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Meta-Analysis
. 2023 May 3;23(1):277.
doi: 10.1186/s12879-023-08237-5.

Prevalence of carbapenemase-producing Enterobacteriaceae from human clinical samples in Ethiopia: a systematic review and meta-analysis

Ermiyas Alemayehu  1 , Temesgen Fiseha  2 , Alemu Gedefie  2 , Nuhamin Alemayehu Tesfaye  3 , Hussen Ebrahim  2 , Endris Ebrahim  2 , Mesfin Fiseha  2 , Habtye Bisetegn  2 , Ousman Mohammed  2 , Mihret Tilahun  2 , Daniel Gebretsadik  2 , Habtu Debash  2 , Mengistie Yirsaw Gobezie  3
Affiliations
Meta-Analysis

Prevalence of carbapenemase-producing Enterobacteriaceae from human clinical samples in Ethiopia: a systematic review and meta-analysis

Ermiyas Alemayehu et al. BMC Infect Dis. .

Abstract

Introduction: Carbapenemase-producing Enterobacteriaceae are by far the most public health and urgent clinical problems with antibiotic resistance. They cause longer hospital stays, more expensive medical care, and greater mortality rates. This systematic review and meta-analysis aimed to indicate the prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia.

Methods: This systematic review and meta-analysis was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Electronic databases like PubMed, Google Scholar, CINAHL, Wiley Online Library, African Journal Online, Science Direct, Embase, ResearchGate, Scopus, and the Web of Sciences were used to find relevant articles. In addition, the Joanna Briggs Institute quality appraisal tool was used to assess the quality of the included studies. Stata 14.0 was used for statistical analysis. Heterogeneity was assessed by using Cochran's Q test and I2 statistics. In addition, publication bias was assessed using a funnel plot and Egger's test. A random effect model was used to estimate the pooled prevalence. Sub-group and sensitivity analysis were also done.

Results: The overall pooled prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia was 5.44% (95% CI 3.97, 6.92). The prevalence was highest [6.45% (95% CI 3.88, 9.02)] in Central Ethiopia, and lowest [(1.65% (95% CI 0.66, 2.65)] in the Southern Nations and Nationalities People Region. In terms of publication year, 2017-2018 had the highest pooled prevalence [17.44 (95% CI 8.56, 26.32)] and 2015-2016 had the lowest [2.24% (95% CI 0.87, 3.60)].

Conclusion: This systematic review and meta-analysis showed a high prevalence of carbapenemase-producing Enterobacteriaceae. So, to alter the routine use of antibiotics, regular drug susceptibility testing, strengthening the infection prevention approach, and additional national surveillance on the profile of carbapenem resistance and their determining genes among Enterobacteriaceae clinical isolates are required.

Systematic review registration: PROSPERO (2022: CRD42022340181).

Keywords: Carbapenemase; Enterobacteriaceae; Ethiopia; Meta-analysis; Prevalence; Systematic review.

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Conflict of interest statement

The authors declared that no competing interest for their work.

Figures

Fig. 1
Fig. 1
Flow diagram of the included studies for the systematic review and meta-analysis of the prevalence of CPE in Ethiopia
Fig. 2
Fig. 2
Forest plot showing the pooled prevalence of CPE in Ethiopia from random-effect model analysis
Fig. 3
Fig. 3
Funnel plot on the prevalence of CPE in Ethiopia
See this image and copyright information in PMC

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