Publication: Decadal Analysis of ESBL-Escherichia coli Antibiotic Resistance Patterns in Urine Samples from Nepal: A Systematic Review and Meta-Analysis
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Health Research Council
Abstract
Abstract
Background: This systematic review aimed to determine the antimicrobial resistance pattern of the extended-spectrum ?-lactamases producing Escherichia coli (ESBL-EC) in urine samples in Nepal.
Methods: Systematic literature review was conducted to locate all articles reporting ESBL-EC in urine samples published between January 2012 to December 2022. The Egger’s weighted regression analysis was done to assess the publication bias. A random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval due to significant between-study heterogeneity. The strength of correlation between multidrug resistance and ESBL production in E.coli strains was determined using Pearson’s correlation coefficient. The data were analyzed using R-language 4.2.2. software.
Results: The combined prevalence of E.coli in urine samples was found to be 14 % (95% CI, 11-18), while the overall pooled prevalence of ESBL E.coli and MDR E.coli were 30% (95% CI, 20-42) and 70% (95% CI, 38-90) respectively. A strong positive correlation of 0.99 (95% CI, 0.89-1.0) was found between ESBL production and MDR among E.coli isolates. Imipenem was the drug of choice against ESBL-E.coli in urine specimens.
Conclusions: Our analyses showed the overall ESBL-EC and MDR-EC burden in Nepal is considerably high. Likewise, the study also infers an increasing trend of antibiotic resistance pattern of ESBL-EC in urine samples.
Keywords: ESBL-E.coli; multi-drug resistance; Nepal; urine.
Description
Bibek Rana Chhetri
Faculty of Medicine and Life Sciences, Chester Medical School, University of Chester, UK
Rajat Thapa
Angel Fertility Clinic, Kathmandu, Nepal
Megha Raj Banjara
Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal