Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-Analysis
Diarrhea is one of the leading causes of morbidity and mortality in developing countries. Diarrheagenic <i>Escherichia coli</i> (DEC) is an important bacterial agent for diarrhea in infants, children, and international travelers, and accounts for more than 30% of diarrheal cases in child...
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MDPI AG
2022-09-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/10/1333 |
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| author | Mohd Zulkifli Salleh Nik Mohd Noor Nik Zuraina Khalid Hajissa Mohamad Ikram Ilias Zakuan Zainy Deris |
| author_facet | Mohd Zulkifli Salleh Nik Mohd Noor Nik Zuraina Khalid Hajissa Mohamad Ikram Ilias Zakuan Zainy Deris |
| author_sort | Mohd Zulkifli Salleh |
| collection | DOAJ |
| description | Diarrhea is one of the leading causes of morbidity and mortality in developing countries. Diarrheagenic <i>Escherichia coli</i> (DEC) is an important bacterial agent for diarrhea in infants, children, and international travelers, and accounts for more than 30% of diarrheal cases in children less than 5 years old. However, the choices of antimicrobial agents are now being limited by the ineffectiveness of many first-line drugs, in relation to the emergence of antimicrobial-resistant <i>E. coli</i> strains. The aim of this systematic review and meta-analysis was to provide an updated prevalence of antimicrobial-resistant DEC in Asia. A comprehensive systematic search was conducted on three electronic databases (PubMed, ScienceDirect, and Scopus), where 40 eligible studies published between 2010 and 2022 were identified. Using meta-analysis of proportions and a random-effects model, the pooled prevalence of DEC in Asian diarrheal patients was 22.8% (95% CI: 16.5–29.2). The overall prevalence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing DEC strains was estimated to be 66.3% (95% CI: 58.9–73.7) and 48.6% (95% CI: 35.1–62.1), respectively. Considering antimicrobial drugs for DEC, the resistance prevalence was highest for the penicillin class of antibiotics, where 80.9% of the DEC isolates were resistant to amoxicillin and 73.5% were resistant to ampicillin. In contrast, resistance to carbapenems such as imipenem (0.1%), ertapenem (2.6%), and meropenem (7.9%) was the lowest. The relatively high prevalence estimation signifies that the multidrug-resistant DEC is a public health threat. Effective antibiotic treatment strategies, which may lead to better outcomes for the control of <i>E. coli</i> infections in Asia, are necessary. |
| first_indexed | 2024-03-09T20:50:42Z |
| format | Article |
| id | doaj.art-7dc87774555c4da4b83f19004c2f22d0 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T20:50:42Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-7dc87774555c4da4b83f19004c2f22d02023-11-23T22:34:42ZengMDPI AGAntibiotics2079-63822022-09-011110133310.3390/antibiotics11101333Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-AnalysisMohd Zulkifli Salleh0Nik Mohd Noor Nik Zuraina1Khalid Hajissa2Mohamad Ikram Ilias3Zakuan Zainy Deris4Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, MalaysiaDepartment of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, MalaysiaDepartment of Zoology, Faculty of Science and Technology, Omdurman Islamic University, P.O. Box 382, Omdurman 14415, SudanDepartment of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, MalaysiaDepartment of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, MalaysiaDiarrhea is one of the leading causes of morbidity and mortality in developing countries. Diarrheagenic <i>Escherichia coli</i> (DEC) is an important bacterial agent for diarrhea in infants, children, and international travelers, and accounts for more than 30% of diarrheal cases in children less than 5 years old. However, the choices of antimicrobial agents are now being limited by the ineffectiveness of many first-line drugs, in relation to the emergence of antimicrobial-resistant <i>E. coli</i> strains. The aim of this systematic review and meta-analysis was to provide an updated prevalence of antimicrobial-resistant DEC in Asia. A comprehensive systematic search was conducted on three electronic databases (PubMed, ScienceDirect, and Scopus), where 40 eligible studies published between 2010 and 2022 were identified. Using meta-analysis of proportions and a random-effects model, the pooled prevalence of DEC in Asian diarrheal patients was 22.8% (95% CI: 16.5–29.2). The overall prevalence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing DEC strains was estimated to be 66.3% (95% CI: 58.9–73.7) and 48.6% (95% CI: 35.1–62.1), respectively. Considering antimicrobial drugs for DEC, the resistance prevalence was highest for the penicillin class of antibiotics, where 80.9% of the DEC isolates were resistant to amoxicillin and 73.5% were resistant to ampicillin. In contrast, resistance to carbapenems such as imipenem (0.1%), ertapenem (2.6%), and meropenem (7.9%) was the lowest. The relatively high prevalence estimation signifies that the multidrug-resistant DEC is a public health threat. Effective antibiotic treatment strategies, which may lead to better outcomes for the control of <i>E. coli</i> infections in Asia, are necessary.https://www.mdpi.com/2079-6382/11/10/1333<i>Escherichia coli</i>diarrheagenicantibiotic resistanceepidemiologyAsiasystematic review |
| spellingShingle | Mohd Zulkifli Salleh Nik Mohd Noor Nik Zuraina Khalid Hajissa Mohamad Ikram Ilias Zakuan Zainy Deris Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-Analysis Antibiotics <i>Escherichia coli</i> diarrheagenic antibiotic resistance epidemiology Asia systematic review |
| title | Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-Analysis |
| title_full | Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-Analysis |
| title_fullStr | Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-Analysis |
| title_short | Prevalence of Multidrug-Resistant Diarrheagenic <i>Escherichia coli</i> in Asia: A Systematic Review and Meta-Analysis |
| title_sort | prevalence of multidrug resistant diarrheagenic i escherichia coli i in asia a systematic review and meta analysis |
| topic | <i>Escherichia coli</i> diarrheagenic antibiotic resistance epidemiology Asia systematic review |
| url | https://www.mdpi.com/2079-6382/11/10/1333 |
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