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Background <p>Extended spectrum beta-lactamases (ESBLs) and carbapenemase producing <i>Acinetobacter baumannii</i> and <i>Pseudomonas aeruginosa</i> are the top antibiotic-resistant priority list of pathogens representing the greatest threat to human health. However, their exact magnitude was not well known. Thus, the aim of this study was to evaluate the magnitude of ESBL and carbapenemase-producing <i>Acinetobacter baumannii</i> and <i>Pseudomonas aeruginosa</i> in Ethiopia.</p> Methods <p>Articles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported into STATA version 11 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of ESBL and carbapenemase-producing <i>A. baumannii</i> and <i>P. aeruginosa</i> clinical isolates. The heterogeneity was quantified by using the I<sup>2</sup> value. Publication bias was assessed using a funnel plot and Egger’s test. Sensitivity analysis was done to assess the impact of a single study on pooled effect size.</p> Result <p>Of the 853 studies identified, 17 studies were eligible for qualitative analysis. A total of 17 studies of <i>P.aeruginosa</i> and 13 <i>A.baumannii</i> studies were included for meta-analysis consisted of 542 and 372 isolates were <i>P. aeruginosa</i> and <i>A. baumannii</i>, respectively. The overall pooled prevalence of ESBL and carbapanamase producing <i>A. baumannii</i> and/or <i>P. aeruginosa</i> in Ethiopia was 34% (95%CI: 30–38). The pooled prevalence of ESBL producing <i>A. baumannii</i> and <i>P. aeruginosa</i> was 23% (95%CI: 21–25) and 38% (95%CI: 4–72), respectively. Likewise, the pooled prevalence of carbapenemase-producing <i>A. baumannii</i> and <i>P. aeruginosa</i> was 36% (95%CI: 29–42) and 25% (95%CI; 20–31), respectively. There was substantial heterogeneity. Additionally, the pooled prevalence of multi-drug resistant <i>A. baumannii</i> and <i>P. aeruginosa</i> isolates was 77% (95% CI: 66–87) and 68% (95% CI: 50–86), respectively.</p> Conclusion <p>ESBL and carbapenemase-producing <i>A. baumannii</i> and <i>P. aeruginosa</i> was highly prevalent among clinical samples of Ethiopian populations. The initial empirical treatment of these patients remains challenging because of the strikingly high prevalence of antimicrobial resistance.</p>

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Extended spectrum beta-lactamase and carbapenemase-producing Acinetobacter species and Pseudomonas aeruginosa in Ethiopia: a systematic review and meta-analysis

  • 期刊论文

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  • 发表日期：

    2025年10月14日

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  • Alemu Gedefie,
  • Habtu Debash,
  • Ermiyas Alemayehu,
  • Ousman Mohammed,
  • Daniel Gebretsadik Weldehanna,
  • Hussen Ebrahim,
  • Mihret Tilahun,
  • Melaku Ashagrie Belete

摘要

Background

Extended spectrum beta-lactamases (ESBLs) and carbapenemase producing Acinetobacter baumannii and Pseudomonas aeruginosa are the top antibiotic-resistant priority list of pathogens representing the greatest threat to human health. However, their exact magnitude was not well known. Thus, the aim of this study was to evaluate the magnitude of ESBL and carbapenemase-producing Acinetobacter baumannii and Pseudomonas aeruginosa in Ethiopia.

Methods

Articles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported into STATA version 11 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of ESBL and carbapenemase-producing A. baumannii and P. aeruginosa clinical isolates. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger’s test. Sensitivity analysis was done to assess the impact of a single study on pooled effect size.

Result

Of the 853 studies identified, 17 studies were eligible for qualitative analysis. A total of 17 studies of P.aeruginosa and 13 A.baumannii studies were included for meta-analysis consisted of 542 and 372 isolates were P. aeruginosa and A. baumannii, respectively. The overall pooled prevalence of ESBL and carbapanamase producing A. baumannii and/or P. aeruginosa in Ethiopia was 34% (95%CI: 30–38). The pooled prevalence of ESBL producing A. baumannii and P. aeruginosa was 23% (95%CI: 21–25) and 38% (95%CI: 4–72), respectively. Likewise, the pooled prevalence of carbapenemase-producing A. baumannii and P. aeruginosa was 36% (95%CI: 29–42) and 25% (95%CI; 20–31), respectively. There was substantial heterogeneity. Additionally, the pooled prevalence of multi-drug resistant A. baumannii and P. aeruginosa isolates was 77% (95% CI: 66–87) and 68% (95% CI: 50–86), respectively.

Conclusion

ESBL and carbapenemase-producing A. baumannii and P. aeruginosa was highly prevalent among clinical samples of Ethiopian populations. The initial empirical treatment of these patients remains challenging because of the strikingly high prevalence of antimicrobial resistance.