The magnitude of extended-spectrum beta-lactamase- producing Enterobacteriaceae from clinical samples in Ethiopia: a systematic review and meta-analysis

Background The rapid spread of resistance among extended-spectrum β-lactamase (ESBL)-producingEnterobacteriaceaeis a serious problem around the world. It results in serious clinical complications in humans and has become a global threat. Therefore, this systematic review and meta-analysis was aimed to estimate the pooled prevalence of ESBL-producingEnterobacteriaceaein different clinical samples in Ethiopia. Methods A systematic search was conducted on PubMed, Web of Science, Embase, Google Scholar and the Cochrane Library. All identified observational studies reporting the prevalence of ESBL-producingEnterobacteriaceaefrom clinical samples in Ethiopia were included. Four authors independently extracted data and analysed using R software version 3.6.1 and STATA statistical software version 13. A random-effects model was computed to estimate the pooled prevalence of ESBL-producingEnterobacteriaceaein Ethiopia. Results Of 142 articles reviewed, 14 studies that fulfilled the inclusion criteria were included in the meta-analysis. The pooled prevalence of ESBL-producingEnterobacteriaceaein the different clinical specimens in Ethiopia was 49 % (95 % CI: 39, 60).Klebsiella pneumoniaewas the leading ESBL-producingEnterobacteriaceaefollowed byEscherichia coliandAcinetobacter baumanniiwith a prevalence of 74, 67 and 60 %, respectively. ESBL-producing isolates showed a high rate of resistance to cefotaxime, ceftriaxone, ceftazidime, Amoxicillin clavulanic acid (AMC), ampicillin and aztreonam. The better options for the treatment of ESBL-producingEnterobacteriaceaeare amikacin and Imipenem. Conclusion The magnitude of ESBL-producingEnterobacteriaceaein different clinical samples in Ethiopia is alarmingly high and represents a threat to human health. Hence, a coordinated effort needs to be implemented for the prevention and control of theseEnterobacteriaceae .