{"title":"埃塞俄比亚卫生保健和社区环境中肠球菌的流行、抗菌药物敏感性模式和相关危险因素：系统回顾和荟萃分析","authors":"Zigale Hibstu Teffera, Wubetu Yihunie Belay, Bantayehu Addis Tegegne, Abebe Dagne, Ademe Adugnaw, Habtamu Belew, Yasabe Leykun, Samrawit Tefera, Bewket Mesganaw Shtie, Abebe Yenesew, Abateneh Melkamu, Gashaw Azanaw Amare, Desalegn Abebaw, Yibeltal Akelew, Mohammed Jemal, Baye Ashenef, Mamaru Getinet, Temesgen Baylie, Mihiretie Kiber, Mamaru Tilahun Afework, Tiruzer Hibistu, Kassaye Enchalew","doi":"10.1177/20499361251354905","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><i>Enterococci</i> are significant contributors to healthcare-associated infections in Ethiopia.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis synthesize data on the prevalence, antimicrobial susceptibility patterns, and associated risk factors for <i>Enterococcus</i> infections in Ethiopia.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>A comprehensive search was conducted in Scopus, PubMed, Web of Science, Cochrane Library, and Google Scholar, covering studies published in English over the past 5 years, with the last search on October 30, 2024. Inclusion criteria targeted original studies on <i>Enterococcus</i> prevalence, resistance, and risk factors in Ethiopian healthcare and community settings. Risk of bias was evaluated using the ROBINS-I tool. Meta-analytic techniques calculated pooled prevalence, log-adjusted odds ratios (log-AORs), and <i>p</i>-values, accompanied by heterogeneity and subgroup analyses.</p><p><strong>Results: </strong>Thirteen studies encompassing 3598 participants (mean age: 29.26 ± 6.6 years) reported a pooled prevalence of 6.67% (95% CI: 5.50-8.85) for <i>Enterococcus</i> species, with substantial regional variation (0.03-55.88). Major risk factors included prolonged hospital stays (OR = 6), catheterization (OR = 3.5), and diabetes (OR = 3.92). The pooled log-AOR was 0.986 (95% CI: 0.214-1.759; <i>p</i> = 0.01). Antimicrobial susceptibility tests identified cephalexin and co-trimoxazole as the most effective antibiotics (100% sensitivity each), while oxacillin, trimethoprim-sulfamethoxazole, and norfloxacin exhibited the highest resistance rates (85.71%, 80.00%, and 80.00%, respectively). Considerable heterogeneity was observed (<i>I</i> <sup>2</sup> = 92.31%, τ<sup>2</sup> = 5882.35).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis found a 6.67% pooled prevalence of <i>Enterococcus</i> infections in Ethiopia, with high variability in antibiotic resistance and key risk factors such as prolonged hospital stays, catheterization, and diabetes. Effective antibiotics included cephalexin and co-trimoxazole, while high resistance was noted for oxacillin and norfloxacin. The findings emphasize the need for targeted infection control and antimicrobial stewardship.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251354905"},"PeriodicalIF":3.8000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246523/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence, antimicrobial susceptibility patterns, and associated risk factors of <i>Enterococci</i> species in healthcare and community settings in Ethiopia: a systematic review and meta-analysis.\",\"authors\":\"Zigale Hibstu Teffera, Wubetu Yihunie Belay, Bantayehu Addis Tegegne, Abebe Dagne, Ademe Adugnaw, Habtamu Belew, Yasabe Leykun, Samrawit Tefera, Bewket Mesganaw Shtie, Abebe Yenesew, Abateneh Melkamu, Gashaw Azanaw Amare, Desalegn Abebaw, Yibeltal Akelew, Mohammed Jemal, Baye Ashenef, Mamaru Getinet, Temesgen Baylie, Mihiretie Kiber, Mamaru Tilahun Afework, Tiruzer Hibistu, Kassaye Enchalew\",\"doi\":\"10.1177/20499361251354905\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong><i>Enterococci</i> are significant contributors to healthcare-associated infections in Ethiopia.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis synthesize data on the prevalence, antimicrobial susceptibility patterns, and associated risk factors for <i>Enterococcus</i> infections in Ethiopia.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>A comprehensive search was conducted in Scopus, PubMed, Web of Science, Cochrane Library, and Google Scholar, covering studies published in English over the past 5 years, with the last search on October 30, 2024. Inclusion criteria targeted original studies on <i>Enterococcus</i> prevalence, resistance, and risk factors in Ethiopian healthcare and community settings. Risk of bias was evaluated using the ROBINS-I tool. Meta-analytic techniques calculated pooled prevalence, log-adjusted odds ratios (log-AORs), and <i>p</i>-values, accompanied by heterogeneity and subgroup analyses.