John Bosco Kalule, Linda A Bester, Daniel L Banda, Firehiwot Abera Derra, Chisomo Msefula, Anthony M Smith, Abraham Ajayi, Happiness Kumburu, Geoffrey Kwenda, Kaunda Yamba, John Mwaba, Yasmina J Fakim, Nyasha Sithole, Aquillah M Kanzi, Patrick M K Njage, Francis Chikuse, Sofonias K Tessema, Stella I Smith, Ebenezer Foster-Nyarko
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引用次数: 0
Abstract
Introduction: Diarrhoeagenic Escherichia coli (DEC) persistently challenges public health in Africa, contributing substantially to the diarrhoeal disease burden. This systematic review and meta-analysis illuminate the distribution and antimicrobial resistance (AMR) patterns of DEC pathotypes across the continent.
Methods: The review selectively focused on pathotype-specific studies reporting prevalence and/or AMR of human-derived DEC pathotypes from African nations, excluding data from extra-intestinal, animal, and environmental sources and studies focused on drug and mechanism experiments. Pertinent studies were retrieved from SCOPUS, PubMed, and EBSCOhost, processed with Covidence, and screened in alignment with PRISMA guidelines.
Results: The reviewed studies were predominantly hospital-based (80%) and paediatric-focused (91%), with a meagre 4.4% documenting DEC outbreaks. Seven DEC pathotypes were discerned, with Enteroaggregative E. coli (EAEC) being notably prevalent (43%, 95% CI 30-55%) and Enteroinvasive E. coli (EIEC) least prevalent (24%, 95% CI 17-32%). Identified non-susceptibilities were noted against essential antibiotics including ciprofloxacin, ceftriaxone, and ampicillin, while instances of carbapenem and Extended-Spectrum ß-Lactamase (ESBL) resistance were scarce.
Conclusion: Despite sporadic data on DEC prevalence and AMR in Africa, particularly in community settings, a palpable gap remains in real-time outbreak surveillance and comprehensive data documentation. Augmenting surveillance and embracing advancements in molecular/genomic characterisation techniques are crucial to precisely discerning DEC's actual impact and resistance continuum in Africa.
导言：腹泻致病性大肠杆菌（DEC）持续挑战着非洲的公共卫生，严重加重了腹泻疾病的负担。本系统综述和荟萃分析揭示了 DEC 病原型在非洲大陆的分布和抗菌药耐药性（AMR）模式：方法：综述有选择性地侧重于报告非洲国家人源 DEC 病原体流行率和/或 AMR 的病原体特异性研究，排除了肠道外、动物和环境来源的数据以及侧重于药物和机制实验的研究。从 SCOPUS、PubMed 和 EBSCOhost 检索相关研究，使用 Covidence 进行处理，并根据 PRISMA 指南进行筛选：所审查的研究主要以医院为基础（80%），以儿科为重点（91%），只有 4.4% 的研究记录了 DEC 的爆发。研究发现了七种DEC病原体类型，其中肠聚集性大肠杆菌（EAEC）最常见（43%，95% CI 30-55%），而肠侵袭性大肠杆菌（EIEC）最少（24%，95% CI 17-32%）。已确定的不耐药抗生素包括环丙沙星、头孢曲松和氨苄西林，而碳青霉烯类和广谱ß-内酰胺酶（ESBL）耐药的情况很少：结论：尽管非洲有关于DEC流行率和AMR的零星数据，尤其是在社区环境中，但在实时疫情监测和全面数据记录方面仍存在明显差距。加强监测和采用先进的分子/基因组特征描述技术，对于准确辨别 DEC 在非洲的实际影响和耐药性连续性至关重要。
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The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.
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