埃塞俄比亚人类和动物中链霉素耐药沙门氏菌的流行病学：系统评价和荟萃分析。
Epidemiology of streptomycin resistant Salmonella from humans and animals in Ethiopia: A systematic review and meta-analysis.
机构信息
Medical Laboratory Science, College of Health Sciences, DebreMarkos University, Debre Marqos, Ethiopia.
Department of Medical Microbiology, School of Laboratory and Biomedical Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
出版信息
PLoS One. 2020 Dec 17;15(12):e0244057. doi: 10.1371/journal.pone.0244057. eCollection 2020.
BACKGROUND
Streptomycin is used as an epidemiological marker in monitoring programs for antimicrobial resistance in Salmonella serovars and indicates the presence of pentaresistance. However, comprehensive data on streptomycin resistant Salmonella among human, animal, and animal products is lacking in Ethiopia. In this review, we aimed to assess heterogeneity and pooled proportion of Salmonella serovars to streptomycin resistance among human, animal and animal products in Ethiopia.
METHODS
We conducted a systematic review and meta-analysis of published literature from Ethiopia. We used the MEDLINE/ PubMed, Embase, Cochrane Library, and Google Scholar databases to identify genetic and phenotypic data on Salmonella isolates. To determine the heterogeneity and pooled proportion, we used metaprop commands and the random-effects model. Relative and cumulative frequencies were calculated to describe the overall preponderance of streptomycin resistance isolates after arcsine-transformed data. Metan funnel and meta-bias using a begg test were performed to check for publication bias.
RESULTS
Overall, we included 1475 Salmonella serovars in this meta-analysis. The pooled proportion of streptomycin resistance was 47% (95% CI: 35-60%). Sub-group analysis by target population showed that the proportion of streptomycin resistance in Salmonella serovars was 54% (95% CI: 35-73%) in animal, 44% (95% Cl: 33-59%) in humans and 39% (95% CI: 24-55%) in animals products. The streptomycin resistant Salmonella serovars were statistically increasing from 0.35(95% CI: 0.12-0.58) in 2003 to 0.77(95% CI: 0.64-0.89) in 2018. The level of multidrug-resistant (MDR) Salmonella serovars was 50.1% in the meta-analysis.
CONCLUSION
We found a high level of streptomycin resistance, including multidrug, Salmonella serovars among human, animals, and animal products. This resistance was significantly increasing in the last three decades (1985-2018). The resistance to streptomycin among Salmonella serovars isolated from animals was higher than humans. This mandates the continuous monitoring of streptomycin use and practicing one health approach to preventing further development of resistance in Ethiopia.
REGISTRATION
We conducted a systematic review and meta-analysis after registration of the protocol in PROSPERO (CRD42019135116) following the MOOSE (Meta-Analysis of Observational Studies in Epidemiology).
背景
链霉素被用作监测沙门氏菌血清型中抗菌药物耐药性的流行病学标志物，表明存在五重耐药性。然而，埃塞俄比亚缺乏有关人类、动物和动物产品中链霉素耐药性沙门氏菌的综合数据。在本综述中，我们旨在评估埃塞俄比亚人类、动物和动物产品中沙门氏菌血清型对链霉素耐药性的异质性和汇总比例。
方法
我们对来自埃塞俄比亚的已发表文献进行了系统评价和荟萃分析。我们使用 MEDLINE/PubMed、Embase、Cochrane 图书馆和 Google Scholar 数据库来确定沙门氏菌分离株的遗传和表型数据。为了确定异质性和汇总比例，我们使用了 metaprop 命令和随机效应模型。使用反正弦转换后的数据计算相对和累积频率，以描述链霉素耐药分离株的总体优势。使用 begg 检验进行 metan 漏斗和荟萃偏倚分析，以检查发表偏倚。
结果
总体而言，我们将 1475 株沙门氏菌血清型纳入本荟萃分析。链霉素耐药的汇总比例为 47%（95%CI：35-60%）。按目标人群进行的亚组分析显示，动物中沙门氏菌血清型的链霉素耐药比例为 54%（95%CI：35-73%），人类为 44%（95%CI：33-59%），动物产品为 39%（95%CI：24-55%）。链霉素耐药的沙门氏菌血清型呈统计学上升趋势，从 2003 年的 0.35（95%CI：0.12-0.58）上升至 2018 年的 0.77（95%CI：0.64-0.89）。耐多药（MDR）沙门氏菌血清型的比例在荟萃分析中为 50.1%。
结论
我们发现人类、动物和动物产品中存在高水平的链霉素耐药性，包括多重耐药性沙门氏菌血清型。这种耐药性在过去三十年（1985-2018 年）显著增加。从动物中分离出的沙门氏菌血清型对链霉素的耐药性高于人类。这需要持续监测链霉素的使用，并采取一种健康的方法来防止耐药性在埃塞俄比亚进一步发展。
登记号
我们在 PROSPERO（CRD42019135116）中注册了方案后进行了系统评价和荟萃分析，遵循 MOOSE（流行病学观察性研究的荟萃分析）。
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