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Meta-Analysis
. 2024 Apr 10;13(1):37.
doi: 10.1186/s13756-024-01389-2.

Prevalence of meropenem-resistant Pseudomonas Aeruginosa in Ethiopia: a systematic review and meta‑analysis

Mengistie Yirsaw Gobezie  1 , Minimize Hassen  2 , Nuhamin Alemayehu Tesfaye  2 , Tewodros Solomon  2 , Mulat Belete Demessie  2 , Tesfaye Dessale Kassa  3 , Teklehaimanot Fentie Wendie  2 , Abel Andualem  4 , Ermiyas Alemayehu  5 , Yaschilal Muche Belayneh  4
Affiliations
Meta-Analysis

Prevalence of meropenem-resistant Pseudomonas Aeruginosa in Ethiopia: a systematic review and meta‑analysis

Mengistie Yirsaw Gobezie et al. Antimicrob Resist Infect Control. .

Abstract

Introduction: Antimicrobial resistance (AMR) is a pressing global health concern, particularly pronounced in low-resource settings. In Ethiopia, the escalating prevalence of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) poses a substantial threat to public health.

Methods: A comprehensive search of databases, including PubMed, Scopus, Embase, Hinari, and Google Scholar, identified relevant studies. Inclusion criteria encompassed observational studies reporting the prevalence of meropenem-resistant P. aeruginosa in Ethiopia. Quality assessment utilized JBI checklists. A random-effects meta-analysis pooled data on study characteristics and prevalence estimates, with subsequent subgroup and sensitivity analyses. Publication bias was assessed graphically and statistically.

Results: Out of 433 studies, nineteen, comprising a total sample of 11,131, met inclusion criteria. The pooled prevalence of meropenem-resistant P. aeruginosa was 15% (95% CI: 10-21%). Significant heterogeneity (I2 = 83.6%) was observed, with the number of P. aeruginosa isolates identified as the primary source of heterogeneity (p = 0.127). Subgroup analysis by infection source revealed a higher prevalence in hospital-acquired infections (28%, 95% CI: 10, 46) compared to community settings (6%, 95% CI: 2, 11). Geographic based subgroup analysis indicated the highest prevalence in the Amhara region (23%, 95% CI: 8, 38), followed by Addis Ababa (21%, 95% CI: 11, 32), and lower prevalence in the Oromia region (7%, 95% CI: 4, 19). Wound samples exhibited the highest resistance (25%, 95% CI: 25, 78), while sputum samples showed the lowest prevalence. Publication bias, identified through funnel plot examination and Egger's regression test (p < 0.001), execution of trim and fill analysis resulted in an adjusted pooled prevalence of (3.7%, 95% CI: 2.3, 9.6).

Conclusion: The noteworthy prevalence of meropenem resistance among P. aeruginosa isolates in Ethiopia, particularly in healthcare settings, underscores the urgency of implementing strict infection control practices and antibiotic stewardship. Further research is imperative to address and mitigate the challenges posed by antimicrobial resistance in the country.

Keywords: Ethiopia; Meropenem Resistant; Meta-analysis; Pseudomonas Aeruginosa; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the included studies for the systematic review and meta-analysis of the prevalence of meropenem resistant P. aeruginosa in Ethiopia
Fig. 2
Fig. 2
Pooled estimate of prevalence of meropenem resistant P. aeruginosa in Ethiopia
Fig. 3
Fig. 3
Subgroup analysis of the prevalence of meropenem-resistant P. aeruginosa by source of infection
Fig. 4
Fig. 4
Subgroup analysis of the prevalence of meropenem-resistant P. aeruginosa by sample type
Fig. 5
Fig. 5
Subgroup analysis of the prevalence of meropenem-resistant P. aeruginosa by region
Fig. 6
Fig. 6
Funnel plot of prevalence of meropenem-resistant P. aeruginosa in Ethiopia
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References

    1. Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Aguilar GR, Gray A, Han C, Bisignano C, Rao P, Wool E. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399(10325):629–55. doi: 10.1016/S0140-6736(21)02724-0. - DOI - PMC - PubMed
    1. World Health Organization. Antimicrobial Resistance in the WHO African Region: a systematic literature review. Antimicrobial resistance in the WHO African Region: a systematic literature review. 2021.
    1. Pier GB. 314 - Pseudomonas and related gram-negative Bacillary infections. In: Goldman L, Schafer AI, editors. Goldman’s Cecil Medicine (Twenty Fourth Edition) Philadelphia: W.B. Saunders; 2012. pp. 1877–81.
    1. Smith RS, Iglewski BH. P. Aeruginosa quorum-sensing systems and virulence. Curr Opin Microbiol. 2003;6(1):56–60. doi: 10.1016/S1369-5274(03)00008-0. - DOI - PubMed
    1. Gómez MI, Prince A. Opportunistic infections in lung disease: Pseudomonas infections in cystic fibrosis. Curr Opin Pharmacol. 2007;7(3):244–51. doi: 10.1016/j.coph.2006.12.005. - DOI - PubMed

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