</p><p><strong>Results: </strong>Thirteen studies encompassing 3598 participants (mean age: 29.26 ± 6.6 years) reported a pooled prevalence of 6.67% (95% CI: 5.50-8.85) for <i>Enterococcus</i> species, with substantial regional variation (0.03-55.88). Major risk factors included prolonged hospital stays (OR = 6), catheterization (OR = 3.5), and diabetes (OR = 3.92). The pooled log-AOR was 0.986 (95% CI: 0.214-1.759; <i>p</i> = 0.01). Antimicrobial susceptibility tests identified cephalexin and co-trimoxazole as the most effective antibiotics (100% sensitivity each), while oxacillin, trimethoprim-sulfamethoxazole, and norfloxacin exhibited the highest resistance rates (85.71%, 80.00%, and 80.00%, respectively). Considerable heterogeneity was observed (<i>I</i> <sup>2</sup> = 92.31%, τ<sup>2</sup> = 5882.35).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis found a 6.67% pooled prevalence of <i>Enterococcus</i> infections in Ethiopia, with high variability in antibiotic resistance and key risk factors such as prolonged hospital stays, catheterization, and diabetes. Effective antibiotics included cephalexin and co-trimoxazole, while high resistance was noted for oxacillin and norfloxacin. The findings emphasize the need for targeted infection control and antimicrobial stewardship.</p>\",\"PeriodicalId\":46154,\"journal\":{\"name\":\"Therapeutic Advances in Infectious Disease\",\"volume\":\"12 \",\"pages\":\"20499361251354905\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-07-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246523/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Infectious Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/20499361251354905\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Infectious Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20499361251354905","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Prevalence, antimicrobial susceptibility patterns, and associated risk factors of Enterococci species in healthcare and community settings in Ethiopia: a systematic review and meta-analysis.
Background: Enterococci are significant contributors to healthcare-associated infections in Ethiopia.
Objectives: This systematic review and meta-analysis synthesize data on the prevalence, antimicrobial susceptibility patterns, and associated risk factors for Enterococcus infections in Ethiopia.
Design: Systematic review and meta-analysis.
Data sources and methods: A comprehensive search was conducted in Scopus, PubMed, Web of Science, Cochrane Library, and Google Scholar, covering studies published in English over the past 5 years, with the last search on October 30, 2024. Inclusion criteria targeted original studies on Enterococcus prevalence, resistance, and risk factors in Ethiopian healthcare and community settings. Risk of bias was evaluated using the ROBINS-I tool. Meta-analytic techniques calculated pooled prevalence, log-adjusted odds ratios (log-AORs), and p-values, accompanied by heterogeneity and subgroup analyses.
Results: Thirteen studies encompassing 3598 participants (mean age: 29.26 ± 6.6 years) reported a pooled prevalence of 6.67% (95% CI: 5.50-8.85) for Enterococcus species, with substantial regional variation (0.03-55.88). Major risk factors included prolonged hospital stays (OR = 6), catheterization (OR = 3.5), and diabetes (OR = 3.92). The pooled log-AOR was 0.986 (95% CI: 0.214-1.759; p = 0.01). Antimicrobial susceptibility tests identified cephalexin and co-trimoxazole as the most effective antibiotics (100% sensitivity each), while oxacillin, trimethoprim-sulfamethoxazole, and norfloxacin exhibited the highest resistance rates (85.71%, 80.00%, and 80.00%, respectively). Considerable heterogeneity was observed (I2 = 92.31%, τ2 = 5882.35).
Conclusion: This systematic review and meta-analysis found a 6.67% pooled prevalence of Enterococcus infections in Ethiopia, with high variability in antibiotic resistance and key risk factors such as prolonged hospital stays, catheterization, and diabetes. Effective antibiotics included cephalexin and co-trimoxazole, while high resistance was noted for oxacillin and norfloxacin. The findings emphasize the need for targeted infection control and antimicrobial stewardship.
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