Wada Yusuf, Harun Azian Binti, Yean Chan Yean, Zaidah Abdul Rahman
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.
Department of Zoology, Faculty of Life Sciences, Ahmadu Bello University, Zaria 810211, Nigeria.
Antibiotics (Basel). 2020 Sep 1;9(9):565. doi: 10.3390/antibiotics9090565.
Vancomycin-Resistant Enterococci (VRE) are on the rise worldwide. Here, we report the first prevalence of VRE in Nigeria using systematic review and meta-analysis. International databases MedLib, PubMed, International Scientific Indexing (ISI), Web of Science, Scopus, Google Scholar, and African journals online (AJOL) were searched. Information was extracted by two independent reviewers, and results were reviewed by the third. Two reviewers independently assessed the study quality using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. OpenMeta analyst was used. The random effect was used, and publication bias was assessed using a funnel plot. Between-study heterogeneity was assessed, and the sources were analysed using the leave-one-out meta-analysis, subgroup analysis, and meta-regression. Nineteen studies met the eligibility criteria and were added to the final meta-analysis, and the study period was from 2009-2018. Of the 2552 isolates tested, 349 were VRE, and was reported the most. The pooled prevalence of VRE in Nigeria was estimated at 25.3% (95% CI; 19.8-30.8%; = 96.26%; < 0.001). Between-study variability was high ( = 0.011; heterogeneity = 96.26% with heterogeneity chi-square (Q) = 480.667, degrees of freedom (df) = 18, and = 0.001). The funnel plot showed no publication bias, and the leave-one-out forest plot did not affect the pooled prevalence. The South-East region had a moderate heterogeneity though not significant ( = 51.15%, = 0.129). Meta-regression showed that all the variables listed contributed to the heterogeneity except for the animal isolate source ( = 0.188) and studies that were done in 2013 ( = 0.219). Adherence to proper and accurate antimicrobial usage, comprehensive testing, and continuous surveillance of VRE are required.
耐万古霉素肠球菌（VRE）在全球范围内呈上升趋势。在此，我们通过系统评价和荟萃分析报告了尼日利亚VRE的首次流行情况。检索了国际数据库MedLib、PubMed、国际科学索引（ISI）、科学网、Scopus、谷歌学术和非洲在线期刊（AJOL）。由两名独立评审员提取信息，结果由第三名评审员审核。两名评审员使用系统评价和荟萃分析的首选报告项目（PRISMA）清单独立评估研究质量。使用OpenMeta分析师。采用随机效应，并使用漏斗图评估发表偏倚。评估研究间异质性，并使用逐一剔除荟萃分析、亚组分析和荟萃回归分析来源。19项研究符合纳入标准并被纳入最终的荟萃分析，研究期间为2009年至2018年。在检测的2552株分离株中，349株为VRE，其中[具体菌株]报告最多。尼日利亚VRE的合并流行率估计为25.3%（95%置信区间；19.8 - 30.8%；I² = 96.26%；P < 0.001）。研究间变异性较高（I² = 0.011；异质性I² = 96.26%，异质性卡方（Q） = 480.667，自由度（df） = 18，P = 0.001）。漏斗图显示无发表偏倚，逐一剔除森林图不影响合并流行率。东南部地区异质性中等，虽不显著（I² = 51.15%，P = 0.129）。荟萃回归显示，除动物分离株来源（P = 0.188）和2013年进行的研究（P = 0.219）外，列出的所有变量均导致异质性。需要坚持正确和准确使用抗菌药物、进行全面检测以及持续监测VRE。
