A meta-analysis of the proportion of antimicrobial resistant human Salmonella isolates in Ethiopia

BMC Clinical Pharmacology

Getachew Tadesse¹ 

[1]Department of Biomedical Sciences, College of Veterinary Medicine and Agriculture, Addis Ababa University, P.O. Box 34, Debre Zeit, Ethiopia

关键词: Salmonella;    Humans;    Ethiopia;    Antimicrobial resistance;   

Others  :  1084755
DOI  :  10.1186/2050-6511-15-51

 received in 2014-04-08, accepted in 2014-09-09,  发布年份 2014

【 摘 要 】

Background

Antimicrobial resistant Salmonella is a global problem and recently, a strain on the verge of pan-resistance was reported. In Ethiopia, the therapeutic management of Salmonellosis is difficult because drug sensitivity tests are not routinely carried out and treatment alternatives are not available in most health care facilities. The objectives of this study were to estimate the temporal changes and proportions of drug resistant isolates in Ethiopia.

Methods

Published studies on drug resistant Salmonella isolates were searched in Medline, Google Scholar and the lists of references of articles. Eligible studies were selected by using inclusion and exclusion criteria. Generic, methodological and statistical information were extracted from the eligible studies. The extracted data included the proportions of ampicillin, co-trimoxazole, chloramphenicol, ceftriaxone, ciprofloxacin and multi-drug resistant isolates. Pooled proportions were estimated by a random effects model.

Results

The odds of multi-drug resistant isolates in the 2000s was higher than before the 1990s (OR =18.86, 95% CI = 13.08, 27.19). The pooled proportions of ampicillin, co-trimoxazole, chloramphenicol, ciprofloxacin and multi-drug resistant isolates in the 2000s were 86.01%, 68.01%, 62.08%, 3.61% and 79.56% respectively. S. Concord (>97%) was resistant to ampicillin, co-trimoxazole, chloramphenicol and ceftriaxone.

Conclusion

The proportion of drug resistant isolates has increased since the 1970s. All drugs currently used for the treatment of Salmonellosis but ciprofloxacin are not reliable for an empirical therapy. Alternative drugs should be included in the essential drug list and measures should be taken to re-enforce the drug use policy.

