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关于尼日利亚产超广谱β-内酰胺酶情况的系统评价与荟萃分析。

A systematic review and meta-analysis on the prevalence of extended-spectrum beta-Lactamase-Producing in Nigeria.

作者信息

Ezeh Christian Kelechi, Digwo Daniel Chinonso, Okeke Irene Amara, Elebe Prisca Chidinma, Ezeh Emmanuel Onyedikachi

机构信息

Department of Microbiology, University of Nigeria, Nsukka, Enugu State, Nigeria.

Department of Biochemistry, University of Nigeria, Nsukka, Enugu State, Nigeria.

出版信息

Afr Health Sci. 2024 Sep;24(3):30-40. doi: 10.4314/ahs.v24i3.5.

Abstract

BACKGROUND

Rapid emergence and proliferation of extended spectrum beta-lactamase producing pneumoniae (ESBL-KP) constitute a serious health problem globally.

OBJECTIVES

The aim of this study was to evaluate the pooled prevalence of ESBL-KP and ESBL genes in Nigeria.

METHODS

A quantitative method (Meta-analysis) design was used to summarize pooled results of primary studies. Different databases [Google Scholar, PubMed, and African Journal Online (AJOL)] were searched for relevant studies. Meta-analysis was done using random-effects model. I2 and Egger test was used to ascertain heterogeneity and publication bias evaluation.

RESULTS

Eighteen observational studies were selected and the pooled prevalence of ESBL-KP in Nigeria was 47.3% [95% confidence interval (CI) 37 - 58%]. Among the genes encoding ESBL, OXA had the highest pooled prevalence in the selected studies [57% (95% CI 32, 76)], followed by TEM [55% (95% CI 36, 70)], CTX-M [54% (95% CI 38, 70)], and 41% (95% CI 27, 57). Heterogeneity tests (I2) was observed to be between 69.22 and 95.63 % for ESBL-KP and ESBL genes in the studies. Egger tests showed no publication bias (0.09 - 0.99).

CONCLUSIONS

This meta-analysis demonstrated that the prevalence of ESBL-KP is increasing in Nigeria. Hence, antimicrobial stewardship and infection control measures for the prevention and spread of these strains be implemented.

摘要

背景

产超广谱β-内酰胺酶肺炎克雷伯菌(ESBL-KP)的迅速出现和扩散在全球构成了严重的健康问题。

目的

本研究旨在评估尼日利亚ESBL-KP和ESBL基因的合并流行率。

方法

采用定量方法(Meta分析)设计来汇总初步研究的合并结果。在不同数据库[谷歌学术、PubMed和非洲期刊在线(AJOL)]中搜索相关研究。使用随机效应模型进行Meta分析。采用I²和Egger检验来确定异质性和评估发表偏倚。

结果

选择了18项观察性研究,尼日利亚ESBL-KP的合并流行率为47.3%[95%置信区间(CI)37 - 58%]。在编码ESBL的基因中,OXA在所选研究中的合并流行率最高[57%(95%CI 32,76)],其次是TEM[55%(95%CI 36,70)]、CTX-M[54%(95%CI 38,70)]和41%(95%CI 27,57)。在这些研究中,ESBL-KP和ESBL基因的异质性检验(I²)在69.22%至95.63%之间。Egger检验显示无发表偏倚(0.09 - 0.99)。

结论

这项Meta分析表明,尼日利亚ESBL-KP的流行率正在上升。因此,应实施抗菌药物管理和感染控制措施以预防和传播这些菌株。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3dd/12327123/bed6654dadef/AFHS2403-0030Fig1.jpg

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