1Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan.
3College of Statistical and Actuarial Sciences, University of the Punjab, Lahore, Pakistan.
Antimicrob Resist Infect Control. 2018 Feb 20;7:26. doi: 10.1186/s13756-018-0309-1. eCollection 2018.
South-Asia is known as a hub for multidrug-resistant (MDR) bacteria. Unfortunately, proper surveillance and documentation of MDR pathogens is lacking in Pakistan. The alarming increase in the prevalence of extended-spectrum β-lactamase (ESBL)-producing is a serious problem. From this perspective, we analysed published data regarding ESBL-producing in different regions of Pakistan.
A meta-analysis was performed to determine the prevalence of ESBL-producing in Pakistan. A Web-based search was conducted in electronic databases, including PubMed, Scopus and PakMedi Net (for non-indexed Pakistani journals). Articles published (in either indexed or non-indexed journals) between January 2002 and July 2016 were included in the study. Relevant data were extracted, and statistical analysis was performed using the command of STATA version 14.1.
A total of 68 studies were identified from the electronic data base search, and 55 of these studies met our inclusion criteria. Pakistan's overall pooled proportion of ESBL-producers was 0.40 (95% CI: 0.34-0.47). The overall heterogeneity was significant (I2 = 99.75%, < 0.001), and significant ES = 0 (Z = 18.41, < 0.001) was found. OXA, SHV, TEM and CTX-M were the most commonly found gene variants for ESBLs in these studies.
The prevalence of ESBL-producing is high in Pakistan. Little is known about the annual frequency of ESBLs and their prevalence in different provinces of Pakistan. No data are available regarding ESBL frequency in Baluchistan. This underscores an urgent demand for regular surveillance to address this antimicrobial resistance problem. Surveillance to better understand the annual ESBL burden is crucial to improve national and regional guidelines.
南亚是多药耐药（MDR）细菌的中心。不幸的是，巴基斯坦缺乏对 MDR 病原体的适当监测和记录。产超广谱β-内酰胺酶（ESBL）的的惊人增加是一个严重的问题。从这个角度来看，我们分析了发表在巴基斯坦不同地区的有关产 ESBL 的数据。
进行了荟萃分析以确定巴基斯坦产 ESBL 的流行率。在电子数据库中（包括 PubMed、Scopus 和 PakMedi Net（用于非索引的巴基斯坦期刊））进行了基于网络的搜索。研究纳入了 2002 年 1 月至 2016 年 7 月期间发表的（包括索引和非索引期刊）文章。提取相关数据，并使用 STATA 版本 14.1 的 命令进行统计分析。
从电子数据库搜索中确定了 68 项研究，其中 55 项符合我们的纳入标准。巴基斯坦的总体 ESBL 生产者的混合比例为 0.40（95%CI：0.34-0.47）。总体异质性显著（I2=99.75%，<0.001），并发现显著的 ES=0（Z=18.41，<0.001）。在这些研究中，OXA、SHV、TEM 和 CTX-M 是最常见的 ESBL 基因变体。
巴基斯坦产 ESBL 的流行率很高。关于 ESBL 的年度频率及其在巴基斯坦不同省份的流行程度知之甚少。关于俾路支省 ESBL 频率的数据尚不可用。这突显了迫切需要进行常规监测以解决这一抗微生物药物耐药问题。监测以更好地了解每年的 ESBL 负担对于改善国家和地区指南至关重要。