【 授权许可】

   
2014 Tadesse; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Amábile-Cuevas CF: Global Perspectives of Antibiotic Resistance. In Antimicrobial Resistance in Developing Countries. Edited by Sosa AJ, Byarugaba DK, Amábile-Cuevas CF, Hsueh P, Kariuki S, Okeke IN. New York: Springer Science + Business Media; 2010:3-13.
• [2]Le Hello S, Harrois D, Bouchrif B, Sontag L, Elhani L, Guibert V, Zerouali K, Weill FX: Highly drug-resistant Salmonella enterica serotype Kentucky ST198-X1: a microbiological study. Lancet Infect Dis 2013, 13:672-679. doi.org/10.1016/S1473-3099 (13)70141-5
• [3]Kariuki S, Revathi G, Kariuki N, Kiiru J, Mwituria J, Hart CA: Increasing prevalence of multidrug-resistant non-typhoidal Salmonellae, Kenya, 1994-2003. Int J Antimicrob Agents 2005, 25:38-43.
• [4]Coovadia YM, Gathiram V, Bhamjee A, Garratt RM, Mlisana K, Pillay N, Madlalose T, Short M: An outbreak of multiresistant Salmonella typhi in South Africa. Q J Med 1992, 82:91-100.
• [5]Niehaus AJ, Apalata T, Coovadia YM, Smith AM, Moodley P: An outbreak of foodborne salmonellosis in rural KwaZulu-Natal, South Africa. Foodborne Pathog Dis 2011, 8:693-697.
• [6]Mølbak K: Human Health Consequences of Antimicrobial Drug-Resistant Salmonella and Other Foodborne Pathogens. Clin Infect Dis 2005, 41:1613-1620.
• [7]Shimelis D, Tadesse Y: Clinical profile of acute renal failure in children admitted to the department of pediatrics, Tikur Anbessa Hospital. Ethiop Med J 2004, 42:17-22.
• [8]Shimeles D, Lulseged S: Clinical profile and pattern of infection in Ethiopian children with severe protein-energy malnutrition. East Afr Med J 1994, 71:264-267.
• [9]Tadesse G: Prevalence of human Salmonellosis in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis 2014, 14:88. doi:10.1186/1471-2334-14-88 BioMed Central Full Text
• [10]Pegram RG, Roeder PL, Hall ML, Rowe B: Salmonella in livestock and animal by-products in Ethiopia. Trop Anim Health Prod 1981, 13:203-207.
• [11]Morris D, Whelan M, Corbett-Feeney G, Cormican M, Hawkey P, Li X, Doran G: First report of extended-spectrum-beta-lactamase-producing Salmonella enterica isolates in Ireland. Antimicrob Agents Chemother 2006, 50:1608-1609.
• [12]Gebre-Yohannes A: Salmonella from Ethiopia: prevalent species and their susceptibility to drugs. Ethiop Med J 1985, 23:97-102.
• [13]Beyene G, Nair S, Asrat D, Mengistu Y, Engers H, Wain J: Multidrug resistant Salmonella Concord is a major cause of Salmonellosis in children in Ethiopia. J Infect Dev Ctries 2011, 5:23-33.
• [14]Hendriksen RS, Mikoleit M, Kornschober C, Rickert RL, Duyne SV, Kjelsø C, Hasman H, Cormican M, Mevius D, Threlfall J, Angulo FJ, Aarestrup FM: Emergence of multidrug-resistant Salmonella Concord infections in Europe and the United States in children adopted from Ethiopia 2003-2007. Pediatr Infect Dis J 2009, 28:814-818.
• [15]Vanhoof R, Gillis P, Stévart O, Boland C, Vandenberg O, Fux F, Collard J, Bertrand S: Transmission of multiple resistant Salmonella Concord from internationally adopted children to their adoptive families and social environment: proposition of guidelines. Eur J Clin Microbiol Infect Dis 2012, 31:491-497.
• [16]Fabre L, Delauné A, Espié E, Nygard K, Pardos M, Polomack L, Guesnier F, Galimand M, Lassen J, Weill FX: Chromosomal integration of the extended-spectrum beta-lactamase gene blaCTX-M-15 in Salmonella enterica serotype Concord isolates from internationally adopted children. Antimicrob Agents Chemother 2009, 53:1808-1816.
• [17]Galanis E, Lo Fo Wong DM, Patrick ME, Binsztein N, Cieslik A, Chalermchikit T, Aidara-Kane A, Ellis A, Angulo FJ, Wegener HC: Web-based surveillance and global Salmonella distribution, 2000-2002. Emerg Infect Dis 2006, 12:381-388.
• [18]Worku B: Typhoid fever in an Ethiopian children's hospital: 1984-1995. Ethiop J health Dev 2000, 14:311-315.
• [19]Animut A, Mekonnen Y, Shimelis D, Ephraim E: Febrile illnesses of different etiology among outpatients in four health centers in Northwestern Ethiopia. Jpn J Infect Dis 2009, 62:107-110.
• [20]Ley B, Le Hello S, Lunguya O, Lejon V, Muyembe JJ, Weill FX, Jacobs J: Invasive Salmonella enterica Serotype Typhimurium Infections, Democratic Republic of the Congo, 2007-2011. Emerg Infect Dis 2014., 20doi.org/10.3201/eid2004.131488
• [21]Berkley JA, Lowe BS, Mwangi I, Williams T, Bauni E, Mwarumba S, Ngetsa C, Slack MP, Njenga S, Hart CA: Bacteremia among children admitted to a rural hospital in Kenya. N Engl J Med 2005, 352:39-47.
