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. 2021 Dec 3;10(1):168.
doi: 10.1186/s13756-021-00965-0.

Prevalence of antimicrobial resistance and its clinical implications in Ethiopia: a systematic review

Derbew Fikadu Berhe  1 , Getachew Tesfaye Beyene  2 , Berhanu Seyoum  3 , Meseret Gebre  2 , Kassa Haile  2 , Mulugeta Tsegaye  4 , Minyahil Tadesse Boltena  2 , Emawayish Tesema  2 , Taddele Cherinet Kibret  5 , Mulatu Biru  2 , Dawd S Siraj  6 , Daniel Shirley  6 , Rawleigh Howe  2 , Alemseged Abdissa  2
Affiliations

Prevalence of antimicrobial resistance and its clinical implications in Ethiopia: a systematic review

Derbew Fikadu Berhe et al. Antimicrob Resist Infect Control. .

Abstract

Background: Antimicrobial resistance is one of the major public health challenges in Ethiopia. However, there is no comprehensive summary of existing AMR data in the country.

Aim: To determine the prevalence of antimicrobial resistance and its clinical implications in Ethiopia.

Methods: A systematic literature search was performed on the PubMed/Medline database. Original studies on antimicrobial resistance conducted in Ethiopia between 1st January 2009 and 31st July 2019 were included. The outcome measure was the number of isolates resistant to antimicrobial agents in terms of specific pathogens, and disease condition. Data was calculated as total number of resistant isolates relative to the total number of isolates per specific pathogen and medication.

Results: A total of 48,021 study participants enrolled from 131 original studies were included resulting in 15,845 isolates tested for antimicrobial resistance. The most common clinical sample sources were urine (28%), ear, nose, and throat discharge collectively (27%), and blood (21%). All the studies were cross-sectional and 83% were conducted in hospital settings. Among Gram-positive bacteria, the reported level of resistance to vancomycin ranged from 8% (Enterococcus species) to 20% (S. aureus). E. coli, K. pneumoniae and P. aeruginosa were the most common Gram-negative pathogens resistant to key antimicrobial agents described in the national standard treatment guideline and were associated with diverse clinical conditions: urinary tract infections, diarrhea, surgical site infections, pneumonia, ocular infections, and middle ear infections.

Conclusion: Overall, there is a high prevalence of antimicrobial resistance in Ethiopia. Empirical treatment of bacterial infections needs to be guided by up-to-date national guidelines considering local antimicrobial susceptibility patterns. Equipping diagnostic laboratories with culture and drug susceptibility testing facilities, and establishing a strong antimicrobial stewardship program should be high priorities.

Keywords: Antibacterial resistance; Antibiotic resistance; Drug resistance; Ethiopia; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
A flow diagram showing study selection and data extraction
See this image and copyright information in PMC

References

    1. Kimang’a AN. A situational analysis of antimicrobial drug resistance in Africa: are we losing the battle? Ethiop J Health Sci. 2012;22:135–143. - PMC - PubMed
    1. Jasovský D, Littmann J, Zorzet A, Cars O. Antimicrobial resistance-a threat to the world’s sustainable development. UPS J Med Sci. 2016;121:159–164. doi: 10.1080/03009734.2016.1195900. - DOI - PMC - PubMed
    1. Worku F, Tewahido D. Retrospective assessment of antibiotics prescribing at public primary healthcare facilities in Addis Ababa. Ethiopia Interdiscip Perspect Infect Dis. 2018;2018:4323769. - PMC - PubMed
    1. WHO. The evolving threat of antimicrobial resistance: options for action. World Health Organization; 2012.
    1. Okeke IN, Aboderin OA, Byarugaba DK, Ojo KK, Opintan JA. Growing problem of multidrug-resistant enteric pathogens in Africa. Emerg Infect Dis. 2007;13:1640–1646. doi: 10.3201/eid1311.070674. - DOI - PMC - PubMed

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