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01.12.2016 | Review | Ausgabe 1/2016 Open Access

Antimicrobial Resistance & Infection Control 1/2016

Meta-analysis of proportion estimates of Extended-Spectrum-Beta-Lactamase-producing Enterobacteriaceae in East Africa hospitals

Zeitschrift:
Antimicrobial Resistance & Infection Control > Ausgabe 1/2016
Autoren:
Tolbert Sonda, Happiness Kumburu, Marco van Zwetselaar, Michael Alifrangis, Ole Lund, Gibson Kibiki, Frank M. Aarestrup
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s13756-016-0117-4) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

TS and GK conceived the idea. TS and MZ gathered data, analyzed them and prepared manuscript draft. All authors read, revised and approved the final manuscript.

Abstract

Background

A high proportion of Extended-Spectrum-Beta-Lactamase (ESBL) producing Enterobacteriaceae is causing common infections in all regions of the world. The burden of antibiotic resistance due to ESBL in East Africa is large but information is scarce and thus it is unclear how big the problem really is. To gain insight into the magnitude and molecular epidemiology of ESBL-producing Enterobacteriaceae in East Africa a literature search was performed in PubMed on 31 July 2015 to retrieve articles with relevant information on ESBL.

Methods and results

Meta-analysis was performed to determine overall proportion estimate of ESBL-producing Enterobacteriaceae. A total of 4076 bacterial isolates were included in the analysis. The overall pooled proportion of ESBL-producing Enterobacteriaceae among included surveys done in East African hospitals was found to be 0.42 (95 % CI: 0.34–0.50). Heterogeneity (I2) between countries’ proportions in ESBL was significantly high (96.95 % and p < 0.001). The frequently detected genes encoding ESBL were CTX-M, TEM, SHV and OXA while the most infrequent reported genes were KPC and NDM.

Conclusion

The available studies show a very wide variation in resistance due to ESBL between countries. This highlights a need for active surveillance systems which can help understand the actual epidemiology of ESBL, aid in formulating national or regional guidelines for proper screening of ESBL, and support developing standardized approaches for managing patients colonized with ESBL.
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