The Prevalence of Metallo-β-Lactamase-Producing Pseudomonas aeruginosa in Egypt: A Systematic Review and Meta-Analysis

Background: Metallo- beta -lactamase (MBL)-producing Pseudomonas aeruginosa represents a serious hazard to humanity because of its high mortality rate, ability to hydrolyze all beta-lactam antibiotics, including carbapenem, and absence of a clinically approved inhibitor. There are several studies conducted in Egypt that report a heterogeneous incidence of MBL among Pseudomonas aeruginosa clinical isolates. Methods: We performed a systematic search in MEDLINE [PubMed], Scopus, Google scholar, and Web of Science. Out of 1882 records, 20 studies agreed with the inclusion and exclusion criteria and are included in our review. Results: Our investigation revealed a high incidence of MBL-producing Pseudomonas aeruginosa of about 33.7% (95% CI: 19.3-48) and MBL-mediated Imipenem resistance among P. aeruginosa of about 74.1% (95% CI: 63.5-84.6). Furthermore, based on the included studies and other molecular studies conducted in Egypt, among MBL-encoding genes, bla VIM appeared to be the most prevalent MBL gene in clinically isolated Pseudomonas aeruginosa in Egypt. Conclusion: This high disseminating rate raises the alarm to support both antimicrobial stewardship activities and infection control programs to prevent further increases.