Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis
Abstract Background Klebsiella pneumoniae is a gram-negative rod belonging to the order Enterobacterales and having a wide distribution in the environment, including the human colon. Recently, the bacterium is one of the known problems in the healthcare setting as it has become resistant to last-res...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13643-022-02110-3 |
| _version_ | 1811217755451424768 |
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| author | Tewodros Tesfa Habtamu Mitiku Mekuria Edae Nega Assefa |
| author_facet | Tewodros Tesfa Habtamu Mitiku Mekuria Edae Nega Assefa |
| author_sort | Tewodros Tesfa |
| collection | DOAJ |
| description | Abstract Background Klebsiella pneumoniae is a gram-negative rod belonging to the order Enterobacterales and having a wide distribution in the environment, including the human colon. Recently, the bacterium is one of the known problems in the healthcare setting as it has become resistant to last-resort drugs like carbapenems. The colonized person can serve as a reservoir for his/herself and others, especially in the healthcare setting leading to nosocomial and opportunistic infections. Therefore, we aimed to quantitatively estimate the rate of prevalence and incidence of colonization with carbapenem-resistant K. pneumoniae. Methods A literature search was conducted on PubMed/MEDLINE, Google Scholar, Science Direct, Cochrane Library, WHO Index Medicus, and university databases. The study includes all published and unpublished papers that addressed the prevalence or incidence of K. pneumoniae colonization. Data were extracted onto format in Microsoft Excel and pooled estimates with a 95% confidence interval calculated using Der-Simonian-Laird random-effects model. With the use of I 2 statistics and prediction intervals, the level of heterogeneity was displayed. Egger’s tests and funnel plots of standard error were used to demonstrate the publication bias. Results A total of 35 studies were included in the review and 32 records with 37,661 patients for assessment of prevalence, while ten studies with 3643 patients for incidence of colonization. The prevalence of carbapenem-resistant K. pneumoniae colonization varies by location and ranges from 0.13 to 22%, with a pooled prevalence of 5.43%. (3.73–7.42). Whereas the incidence of colonization ranges from 2 to 73% with a pooled incidence of 22.3% (CI 12.74–31.87), both prevalence and incidence reports are majorly from developed countries. There was a variation in the distribution of carbapenem resistance genes among colonizing isolates with KPC as a prominent gene reported from many studies and NDM being reported mainly by studies from Asian countries. A univariate meta-regression analysis indicated continent, patient type, study design, and admission ward do not affect the heterogeneity (p value>0.05). Conclusion The review revealed that colonization with K. pneumoniae is higher in a healthcare setting with variable distribution in different localities, and resistance genes for carbapenem drugs also have unstable distribution in different geographic areas. |
| first_indexed | 2024-04-12T06:59:45Z |
| format | Article |
| id | doaj.art-e0cd9b95cdf44df3ab49ceaf2dc7d7af |
| institution | Directory Open Access Journal |
| issn | 2046-4053 |
| language | English |
| last_indexed | 2024-04-12T06:59:45Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj.art-e0cd9b95cdf44df3ab49ceaf2dc7d7af2022-12-22T03:43:03ZengBMCSystematic Reviews2046-40532022-11-0111111510.1186/s13643-022-02110-3Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysisTewodros Tesfa0Habtamu Mitiku1Mekuria Edae2Nega Assefa3Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya UniversityDepartment of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya UniversityHiwot Fana Specialized University Hospital, College of Health and Medical Sciences, Haramaya UniversitySchool of Nursing Midwifery, College of Health and Medical Sciences, Haramaya UniversityAbstract Background Klebsiella pneumoniae is a gram-negative rod belonging to the order Enterobacterales and having a wide distribution in the environment, including the human colon. Recently, the bacterium is one of the known problems in the healthcare setting as it has become resistant to last-resort drugs like carbapenems. The colonized person can serve as a reservoir for his/herself and others, especially in the healthcare setting leading to nosocomial and opportunistic infections. Therefore, we aimed to quantitatively estimate the rate of prevalence and incidence of colonization with carbapenem-resistant K. pneumoniae. Methods A literature search was conducted on PubMed/MEDLINE, Google Scholar, Science Direct, Cochrane Library, WHO Index Medicus, and university databases. The study includes all published and unpublished papers that addressed the prevalence or incidence of K. pneumoniae colonization. Data were extracted onto format in Microsoft Excel and pooled estimates with a 95% confidence interval calculated using Der-Simonian-Laird random-effects model. With the use of I 2 statistics and prediction intervals, the level of heterogeneity was displayed. Egger’s tests and funnel plots of standard error were used to demonstrate the publication bias. Results A total of 35 studies were included in the review and 32 records with 37,661 patients for assessment of prevalence, while ten studies with 3643 patients for incidence of colonization. The prevalence of carbapenem-resistant K. pneumoniae colonization varies by location and ranges from 0.13 to 22%, with a pooled prevalence of 5.43%. (3.73–7.42). Whereas the incidence of colonization ranges from 2 to 73% with a pooled incidence of 22.3% (CI 12.74–31.87), both prevalence and incidence reports are majorly from developed countries. There was a variation in the distribution of carbapenem resistance genes among colonizing isolates with KPC as a prominent gene reported from many studies and NDM being reported mainly by studies from Asian countries. A univariate meta-regression analysis indicated continent, patient type, study design, and admission ward do not affect the heterogeneity (p value>0.05). Conclusion The review revealed that colonization with K. pneumoniae is higher in a healthcare setting with variable distribution in different localities, and resistance genes for carbapenem drugs also have unstable distribution in different geographic areas.https://doi.org/10.1186/s13643-022-02110-3ColonizationCarbapenem-resistant K. pneumoniaePrevalenceIncidencesystematic review |
| spellingShingle | Tewodros Tesfa Habtamu Mitiku Mekuria Edae Nega Assefa Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis Systematic Reviews Colonization Carbapenem-resistant K. pneumoniae Prevalence Incidence systematic review |
| title | Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis |
| title_full | Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis |
| title_fullStr | Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis |
| title_full_unstemmed | Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis |
| title_short | Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis |
| title_sort | prevalence and incidence of carbapenem resistant k pneumoniae colonization systematic review and meta analysis |
| topic | Colonization Carbapenem-resistant K. pneumoniae Prevalence Incidence systematic review |
| url | https://doi.org/10.1186/s13643-022-02110-3 |
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