Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, P.O. Box: 1145, Dessie, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.
BMC Infect Dis. 2024 Nov 28;24(1):1358. doi: 10.1186/s12879-024-10231-4.
Otitis media is an inflammation of the middle ear that affects both adults and children, leading to hearing loss and impacting intellectual performance, especially in developing countries. Key factors contributing to its development include lack of vaccination, inadequate breastfeeding, overcrowding, and malnutrition. Major bacterial pathogens involved are Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumoniae, Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.This systematic review and meta-analysis revealed the pooled prevalence of bacterial ear infections and multidrug resistance in Ethiopia.
Thorough searches were conducted across electronic databases and grey literature using precise entry terms or phrases. Eligible studies were compiled into MS Excel and imported into STATA version 14 software for statistical analysis. The collective prevalence of bacterial ear infections and multidrug resistance patterns were calculated using a random-effect model, with heterogeneity assessed via the I value. Publication bias was examined using a funnel plot and Egger's test. Sensitivity analysis was performed to gauge the impact of individual studies on the overall effect size.
Seventy studies met the criteria for qualitative analysis, with 14 selected for the meta-analysis. These studies reported a total of 3,667 bacterial isolates. The prevalence of bacterial ear infections varied significantly, ranging from 28.2% to 98.2% across individual studies. In this systematic review and meta-analysis, the pooled prevalence of bacterial ear infections in Ethiopia was found to be 73.39% (95% CI: 65.15-81.63), demonstrating substantial heterogeneity (I = 98.5%, p < 0.001). Additionally, the pooled prevalence of multidrug resistance among bacterial ear infections was 72.45% (95% CI: 66.86-78.04). The most frequently identified isolate was Staphylococcus aureus, with a pooled prevalence of 68.87% (95% CI: 13.94-123.79), followed closely by Proteus spp. at 68.55% (95% CI: 3.15-140.26), Pseudomonas aeruginosa at 48.15% (95% CI: 1.84-94.45), and Escherichia coli at 37.15% (95% CI: 14.03-88.34).
The pooled prevalence of bacterial ear infections in Ethiopia is alarmingly high, accompanied by significant levels of multidrug resistance. These findings highlight the urgent need to reevaluate empirical treatment strategies due to the rising antimicrobial resistance.
中耳炎是一种影响成人和儿童的中耳炎症，可导致听力损失，并影响智力表现，尤其是在发展中国家。导致其发展的关键因素包括疫苗接种不足、母乳喂养不足、过度拥挤和营养不良。涉及的主要细菌病原体包括绿脓假单胞菌、金黄色葡萄球菌、奇异变形杆菌、肺炎克雷伯菌、化脓链球菌、肺炎链球菌、流感嗜血杆菌和卡他莫拉菌。本系统评价和荟萃分析揭示了埃塞俄比亚耳部细菌感染和多药耐药的综合流行率。
通过使用精确的条目或短语，对电子数据库和灰色文献进行了全面搜索。将符合条件的研究汇编到 MS Excel 中，并导入 STATA 版本 14 软件进行统计分析。使用随机效应模型计算细菌耳部感染和多药耐药模式的总流行率，并通过 I 值评估异质性。使用漏斗图和 Egger 检验检查发表偏倚。进行敏感性分析以评估个别研究对总效应大小的影响。
70 项研究符合定性分析标准，其中 14 项研究纳入荟萃分析。这些研究共报告了 3667 株细菌分离株。细菌耳部感染的流行率差异很大，个别研究的范围从 28.2%到 98.2%。在本系统评价和荟萃分析中，发现埃塞俄比亚细菌耳部感染的总流行率为 73.39%（95%CI：65.15-81.63），表现出显著的异质性（I=98.5%，p<0.001）。此外，细菌耳部感染的多药耐药率的总流行率为 72.45%（95%CI：66.86-78.04）。最常鉴定的分离株是金黄色葡萄球菌，其总流行率为 68.87%（95%CI：13.94-123.79），紧随其后的是变形杆菌属，流行率为 68.55%（95%CI：3.15-140.26），绿脓假单胞菌为 48.15%（95%CI：1.84-94.45），大肠杆菌为 37.15%（95%CI：14.03-88.34）。
埃塞俄比亚耳部细菌感染的综合流行率高得惊人，同时伴有显著水平的多药耐药性。这些发现突显了由于抗菌药物耐药性不断上升，迫切需要重新评估经验性治疗策略。
