A systematic review and meta-analysis of the global epidemiology of carbapenem-resistant Escherichia coli

IF 5 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Antimicrobial Agents Pub Date : 2026-01-01 Epub Date: 2025-11-17 DOI:10.1016/j.ijantimicag.2025.107668

Mikaela M. Walker , Jason A. Roberts , Yixuan Li , Fekade B. Sime

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引用次数: 0

Abstract

Objectives

Among drug-resistant strains, Escherichia coli is estimated to cause the largest number of deaths per year, globally. This study aimed to estimate the global prevalence of carbapenem-resistant E. coli through a systematic review and meta-analysis of the available literature.

Methods

Three databases, Embase, PubMed, and Scopus were screened for original research articles reporting the epidemiology of carbapenem-resistant E. coli between 2019 and 2023. Following data extraction, a meta-analysis was performed using the random effects model for overall prevalence and prevalence of key carbapenemase enzymes (NDM, OXA, IMP, VIM, and KPC). This systematic review was registered with PROSPERO (CRD42023433370).

Results

A total of 44 studies were included in this review, spanning 16 countries over five WHO regions, with a pooled global prevalence of carbapenem-resistant E. coli at 7 % (95 % CI 0.01; 0.31). The highest pooled prevalence was 51 % (95 % CI 43 % to 58 %) for Bangladesh, and the lowest was 0.15 % (95 % CI 0.08 % to 0.23 %) for Australia. NDM was the most frequent E. coli carbapenemase identified, followed by OXA, KPC, VIM, and IMP.

Conclusions

This study found that the prevalence of carbapenem-resistance amongst E. coli populations is highly variable between countries and significantly lacking in most, suggesting an increased need for robust global surveillance.

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碳青霉烯耐药大肠杆菌全球流行病学的系统回顾和荟萃分析。

目的：在耐药菌株中，估计大肠杆菌每年在全球造成的死亡人数最多。本研究旨在通过对现有文献的系统回顾和荟萃分析，估计耐碳青霉烯类大肠杆菌的全球流行率。方法：筛选Embase、PubMed和Scopus三个数据库，检索2019 - 2023年碳青霉烯类耐药大肠杆菌流行病学的原创研究文章。数据提取后，采用随机效应模型对总体患病率和关键碳青霉烯酶（NDM、OXA、IMP、VIM和KPC）的患病率进行meta分析。该系统评价已在PROSPERO注册（CRD42023433370）。结果：本综述共纳入44项研究，涉及世卫组织5个区域的16个国家，耐碳青霉烯类大肠杆菌的全球总流行率为7% （95% CI 0.01; 0.31）。孟加拉国的总患病率最高为51% (95% CI 43%至58%)，澳大利亚最低为0.15% （95% CI 0.08%至0.23%）。NDM是最常见的大肠杆菌碳青霉烯酶，其次是OXA、KPC、VIM和imp。结论：本研究发现，不同国家的大肠杆菌群体中碳青霉烯耐药性的流行程度差异很大，大多数国家明显缺乏，这表明需要加强全球监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Antimicrobial Agents 医学-传染病学

CiteScore

21.60

自引率

0.90%

发文量

176

审稿时长

36 days

期刊介绍： The International Journal of Antimicrobial Agents is a peer-reviewed publication offering comprehensive and current reference information on the physical, pharmacological, in vitro, and clinical properties of individual antimicrobial agents, covering antiviral, antiparasitic, antibacterial, and antifungal agents. The journal not only communicates new trends and developments through authoritative review articles but also addresses the critical issue of antimicrobial resistance, both in hospital and community settings. Published content includes solicited reviews by leading experts and high-quality original research papers in the specified fields.