Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan
Abstract Background South-Asia is known as a hub for multidrug-resistant (MDR) bacteria. Unfortunately, proper surveillance and documentation of MDR pathogens is lacking in Pakistan. The alarming increase in the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is a ser...
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | http://link.springer.com/article/10.1186/s13756-018-0309-1 |
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| author | Samyyia Abrar Shahida Hussain Rehan Ahmad Khan Noor Ul Ain Hayat Haider Saba Riaz |
| author_facet | Samyyia Abrar Shahida Hussain Rehan Ahmad Khan Noor Ul Ain Hayat Haider Saba Riaz |
| author_sort | Samyyia Abrar |
| collection | DOAJ |
| description | Abstract Background South-Asia is known as a hub for multidrug-resistant (MDR) bacteria. Unfortunately, proper surveillance and documentation of MDR pathogens is lacking in Pakistan. The alarming increase in the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is a serious problem. From this perspective, we analysed published data regarding ESBL-producing Enterobacteriaceae in different regions of Pakistan. Methods A meta-analysis was performed to determine the prevalence of ESBL-producing Enterobacteriaceae in Pakistan. A Web-based search was conducted in electronic databases, including PubMed, Scopus and PakMedi Net (for non-indexed Pakistani journals). Articles published (in either indexed or non-indexed journals) between January 2002 and July 2016 were included in the study. Relevant data were extracted, and statistical analysis was performed using the Metaprop command of STATA version 14.1. Results A total of 68 studies were identified from the electronic data base search, and 55 of these studies met our inclusion criteria. Pakistan’s overall pooled proportion of ESBL-producers was 0.40 (95% CI: 0.34–0.47). The overall heterogeneity was significant (I2 = 99.75%, p < 0.001), and significant ES = 0 (Z = 18.41, p < 0.001) was found. OXA, SHV, TEM and CTX-M were the most commonly found gene variants for ESBLs in these studies. Conclusion The prevalence of ESBL-producing Enterobacteriaceae is high in Pakistan. Little is known about the annual frequency of ESBLs and their prevalence in different provinces of Pakistan. No data are available regarding ESBL frequency in Baluchistan. This underscores an urgent demand for regular surveillance to address this antimicrobial resistance problem. Surveillance to better understand the annual ESBL burden is crucial to improve national and regional guidelines. |
| first_indexed | 2024-12-21T18:10:22Z |
| format | Article |
| id | doaj.art-2f27632cda304b83bd73b56166025d14 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-21T18:10:22Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-2f27632cda304b83bd73b56166025d142022-12-21T18:54:48ZengBMCAntimicrobial Resistance and Infection Control2047-29942018-02-017111110.1186/s13756-018-0309-1Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from PakistanSamyyia Abrar0Shahida Hussain1Rehan Ahmad Khan2Noor Ul Ain3Hayat Haider4Saba Riaz5Department of Microbiology and Molecular Genetics, University of the PunjabDepartment of Microbiology and Molecular Genetics, University of the PunjabCollege of Statistical and Actuarial Sciences, University of the PunjabDepartment of Microbiology and Molecular Genetics, University of the PunjabDepartment of Microbiology and Molecular Genetics, University of the PunjabDepartment of Microbiology and Molecular Genetics, University of the PunjabAbstract Background South-Asia is known as a hub for multidrug-resistant (MDR) bacteria. Unfortunately, proper surveillance and documentation of MDR pathogens is lacking in Pakistan. The alarming increase in the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is a serious problem. From this perspective, we analysed published data regarding ESBL-producing Enterobacteriaceae in different regions of Pakistan. Methods A meta-analysis was performed to determine the prevalence of ESBL-producing Enterobacteriaceae in Pakistan. A Web-based search was conducted in electronic databases, including PubMed, Scopus and PakMedi Net (for non-indexed Pakistani journals). Articles published (in either indexed or non-indexed journals) between January 2002 and July 2016 were included in the study. Relevant data were extracted, and statistical analysis was performed using the Metaprop command of STATA version 14.1. Results A total of 68 studies were identified from the electronic data base search, and 55 of these studies met our inclusion criteria. Pakistan’s overall pooled proportion of ESBL-producers was 0.40 (95% CI: 0.34–0.47). The overall heterogeneity was significant (I2 = 99.75%, p < 0.001), and significant ES = 0 (Z = 18.41, p < 0.001) was found. OXA, SHV, TEM and CTX-M were the most commonly found gene variants for ESBLs in these studies. Conclusion The prevalence of ESBL-producing Enterobacteriaceae is high in Pakistan. Little is known about the annual frequency of ESBLs and their prevalence in different provinces of Pakistan. No data are available regarding ESBL frequency in Baluchistan. This underscores an urgent demand for regular surveillance to address this antimicrobial resistance problem. Surveillance to better understand the annual ESBL burden is crucial to improve national and regional guidelines.http://link.springer.com/article/10.1186/s13756-018-0309-1MDRESBLsEnterobacteriaceaeMeta-analysisPakistan |
| spellingShingle | Samyyia Abrar Shahida Hussain Rehan Ahmad Khan Noor Ul Ain Hayat Haider Saba Riaz Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan Antimicrobial Resistance and Infection Control MDR ESBLs Enterobacteriaceae Meta-analysis Pakistan |
| title | Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan |
| title_full | Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan |
| title_fullStr | Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan |
| title_full_unstemmed | Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan |
| title_short | Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan |
| title_sort | prevalence of extended spectrum β lactamase producing enterobacteriaceae first systematic meta analysis report from pakistan |
| topic | MDR ESBLs Enterobacteriaceae Meta-analysis Pakistan |
| url | http://link.springer.com/article/10.1186/s13756-018-0309-1 |
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