Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated from animals in Bangladesh: A systematic review and meta-analysis.

BACKGROUND

The emergence of antimicrobial resistance, particularly caused by β-lactamase-producing species within the Enterobacteriaceae family, has become a significant worldwide health concern. This study focuses on quantifying the overall prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in animals across Bangladesh, providing year-wise and species-wise distributions, and analysing the correlation between ESBL-PE and multidrug resistance (MDR).

METHODS

This study was registered in PROSPERO (CRD42025634466). A systematic search of PubMed, Scopus, MEDLINE, CINAHL, and Web of Science was conducted for studies published between 2010 and 2024. PRISMA guidelines were followed and the quality of the included studies was assessed using the "Joanna Briggs Institute Critical Appraisal Checklist". Meta-analysis was performed in R (meta-package) using a random-effects model and 95 % confidence intervals.

RESULTS

Among 1816 studies screened, 18 fulfilled the inclusion criteria. The pooled prevalence of ESBL-producing Enterobacteriaceae was 20 % (95 % CI: 11 %-30 %), showing high heterogeneity (I 2 = 98.2 %, p < 0.0001). ESBL-producing E. coli was most common at 41.2 % (I 2 = 90 %, p < 0.0001), followed by Klebsiella spp. (6.29 %) and Citrobacter spp. (5.93 %). Year-wise prevalence was 19 %, 31 %, and 17 % for 2010-2014, 2015-2019, and 2020-2024, respectively. Prevalence was higher in avian species (22 %) compared to non-avian species (15 %). Among detected ESBL genes, bla CTX-M was predominant (87.83 %), followed by bla TEM (71.7 %) and bla SHV (17.92 %). High resistance to penicillins, cephalosporins, and tetracyclines was shown in ESBL-PE isolates. A moderate positive correlation (r = 0.6) was found between ESBL production and multidrug resistance. ST131 clones were identified among ESBL-producing E. coli isolates from animals in Bangladesh.

CONCLUSION

This systematic review and meta-analysis observed a high occurrence of ESBL-producing Enterobacteriaceae in animals, including resistance genes, antibiotic resistance profiles, multidrug resistance, and relevant clones. These findings emphasise the need for comprehensive AMR surveillance to combat antimicrobial resistance in Bangladesh.