]) were associated with increased risk of fecal carriage of drug-resistant E. coli. Among travellers, antimicrobial use (OR 2.81 [95%CI 1.47-5.36]), diarrhea symptoms (OR 1.65 [95%CI 1.02-2.68]), travel to India (OR 3.80 [95%CI 2.23-6.47]), and vegetarian diet (OR 1.92 [95%CI 1.13-3.26]) were associated with increased risk. Among general adult population, antimicrobial use (OR 1.51 [95%CI 1.17-1.94]), diarrhea symptoms (OR 1.53 [95%CI 1.27-1.84]), and travel to Southeast Asia (OR 1.67 [95%CI 1.02-2.73]) were associated with the increased risk of drug-resistant E. coli carriage.ConclusionsThe findings indicate that dietary habit as well as past antimicrobial use and travel to high-risk country are associated with the risk of fecal carriage of drug-resistant commensal E. coli.

Project description:BackgroundShigella species are a major cause of dysentery and may attribute for death worldwide. Currently antibiotic resistance became the critical challenges for management of infectious disease. The aim was to conduct a systematic review and meta-analysis of Shigella species and its drug resistance pattern in Ethiopia.MethodsA comprehensive literature search was conducted through internet searches using database of MEDLINE, PubMed, Google scholar, EMBASE, HINARI, Cochrane Library and reference lists of previous prevalence studies from January 1999 to November 2018. Results were presented in forest plot, tables and figures with 95% CI. The Cochrane Q test and I2 test statistic were used to test heterogeneity across studies. The Pooled estimate of Shigella species and its drug resistance pattern was computed by a random effects model.ResultsThe pooled prevalence of Shigella species in Ethiopia was 6.6% (95% CI 4.7-8.8). In the subgroup analysis, the highest prevalence was observed among patients in Health facility (8.5%, 95% CI 6.2-11.5) whereas the lowest prevalence was observed in Community based studies (1.6%, 95% CI 0.8-3.4). In addition, Shigella species were highly resistant to ampicillin, amoxicillin, erythromycin and multi-drug resistant (MDR) with the pooled resistance proportions of 83.1% (95% CI 75.7-88.6), 84.1% (95% CI 75.6-90.1), 86.5% (95% CI 70.9-94.4) and 83.2% (95% CI 77.1-87.9), respectively. On the other hand, comparably low resistance pattern was reported for ciprofloxacin 8.9% (95% CI 6.0-12.8), ceftriaxone 9.3% (95% CI 3.9-20.5), and norfloxacin 8.2% (95% CI 3.8-16.6) and gentamycin 17.3% (95% CI 11.2-25.9). Subgroup analyses indicated that study years were associated with a decreasing Shigella prevalence over time (p = 0.002).ConclusionThe pooled estimate showed high burden of Shigella infection and its high proportion of drug resistance pattern to ampicillin, amoxicillin and erythromycin in Ethiopia. Therefore, initiating and scale up of performing drug susceptibility test for each shigellosis case, educate the community and health care providers on appropriate use of antibiotics need to be considered and strengthened.

Project description:Antimicrobial resistance (AMR) is an emerging global concern, with the widespread use of antimicrobials in One Health contributing significantly to this phenomenon. Among various antimicrobials, tetracyclines are extensively used in the beef cattle industry, potentially contributing to the development of resistance in bacterial populations. This meta-analysis aimed to examine the association between tetracycline use in beef cattle and the development of tetracycline resistance in Escherichia coli isolates. A comprehensive search was conducted using multiple databases to gather relevant observational studies evaluating tetracycline use and tetracycline resistance in Escherichia coli isolates from beef cattle. The rate of tetracycline resistance from each study served as the effect measure and was pooled using a random-effects model, considering possible disparities among studies. The meta-analysis of 14 prospective longitudinal studies resulted in a 0.31 prevalence of tetracycline resistance in Escherichia coli in non-intervention (no exposure), contrasting numerically elevated resistance rates in the intervention (exposed) groups of 0.53 and 0.39 in those receiving tetracyclines via feed or systemically, respectively. Despite the observed numerical differences, no statistically significant differences existed between intervention and non-intervention groups, challenging the conventional belief that antimicrobial use in livestock inherently leads to increased AMR. The findings of this study underscore the need for additional research to fully understand the complex relationship between antimicrobial use and AMR development. A considerable degree of heterogeneity across studies, potentially driven by variations in study design and diverse presentation of results, indicates the intricate and complex nature of AMR development. Further research with standardized methodologies might help elucidate the relationship between tetracycline use and resistance in Escherichia coli isolated from beef cattle.

Dataset Information

Drug Resistance Patterns of Escherichia coli in Ethiopia: A Meta-Analysis.

Publications

Drug Resistance Patterns of <i>Escherichia coli</i> in Ethiopia: A Meta-Analysis.

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