从“同一健康”视角看埃塞俄比亚的多重耐药性：文献系统评价与荟萃分析（2015 - 2020年） - Suppr

Multidrug resistance from a one health perspective in Ethiopia: A systematic review and meta-analysis of literature (2015-2020).

作者信息

Tweldemedhin Mebrahtu, Muthupandian Saravanan, Gebremeskel Tsega Kahsay, Mehari Kibrti, Abay Getahun Kahsay, Teklu Teklay Gebrecherkos, Dhandapani Ranjithkumar, Paramasivam Ragul, Asmelash Tsehaye

机构信息

Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Ethiopia.

AMR and Nanomedicine Laboratory, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai 600 077, India.

出版信息

One Health. 2022 Apr 20;14:100390. doi: 10.1016/j.onehlt.2022.100390. eCollection 2022 Jun.

PURPOSE

The emergence of antimicrobial resistance is a major global health challenge and becoming an urgent priority for policymakers. There is a paucity of scientific studies presenting the multidrug resistance pattern from one health perspective in Ethiopia. Therefore, a systematic review and meta-analysis aimed to determine the pooled prevalence of multidrug resistance in bacteria from human, animal, food, and environmental sources.

METHODS

In this systematic review and meta-analysis, an electronic search was made in PubMed & Google scholar using different keywords. The studies conducted in all areas of Ethiopia, published from 2015 to 2020 in peer-reviewed journals, English full-length papers were included. The meta-analysis was done on STATA version 14. The pooled prevalence of multidrug resistance for each bacterium was analysed using the random-effects model; Cochran Q statistics and the statistic was used to analyse heterogeneity and considered significant at p < 0.01.

RESULTS

81 studies were included in the systematic review and meta-analysis; 53 human studies, eight animal studies, and 16 environments/food studies. The meta-analysis included six species from gram-positive bacteria and 13 from gram-negative bacteria. 53% (95%CI: 42-64%), Coagulase negative 68%(95%CI:53-82), spp. 73%(95%CI:48-93%), 70% (95%CI:61-78%), spp. 71%(95%CI:54-87%), spp. 68% (54-80%), spp. 67% (48-83%) and spp. 65% (95%CI:48-81%) were the common multidrug-resistant species of bacteria from two or more sources.

CONCLUSION

In Ethiopia, the pooled prevalence of MDR is high in most bacterial species from humans, animals, food, and environmental sources. most members of the Enterobacteriaceae and are the standard MDR bacterial population involving all sources. Therefore, integrated policy and intervention measures should be implemented to reduce the emergence and spread of MDR bacteria for better animal and human health outcomes.

目的

抗菌药物耐药性的出现是一项重大的全球卫生挑战，正成为政策制定者的当务之急。在埃塞俄比亚，从“同一个健康”视角呈现多重耐药模式的科学研究匮乏。因此，进行了一项系统评价和荟萃分析，旨在确定来自人类、动物、食物和环境来源的细菌中多重耐药的合并患病率。

方法

在本系统评价和荟萃分析中，使用不同关键词在PubMed和谷歌学术上进行了电子检索。纳入了2015年至2020年在埃塞俄比亚所有地区开展、发表于同行评审期刊的英文全文论文。在STATA 14版本上进行荟萃分析。使用随机效应模型分析每种细菌的多重耐药合并患病率；采用 Cochr an Q统计量和I²统计量分析异质性，p<0.01时认为具有显著性。

结果

81项研究纳入了系统评价和荟萃分析；53项人类研究、8项动物研究以及16项环境/食物研究。荟萃分析纳入了6种革兰氏阳性菌和13种革兰氏阴性菌。53%（95%置信区间：42 - 64%）、凝固酶阴性葡萄球菌68%（95%置信区间：53 - 82%）、肺炎克雷伯菌73%（95%置信区间：48 - 93%）、大肠埃希菌70%（95%置信区间：61 - 78%）、奇异变形杆菌71%（95%置信区间：54 - 87%）、鲍曼不动杆菌68%（54 - 80%）、铜绿假单胞菌67%（48 - 83%）和金黄色葡萄球菌65%（95%置信区间：48 - 81%）是来自两种或更多来源的常见多重耐药细菌种类。