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A systematic review and meta-analysis on the prevalence of extended-spectrum beta-Lactamase-Producing Klebsiella Pneumonia in Nigeria


Christian Kelechi Ezeh
Daniel Chinonso Digwo
Irene Amara Okeke
Prisca Chidinma Elebe
Emmanuel Onyedikachi Ezeh

Abstract

 


Background: Rapid emergence and proliferation of extended spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL-KP) constitute a serious health problem globally.


Objectives: The aim of this study was to evaluate the pooled prevalence of ESBL-KP and ESBL genes in Nigeria.


Methods: A quantitative method (Meta-analysis) design was used to summarize pooled results of primary studies. Different databases [Google Scholar, PubMed, and African Journal Online (AJOL)] were searched for relevant studies. Meta-analysis was done using random-effects model. I2 and Egger test was used to ascertain heterogeneity and publication bias evaluation.


Results: Eighteen observational studies were selected and the pooled prevalence of ESBL-KP in Nigeria was 47.3% [95% confidence interval (CI) 37 – 58%]. Among the genes encoding ESBL, OXA had the highest pooled prevalence in the selected studies [57% (95% CI 32, 76)], followed by TEM [55% (95% CI 36, 70)], CTX-M [54% (95% CI 38, 70)], and 41% (95% CI 27, 57). Heterogeneity tests (I2) was observed to be between 69.22 and 95.63 % for ESBL-KP and ESBL genes in the studies. Egger tests showed no publication bias (0.09 – 0.99).


Conclusions: This meta-analysis demonstrated that the prevalence of ESBL-KP is increasing in Nigeria. Hence, antimicrobial stewardship and infection control measures for the prevention and spread of these strains be implemented.


Keywords: Extended spectrum beta-latamase; Klebsiella Pneumonia; meta-analysis; Nigeria.


Journal Identifiers


eISSN: 1729-0503
print ISSN: 1680-6905