• [22]Gordon MA, Graham SM, Walsh AL, Phiri LW, Molyneux E, Zijlstra EE, Heyderman RS, Hart CA, Molyneux ME: Epidemics of invasive Salmonella enterica serovar Enteritidis and S. enterica serovar Typhimurium infection associated with multidrug resistance among adults and children in Malawi. Clin Infect Dis 2008, 46:963-969.
• [23]Fisk TL, Lundberg BE, Guest JL, Ray S, Barrett TJ, Holland B, Stamey K, Angulo FJ, Farley MM: Invasive infection with multidrug-resistant Salmonella enterica serotype Typhimurium definitive type 104 among HIV-infected adults. Clin Infect Dis 2005, 40:1016-1021.
• [24]Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group: Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009, 6:e1000097. doi:10.1371/journal.pmed.1000097
• [25]Tricco AC, Ng CH, Gilca V, Anonychuk A, Pham B, Berliner S: Canadian oncogenic human papillomavirus cervical infection prevalence: Systematic review and meta-analysis. BMC Infect Dis 2011, 11:235. doi:10.1186/1471-2334-11-235 BioMed Central Full Text
• [26]Calvo-Muñoz I, Gómez-Conesa A, Sánchez-Meca J: Prevalence of low back pain in children and adolescents: a meta-analysis. BMC Pediatr 2013, 13:14. doi:10.1186/1471-2431-13-14 BioMed Central Full Text
• [27]Hurley JC: Lack of impact of Selective Digestive Decontamination on Pseudomonas aeruginosa ventilator associated pneumonia: benchmarking the evidence base. J Antimicrob Chemother 2011, 66:1365-1373.
• [28]Higgins JP, Thompson SG: Quantifying heterogeneity in a meta-analysis. Stat Med 2002, 21:1539-1558.
• [29]DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986, 7:177-188.
• [30]Yang Y, Li X, Zhou F, Jin Q, Gao L: Prevalence of Drug-Resistant Tuberculosis in Mainland China: Systematic Review and Meta-Analysis. PLoS One 2011, 6:e20343. doi:10.1371/journal.pone.0020343
• [31]Gao L, Zhang L, Jin Q: Meta-analysis: prevalence of HIV infection and syphilis among MSM in China. Sex Transm Infect 2009, 85:354-358. doi:10.1136/sti.2008.034702
• [32]Gedebou M, Tassew A: Antimicrobial resistance and R factor of Salmonella isolates from Addis Ababa. Ethiop Med J 1981, 19:77-85.
• [33]Ashenafi M, Gedebou M: Salmonella and Shigella in adult diarrhoea in Addis Ababa- prevalence and antibiograms. Trans R Soc Trop Med Hyg 1985, 79:719-721.
• [34]Asrat D: Shigella and Salmonella serogroups and their antibiotic susceptibility patterns in Ethiopia. East Mediterr Health J 2008, 14:760-767.
• [35]Wolday D: Increase in the incidence of multidrug-resistant Salmonellae in Ethiopia. J Antimicrob Chemother 1998, 41:421-423.
• [36]Mache A, Mengistu Y, Cowley C: Salmonella serogroups identified from adult diarrhoeal out-patients in Addis Ababa Ethiopia: antibiotic resistance and plasmid profile analysis. East Afr Med J 1997, 74:183-186.
• [37]Mache A: Salmonella serogroup and their antibiotic resistance patterns isolated from diarrhoeal stools of pediatric out patients in Jimma Hospital and Jimma Health Center, South West Ethiopia. Ethiop J Health Sci 2002, 37:37-45.
• [38]Yismaw G, Negeri C, Kassu A, Tiruneh M, Mulu A: Antimicrobial Resistance Pattern of Salmonella Isolates from Gondar University Hospital, Northwest Ethiopia. Ethiop Pharm J 2007, 25:85-90.
• [39]Abera B, Biadglegne F: Antimicrobial resistance of fecal isolates of Salmonella and Shigella spp. at Bahir Dar regional health research laboratory, Northwest Ethiopia. Ethiop Pharm J 2009, 27:55-60.
• [40]Reda AA, Seyoum B, Yimam J, Andualem G, Fiseha S, Vandeweerd JM: Antibiotic susceptibility patterns of Salmonella and Shigella isolates in Harar, Eastern Ethiopia. J Infect Dis Immun 2011, 3:134-139.
• [41]Hendriksen RS, Kjelsø C, Torpdahl M, Ethelberg S, Mølbak K, Aarestrup FM: Upsurge of infections caused by Salmonella Concord among Ethiopian adoptees in Denmark. Euro Surveill 2010, 15:pii=19587.
• [42]Beyene G, Asrat D, Mengistu Y, Sofa A, Wain J: Typhoid fever in Ethiopia: Review. J Infect Dev Ctries 2008, 2:448-453.
• [43]Bauer AW, Kirby WM, Sherris JC, Turck M: Antibiotic Susceptibility Testing by a Standardized Single Disk Method. Am J Clin Pathol 1966, 45:493-496.
• [44]Desta Z, Abdulwhab M: Prescription writing in Gondar outpatient teaching hospital, Ethiopia. East Afr Med J 1996, 73:115-119.
• [45]Desalegn AA: Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, South Ethiopia: a cross-sectional study. BMC Health Serv Res 2013, 13:170. doi:10.1186/1472-6963-13-170 BioMed Central Full Text
• [46]Desta Z, Abula T, Beyene L, Fantahun M, Yohannes AG, Ayalew S: Assessment of rational drug use and prescribing in primary health care facilities in north west Ethiopia. East Afr Med J 1997, 74:758-763.
• [47]Fenta A, Belay M, Mekonnen E: Assessment of antibacterial drug exposure patterns of patient encounters seen by different categories of prescribers at health institutions in Bahir Dar, Ethiopia. Ethiop Med J 2013, 51:33-39.
