Extended Spectrum Beta-Lactamase-Producing Bacterial Clones in West Africa: A Systematic Review and Meta-Analysis from a One Health Perspective.

Extended-spectrum beta-lactamase (ESBL)-producing bacteria are associated with life-threatening infections with limited treatment options worldwide. In this review, we assess the circulating ESBL-producing bacterial clones from human, animal, and environmental sources in West Africa, through a One Health approach. A systematic search in PubMed, Scopus, and Web of Science identified 485 records, with 38 studies analysed. Data were organized thematically and pooled prevalence estimates calculated through a random-effects meta-analysis. Results showed a 16.8% (95% CI [12.1; 22.1]) prevalence of ESBL-producing bacteria, with Escherichia coli (64%) being the most frequently detected species. Humans were the most affected (20.4%), followed by animals (12.8%) and the environment (9.3%). Among the 153 identified bacterial clones, ST10, ST410, ST58, ST155, ST4684, ST2178, and ST37, found majorly in E. coli, occurred across multiple sources, suggesting cross-sectoral transmission. The blaCTX-M gene, prevalent with several fluoroquinolone and aminoglycoside resistance genes, was often on conjugative IncF plasmids (50.0%), suggesting high horizontal transmission potential. The emerging ESBL gene, GES (1.2%) was also detected in Pseudomonas aeruginosa. The findings reinforce the need for robust antimicrobial resistance monitoring and intervention strategies in West Africa. A regional One Health-based approach is necessary to curtail the spread of resistant bacterial clones and safeguard the efficacy of available treatment options.