BMC infectious diseases · 2025
Extended-spectrum beta-lactam-resistant Klebsiella pneumoniae in sub-Saharan Africa: a systematic review and meta-analysis from a One Health perspective.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Olaitan Morufat Oluwatosin, Orababa Oluwatosin Qawiyy, Shittu Rukayya Bushola, Oyediran Adams Alabi, Obunukwu Gift Maureen, Arowolo Margaret Toluwalayo, Kade Ayomikun Emmanuel, Yahaya Khalid Ibrahim, Yusuff Rildwan Alaba
Аннотация
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae is a critical priority pathogen for which there is a need for new antimicrobials and poses a great public health threat to many parts of the world including sub-Saharan Africa (SSA). This study aims to determine the prevalence of ESBL-producing K. pneumoniae in SSA using a one health perspective, and the predominant ESBL genes in the region.
METHODS: Databases such as PubMed, Scopus, Web of Science, Africa Journal Online, and Google Scholar were searched for eligible articles based on pre-set eligibility criteria. After screening of titles, abstracts, and full texts, a meta-analysis using a random-effect model was conducted on the eligible studies to determine the overall and subgroup prevalence of ESBL-producing K. pneumoniae in SSA.
RESULTS: This meta-analysis included 119 eligible studies from 25 SSA countries in all SSA subregions. The overall prevalence of ESBL-producing K. pneumoniae in SSA is estimated to be 8.6% [95% CI: 6.4-11]. South Africa (18.5%) and Central Africa (4.6%) subregions have the highest and lowest prevalence of ESBL-producing K. pneumoniae in the region, respectively. Additionally, South Africa (23.3%), Kenya (23%), and Nigeria (11.1%) are the top three countries with ESBL-K. pneumoniae. Animal samples were also seen to have the highest prevalence compared to clinical and environmental samples in this study. Lastly, blaCTX-M-15 was the most reported ESBL gene in SSA.
CONCLUSION: The widespread presence of resistant strains in certain regions poses a significant risk of inter-country transmission, highlighting the need for collaborative regional surveillance and control efforts.
METHODS: Databases such as PubMed, Scopus, Web of Science, Africa Journal Online, and Google Scholar were searched for eligible articles based on pre-set eligibility criteria. After screening of titles, abstracts, and full texts, a meta-analysis using a random-effect model was conducted on the eligible studies to determine the overall and subgroup prevalence of ESBL-producing K. pneumoniae in SSA.
RESULTS: This meta-analysis included 119 eligible studies from 25 SSA countries in all SSA subregions. The overall prevalence of ESBL-producing K. pneumoniae in SSA is estimated to be 8.6% [95% CI: 6.4-11]. South Africa (18.5%) and Central Africa (4.6%) subregions have the highest and lowest prevalence of ESBL-producing K. pneumoniae in the region, respectively. Additionally, South Africa (23.3%), Kenya (23%), and Nigeria (11.1%) are the top three countries with ESBL-K. pneumoniae. Animal samples were also seen to have the highest prevalence compared to clinical and environmental samples in this study. Lastly, blaCTX-M-15 was the most reported ESBL gene in SSA.
CONCLUSION: The widespread presence of resistant strains in certain regions poses a significant risk of inter-country transmission, highlighting the need for collaborative regional surveillance and control efforts.