• [48]Assessment of the Pharmaceutical Sector in Ethiopia [http://www.who.int/medicines/areas/coordination/Ethiopia-pharmaceutical.pdf webcite]
• [49]Tsega B, Hailu W, Ergetie Z: Measuring quality of drug use in primary healthcare facilities: a yearlong assessment of WHO prescribing indicators, Wolkite town, South West Ethiopia. Int J Pharm & Ind Res 2012, 2:485-491.
• [50]Isah AO, Ross-Degnan D, Quick J, Laing R, Mabadeje AFB: The development of standard values for the WHO drug use prescribing indicators. [http://archives.who.int/prduc2004/rducd/ICIUM_Posters/1a2_txt.htm webcite]
• [51]Abula T, Worku A, Thomas K: Assessment of the dispensing practices of drug retail outlets in selected towns, North West Ethiopia. Ethiop Med J 2006, 44:145-150.
• [52]Suleman S, Ketsela A, Mekonnen Z: Assessment of self-medication practices in Assendabo Town Jimma zone, Southwestern Ethiopia. Res Soc Adm Pharm 2009, 5:76-81.
• [53]Angamo MT, Wabe NT, Raju NJ: Assessment of Patterns of Drug use by using World Health Organization’s Prescribing Patient Care and Health facility indicators in Selected Health Facilities in Southwest Ethiopia. JAPS 2011, 1:62-66.
• [54]Molla B, Miko A, Pries K, Hildebrandt G, Klee J, Schroeter A, Helmuth R: Class 1 integrons and resistance gene cassettes among multidrug resistant Salmonella serovars isolated from slaughter animals and foods of animal origin in Ethiopia. Acta Trop 2007, 103:142-149.
• [55]Abera B, Biadegelgen F, Bezabih B: Prevalence of Salmonella typhi and intestinal parasites among food handlers in Bahir Dar Town, North West Ethiopia. Ethiop J Health Dev 2010, 24:46-50.
• [56]Aragaw K, Molla B, Muckle A, Cole L, Wilkie E, Poppe C, Kleer J, Hildebrandt G: The characterization of Salmonella serovars isolated from apparently healthy slaughtered pigs at Addis Ababa abattoir, Ethiopia. Prev Vet Med 2007, 82:252-261.
• [57]Alemayehu D, Molla B, Muckle A: Prevalence and antimicrobial resistance pattern of Salmonella isolates from apparently healthy slaughtered cattle in Ethiopia. Trop Anim Health Prod 2003, 35:309-319.
• [58]Molla B, Salah W, Alemayehu D, Mohammed A: Antimicrobial resistance pattern of Salmonella serotypes isolated from apparently healthy slaughtered camels (Camelus dromedarius) in Eastern Ethiopia. Berl Münch Tierärztl Wschr 2004, 117:39-45.
• [59]Molla W, Molla B, Alemayehu D, Muckle A, Cole L, Wilkie E: Occurrence and antimicrobial resistance of Salmonella serovars in apparently healthy slaughtered sheep and goats of central Ethiopia. Trop Anim Health Prod 2006, 38:455-462.
• [60]Sibhat B, Zewde BM, Zerihun A, Muckle A, Cole L, Boerlin P, Wilkie E, Perets A, Mistry K, Gebreyes WA: Salmonella serovars and antimicrobial resistance profiles in beef cattle, slaughterhouse personnel and slaughterhouse environment in Ethiopia. Zoonoses Public Hlth 2011, 58:102-109.
• [61]Alemu S, Zewde BM: Prevalence and antimicrobial resistance profiles of Salmonella enterica serovars isolated from slaughtered cattle in Bahir Dar, Ethiopia. Trop Anim Health Prod 2012, 44:595-600.
• [62]Kingsley RA, Msefula CL, Thomson NR: Epidemic multiple drug resistant Salmonella typhimurium causing invasive disease in sub-Saharan Africa have a distinct genotype. Genome Res 2009, 19:2279-2287.
• [63]Feasey NA, Dougan G, Kingsley RA, Heyderman RS, Gordon MA: Invasive non-typhoidal salmonella disease: an emerging and neglected tropical disease in Africa. Lancet 2012, 379:2489-2499.
• [64]Leibovitz E: The use of fluoroquinolones in children. Curr Opin Pediatr 2006, 18:64-70.
• [65]Ferrera KP, Bomasang ES: Azithromycin versus First Line Antibiotics in the Therapeutic Management of Documented Cases of Typhoid Fever: A Meta-analysis. Phil J Microbiol Infect Dis 2004, 33:163-168.
• [66]Frenck RW, Nakhla I, Sultan Y, Bassily SB, Girgis YF, David J, Butler TC, Girgis NI, Morsy M: Azithromycin versus Ceftriaxone for the Treatment of Uncomplicated Typhoid Fever in Children. Clin Infect Dis 2000, 31:1134-1138.
• [67]Keenan JD, Ayele B, Gebre T, Zerihun M, Zhou Z, House JI, Gaynor BD, Porco TC, Emerson PM, Lietman TM: Childhood mortality in a cohort treated with mass azithromycin for trachoma. Clin Infect Dis 2011, 52:883-888.
• [68]Chuc NT, Larsson M, Do NT, Diwan VK, Tomson GB, Falkenberg T: Improving private pharmacy practice: a multi-intervention experiment in Hanoi Vietnam. J Clinic Epidemiol 2002, 55:1148-1155.
• [69]Laing R, Hogerzeil H, Ross-Degnan D: Ten recommendations to improve use of medicines in developing countries. Health Policy Plan 2001, 16:13-20.