Irekeola Ahmad Adebayo, Shueb Rafidah Hanim, Engku Abd Rahman Engku Nur Syafirah, Afolabi Hafeez Abiola, Wada Yusuf, Elmi Abdirahman Hussein, Hakami Muath Abdu, Alghzwani Sfeeah Mofareah, Elnoubi Osman Ae, Alshehri Ahmad A
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, Offa, PMB 4412, Kwara State, Nigeria.
Heliyon. 2024 Jul 20;10(15):e34926. doi: 10.1016/j.heliyon.2024.e34926. eCollection 2024 Aug 15.
The rise in Carbapenem-resistant (CRE) is perturbing. To curb the menace of CRE, a comprehensive understanding of its prevalence and epidemiology is crucial. As varying reports abound, the true prevalence of CRE in Nigeria remains unknown. Here, we conducted a systematic review and meta-analysis following standard guidelines to assess the situation of CRE in Nigeria.
We searched electronic databases including Pubmed, ScienceDirect, Scopus, Web of Science, and Google Scholar for articles providing information on CRE in Nigeria. The data gathered were analyzed using OpenMeta Analyst and Comprehensive Meta-Analysis software. The random-effect model was employed to calculate pooled resistance to carbapenem antibiotics.
From 321 retrieved records, 57 were finally included. The studies were predominantly from the South-West region (n = 19). and were the most frequently tested among the included studies. The pooled prevalence estimate for imipenem resistance among CRE was 11.2 % (95 % CI: 7.9-15.7). Meropenem resistance had an estimate of 13.5 % (95 % CI: 9.1-19.6), whereas ertapenem and doripenem were estimated at 17.0 % (95 % CI: 9.9-27.7) and 37.9 % (95 % CI: 15.0-67.8), respectively. High heterogeneity ( >85 %, < 0.001) was observed for the estimates. The highest resistance rate to imipenem (28.4 %), meropenem (37.2 %) and ertapenem (46.5 %) were observed for the South-South region. Based on specific CRE genera, sp. was the most resistant (37.0 %) while sp. was the least (9.4 %). Our analyses also revealed a progressive increase in resistance to carbapenem antibiotics over the years.
This study highlights carbapenem resistance as a concern in Africa's most populous nation, underscoring the need for proactive measures to address and mitigate the threat of CRE.
耐碳青霉烯类肠杆菌科细菌（CRE）的增加令人不安。为遏制CRE的威胁，全面了解其流行情况和流行病学至关重要。由于存在各种不同的报告，CRE在尼日利亚的真实流行情况仍然未知。在此，我们按照标准指南进行了一项系统评价和荟萃分析，以评估尼日利亚CRE的情况。
我们在电子数据库中进行搜索，包括PubMed、ScienceDirect、Scopus、Web of Science和谷歌学术，查找提供尼日利亚CRE相关信息的文章。使用OpenMeta Analyst和Comprehensive Meta - Analysis软件对收集到的数据进行分析。采用随机效应模型计算对碳青霉烯类抗生素的合并耐药率。
从检索到的321条记录中，最终纳入57条。这些研究主要来自西南地区（n = 19）。在纳入的研究中，大肠埃希菌和肺炎克雷伯菌是最常检测的菌种。CRE中对亚胺培南耐药的合并流行率估计为11.2%（95%可信区间：7.9 - 15.7）。对美罗培南耐药的估计为13.5%（95%可信区间：9.1 - 19.6），而对厄他培南和多利培南耐药的估计分别为17.0%（95%可信区间：9.9 - 27.7）和37.9%（95%可信区间：15.0 - 67.8）。观察到这些估计值存在高度异质性（I²>85%，P<0.001）。在南南地区观察到对亚胺培南（28.4%）、美罗培南（37.2%）和厄他培南（46.5%）的最高耐药率。基于特定的CRE菌属，鲍曼不动杆菌属的耐药性最强（37.0%），而阴沟肠杆菌属的耐药性最弱（9.4%）。我们的分析还显示，多年来对碳青霉烯类抗生素的耐药性呈逐步上升趋势。
本研究强调了碳青霉烯类耐药性是这个非洲人口最多的国家所面临的一个问题，凸显了采取积极措施应对和减轻CRE威胁的必要性。
