埃塞俄比亚人类临床样本中产碳青霉烯酶肠杆菌科的流行情况：系统评价和荟萃分析。
Prevalence of carbapenemase-producing Enterobacteriaceae from human clinical samples in Ethiopia: a systematic review and meta-analysis.
机构信息
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
出版信息
BMC Infect Dis. 2023 May 3;23(1):277. doi: 10.1186/s12879-023-08237-5.
INTRODUCTION
Carbapenemase-producing Enterobacteriaceae are by far the most public health and urgent clinical problems with antibiotic resistance. They cause longer hospital stays, more expensive medical care, and greater mortality rates. This systematic review and meta-analysis aimed to indicate the prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia.
METHODS
This systematic review and meta-analysis was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Electronic databases like PubMed, Google Scholar, CINAHL, Wiley Online Library, African Journal Online, Science Direct, Embase, ResearchGate, Scopus, and the Web of Sciences were used to find relevant articles. In addition, the Joanna Briggs Institute quality appraisal tool was used to assess the quality of the included studies. Stata 14.0 was used for statistical analysis. Heterogeneity was assessed by using Cochran's Q test and I statistics. In addition, publication bias was assessed using a funnel plot and Egger's test. A random effect model was used to estimate the pooled prevalence. Sub-group and sensitivity analysis were also done.
RESULTS
The overall pooled prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia was 5.44% (95% CI 3.97, 6.92). The prevalence was highest [6.45% (95% CI 3.88, 9.02)] in Central Ethiopia, and lowest [(1.65% (95% CI 0.66, 2.65)] in the Southern Nations and Nationalities People Region. In terms of publication year, 2017-2018 had the highest pooled prevalence [17.44 (95% CI 8.56, 26.32)] and 2015-2016 had the lowest [2.24% (95% CI 0.87, 3.60)].
CONCLUSION
This systematic review and meta-analysis showed a high prevalence of carbapenemase-producing Enterobacteriaceae. So, to alter the routine use of antibiotics, regular drug susceptibility testing, strengthening the infection prevention approach, and additional national surveillance on the profile of carbapenem resistance and their determining genes among Enterobacteriaceae clinical isolates are required.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (2022: CRD42022340181).
介绍
碳青霉烯酶产生的肠杆菌科细菌是迄今为止抗生素耐药性方面最严重的公共卫生和临床紧急问题。它们会导致住院时间延长、医疗费用增加和死亡率上升。本系统评价和荟萃分析旨在指出在埃塞俄比亚产碳青霉烯酶肠杆菌科细菌的流行率。
方法
本系统评价和荟萃分析是根据系统评价和荟萃分析的首选报告项目进行的。使用了电子数据库，如 PubMed、Google Scholar、CINAHL、Wiley Online Library、African Journal Online、Science Direct、Embase、ResearchGate、Scopus 和 Web of Sciences，以查找相关文章。此外，还使用了 Joanna Briggs 研究所的质量评估工具来评估纳入研究的质量。使用 Stata 14.0 进行统计分析。使用 Cochran's Q 检验和 I 统计量评估异质性。此外，还使用漏斗图和 Egger 检验评估发表偏倚。使用随机效应模型估计合并患病率。还进行了亚组和敏感性分析。
结果
埃塞俄比亚产碳青霉烯酶肠杆菌科细菌的总体合并患病率为 5.44%（95%CI 3.97，6.92）。在埃塞俄比亚中部，患病率最高[6.45%（95%CI 3.88，9.02）]，而在南部各族人民地区，患病率最低[1.65%（95%CI 0.66，2.65）]。就发表年份而言，2017-2018 年的合并患病率最高[17.44%（95%CI 8.56，26.32）]，而 2015-2016 年的合并患病率最低[2.24%（95%CI 0.87，3.60）]。
结论
本系统评价和荟萃分析表明，产碳青霉烯酶肠杆菌科细菌的患病率很高。因此，需要改变抗生素的常规使用方式，定期进行药敏试验，加强感染预防措施，并在全国范围内对肠杆菌科临床分离株的碳青霉烯类耐药情况及其决定基因进行额外监测。
系统评价注册
PROSPERO（2022：CRD42022340181）。
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