Arsi University College of Health Sciences, Arsi University, PO Box 0193, Asella, Ethiopia.
School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
J Antimicrob Chemother. 2021 Jan 1;76(1):22-29. doi: 10.1093/jac/dkaa399.
Intestinal colonization by ESBL Escherichia coli and its association with community-acquired MDR infections is of great concern. This review determined the worldwide prevalence of human faecal ESBL E. coli carriage and its trend in the community over the past two decades.
A systematic literature search was conducted using PubMed, EMBASE and Google Scholar to retrieve articles published between 1 January 2000 and 13 February 2020 that contained data on the prevalence of faecal carriage of ESBL E. coli among healthy individuals. A cumulative (for the whole period) meta-analysis was used to estimate the global and regional pooled prevalence rates. Articles were grouped into study periods of 3 years, and subgroup meta-analyses were undertaken to examine the global pooled prevalence over time.
Sixty-two articles covering 29 872 healthy persons were included in this meta-analysis. The cumulative (2003-18) global pooled prevalence of ESBL E. coli intestinal carriage in the community was 16.5% (95% CI 14.3%-18.7%; P < 0.001). The pooled prevalence showed an upward trend, increasing from 2.6% (95% CI 1.6%-4.0%) in 2003-05 to 21.1% (95% CI 15.8%-27.0%) in 2015-18. Over the whole period, the highest carriage rate was observed in South-East Asia (27%; 95% CI 2.9%-51.3%), while the lowest occurred in Europe (6.0%; 95% CI 4.6%-7.5%).
Globally, an 8-fold increase in the intestinal carriage rate of ESBL E. coli in the community has occurred over the past two decades. Prevention of its spread may require new therapeutic and public health strategies.
肠外分泌型 ESBL 大肠杆菌定植及其与社区获得性 MDR 感染的关联受到高度关注。本综述确定了过去二十年中人类粪便 ESBL 大肠杆菌携带率及其在社区中的趋势。
使用 PubMed、EMBASE 和 Google Scholar 进行系统文献检索，检索 2000 年 1 月 1 日至 2020 年 2 月 13 日期间发表的文章，其中包含健康个体粪便携带 ESBL 大肠杆菌的流行率数据。采用累积（整个时期）荟萃分析来估计全球和区域汇总流行率。文章分为 3 年研究期，并进行亚组荟萃分析以检查随时间的全球汇总流行率。
本荟萃分析共纳入 62 篇涵盖 29872 名健康个体的文章。社区中 ESBL 大肠杆菌肠内携带的累积（2003-18 年）全球总体流行率为 16.5%（95%CI 14.3%-18.7%；P<0.001）。总体流行率呈上升趋势，从 2003-05 年的 2.6%（95%CI 1.6%-4.0%）增加到 2015-18 年的 21.1%（95%CI 15.8%-27.0%）。在整个时期，东南亚的携带率最高（27%；95%CI 2.9%-51.3%），而欧洲最低（6.0%；95%CI 4.6%-7.5%）。
在过去的二十年中，社区中 ESBL 大肠杆菌的肠内携带率增加了 8 倍。可能需要新的治疗和公共卫生策略来防止其传播。
