Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
BMC Pulm Med. 2024 Apr 16;24(1):182. doi: 10.1186/s12890-024-03000-1.
Bacterial pneumonia can affect all age groups, but people with weakened immune systems, young children, and the elderly are at a higher risk. Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa are the most common causative agents of pneumonia, and they have developed high MDR in recent decades in Ethiopia. This systematic review and meta-analysis aimed to determine the pooled prevalence of bacterial pneumonia and multidrug resistance in Ethiopia.
The articles were searched extensively in the electronic databases and grey literature using entry terms or phrases. Studies meeting the eligibility criteria were extracted in MS Excel and exported for statistical analysis into STATA version 14 software. The pooled prevalence of bacterial pneumonia and multidrug resistance were calculated using a random-effects model. Heterogeneity was assessed by using the I value. Publication bias was assessed using a funnel plot and Egger's test. A sensitivity analysis was done to assess the impact of a single study on the pooled effect size.
Of the 651 studies identified, 87 were eligible for qualitative analysis, of which 11 were included in the meta-analysis consisting of 1154 isolates. The individual studies reported prevalence of bacterial pneumonia ranging from 6.19 to 46.3%. In this systematic review and metanalysis, the pooled prevalence of bacterial pneumonia in Ethiopia was 37.17% (95% CI 25.72-46.62), with substantial heterogeneity (I = 98.4%, p < 0.001) across the studies. The pooled prevalence of multidrug resistance in bacteria isolated from patients with pneumonia in Ethiopia was 67.73% (95% CI: 57.05-78.40). The most commonly isolated bacteria was Klebsiella pneumoniae, with pooled prevalence of 21.97% (95% CI 16.11-27.83), followed by Streptococcus pneumoniae, with pooled prevalence of 17.02% (95% CI 9.19-24.86), respectively.
The pooled prevalence of bacterial isolates from bacterial pneumonia and their multidrug resistance were high among Ethiopian population. The initial empirical treatment of these patients remains challenging because of the strikingly high prevalence of antimicrobial resistance.
细菌性肺炎可影响所有年龄段的人群，但免疫系统较弱、儿童和老年人的风险更高。肺炎链球菌、肺炎克雷伯菌、流感嗜血杆菌和铜绿假单胞菌是导致肺炎最常见的病原体，近几十年来，它们在埃塞俄比亚已经产生了很高的 MDR。本系统评价和荟萃分析旨在确定埃塞俄比亚细菌性肺炎和多重耐药菌的总患病率。
使用输入词或短语在电子数据库和灰色文献中广泛搜索文章。将符合入选标准的研究提取到 MS Excel 中，并导出到 STATA 版本 14 软件中进行统计分析。使用随机效应模型计算细菌性肺炎和多重耐药菌的总患病率。使用 I 值评估异质性。使用漏斗图和 Egger 检验评估发表偏倚。进行敏感性分析以评估单个研究对汇总效应量的影响。
在 651 项研究中，有 87 项符合定性分析标准，其中 11 项符合荟萃分析标准，共纳入 1154 株分离株。这些研究报告的细菌性肺炎患病率从 6.19%到 46.3%不等。在本系统评价和荟萃分析中，埃塞俄比亚细菌性肺炎的总患病率为 37.17%（95%CI 25.72-46.62），各研究之间存在显著异质性（I=98.4%，p<0.001）。从肺炎患者分离的细菌中多重耐药菌的总患病率为 67.73%（95%CI：57.05-78.40）。最常分离的细菌是肺炎克雷伯菌，总患病率为 21.97%（95%CI 16.11-27.83），其次是肺炎链球菌，总患病率为 17.02%（95%CI 9.19-24.86）。
从埃塞俄比亚人群中分离出的细菌及其多重耐药菌的总患病率较高。由于抗菌药物耐药率高，这些患者的初始经验性治疗仍然具有挑战性。
