“One Health” perspective on prevalence of co-existing extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae: a comprehensive systematic review and meta-analysis

Abstract Background The Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacterial isolates that produce extended-spectrum β -lactamases (ESBLs) contribute to global life-threatening infections. This study conducted a systematic review and meta-analysis on the global prevalence o...

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Published in:Annals of clinical microbiology and antimicrobials 2023-09, Vol.22 (1), p.1-88, Article 88
Main Authors: Ramatla, Tsepo, Mafokwane, Tshepo, Lekota, Kgaugelo, Monyama, Maropeng, Khasapane, George, Serage, Naledi, Nkhebenyane, Jane, Bezuidenhout, Carlos, Thekisoe, Oriel
Format: Article
Language:English
Subjects:
Animals
Antibiotic resistance
Antibiotics
Antimicrobial agents
Antimicrobial resistance
Bacteria
Bias
Data analysis
Drug resistance
E coli
ESBL
Escherichia coli
Genes
Global
Infections
K. pneumoniae
Klebsiella
Klebsiella pneumoniae
Literature reviews
Meta-analysis
One health
Response rates
Review
Reviews
Surveillance systems
Systematic review
β Lactamase
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Summary:Abstract Background The Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacterial isolates that produce extended-spectrum β -lactamases (ESBLs) contribute to global life-threatening infections. This study conducted a systematic review and meta-analysis on the global prevalence of ESBLs in co-existing E. coli and K. pneumoniae isolated from humans, animals and the environment. Methods The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) [ID no: CRD42023394360]. This study was carried out following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. One hundred and twenty-six eligible studies published on co-existing antibiotic resistance in E. coli and K. pneumoniae between 1990 and 2022 were included. Results The pooled prevalence of ESBL-producing E. coli and K. pneumoniae was 33.0% and 32.7% for humans, 33.5% and 19.4% for animals, 56.9% and 24.2% for environment, 26.8% and 6.7% for animals/environment, respectively. Furthermore, the three types of resistance genes that encode ESBLs, namely bla SHV bla CTX−M , bla OXA , and bla TEM , were all detected in humans, animals and the environment. Conclusions The concept of “One-Health” surveillance is critical to tracking the source of antimicrobial resistance and preventing its spread. The emerging state and national surveillance systems should include bacteria containing ESBLs. A well-planned, -implemented, and -researched alternative treatment for antimicrobial drug resistance needs to be formulated.
ISSN:1476-0711
1476-0711
DOI:10.1186/s12941-023-00638-3