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Review
. 2022 Jan 28;11(2):171.
doi: 10.3390/antibiotics11020171.

Prevalence of Vancomycin-Resistant Enterococcus (VRE) in Poultry in Malaysia: The First Meta-Analysis and Systematic Review

Yusuf Wada  1   2 , Ahmad A Irekeola  1   3 , Rafidah H Shueb  1 , Mustapha Wada  4 , Hafeez A Afolabi  5 , Chan Y Yean  1 , Azian Harun  1   6 , Abdul R Zaidah  1   6
Affiliations
Review

Prevalence of Vancomycin-Resistant Enterococcus (VRE) in Poultry in Malaysia: The First Meta-Analysis and Systematic Review

Yusuf Wada et al. Antibiotics (Basel). .

Abstract

Databases such as PubMed, Scopus and Google Scholar were searched. Data extraction and assessment of study protocol was done by two independent reviewers and the results were reviewed by a third. OpenMeta analyst and comprehensive meta-analysis (CMA) were used for the meta-analysis. The random effect model was used, publication bias and between-study heterogeneity was assessed. Seventeen studies were added to the final meta-analysis. Studies were sampled from 2000-2018 and of the 8684 isolates tested, 2824 were VRE. The pooled prevalence of VRE among poultry in Malaysia was estimated at 24.0% (95% CI; 16.7-33.1%; I2 = 98.14%; p < 0.001). Between-study variability was high (t2 = 0.788; heterogeneity I2 = 98.14% with heterogeneity chi-square (Q) = 858.379, degrees of freedom (df) = 16, and p < 0.001). The funnel plot showed bias which was confirmed by Egger's test and estimates from the leave-one-out forest plot did not affect the pooled prevalence. Pooled prevalence of VRE in chickens and ducks were 29.2% (CI = 18.8-42.5%) and 11.2%, CI = 9.0-14.0%) respectively. Enterococcus faecalis was reported most with more studies being reported in Peninsular Malaysia Central region and used antibiotic disc diffusion as detection method. Increased surveillance of VRE in poultry in Malaysia is required.

Keywords: Malaysia; meta-analysis; poultry; vancomycin-resistant Enterococcus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram for the selection of eligible articles included in the study.
Figure 2
Figure 2
Forest plot showing the pooled prevalence of VRE in poultry in Malaysia.
Figure 3
Figure 3
Leave-one-out forest plot of VRE in poultry in Malaysia.
Figure 4
Figure 4
Funnel plot showing publication bias in studies reporting the prevalence of VRE in in poultry in Malaysia. Studies on the right side are fewer than those on the left and thus asymmetrical. The funnel plot is used for the visualization of bias.
Figure 5
Figure 5
Funnel plot showing 4 added studies (in Red) in the Trim-and-Fill method reporting the prevalence of VRE in in poultry in Malaysia. This method simply looks for missing studies that will eventually eliminate bias. In this case, 4 studies will have to be added to the right side for the plot to be symmetrical.
Figure 6
Figure 6
Forest plot showing the subgroup meta-analysis by study year of VRE in poultry in Malaysia.
Figure 7
Figure 7
Forest plot showing the subgroup meta-analysis by study region of VRE in poultry in Malaysia.
Figure 8
Figure 8
Forest plot showing the subgroup meta-analysis by Isolate sources of VRE in poultry in Malaysia.
Figure 9
Figure 9
Forest plot showing the subgroup meta-analysis by detection method of VRE in poultry in Malaysia.
See this image and copyright information in PMC

References

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