Gram-negative bacteria isolates and their antibiotic-resistance patterns among pediatrics patients in Ethiopia: A systematic review

Abstract

Objective: Antimicrobial resistance is one of the serious threats in the world, including Ethiopia. Even though several studies were conducted to estimate common bacteria and their antibiotic-resistance profile in Ethiopia, it is difficult to estimate the overall resistant patterns due to the lack of a nationwide study. This systematic review aimed to determine the prevalence of gram-negative bacteria isolates and their antibiotic-resistance profile among pediatrics patients in Ethiopia. Methods: A web-based search using PubMed, EMBASE, Science Direct, the Cochrane Database for Systematic Reviews, Scopus, Hinari, Sci-Hub, African Journals Online Library, and free-text web searches using Google Scholar was conducted from August to September 16, 2021. Each of the original articles was searched by Boolean search technique using various keywords and was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The data were extracted using Microsoft Excel format and exported to STATA 14.0 for statistical analyses. Results: The database search delivered a total of 2,684 studies. After articles were removed by duplications, title, reading the abstract, and assessed for eligibility criteria, 19 articles were included in the systematic review. Of a total of 1372 (16.77%) culture-positive samples, 735 (53.57%) were gram-negative. Escherichia coli was the most frequently isolated bacteria followed by Klebsiella species, 139/1372 (10.13%), and 125/1372(9.11%), respectively. More than 66.67% of isolates were resistant to ampicillin except for Neisseria meningitidis which was 32.35% (11/34). Pseudomonas aeruginosa, Klebsiela species, and Citrobacter species were 100% resistance for cefepime. Haemophilus influenzae was 100% resistant to meropenem. Salmonella species were 93.30%, 78.26%, and 63.64% resistant to tetracycline, chloramphenicol, and cotrimoxazole, respectively. Conclusion: Gram-negative bacteria were identified as the common pathogen causing infection in pediatrics and the level of resistance to commonly prescribed antibiotics was significantly higher in Ethiopia. Culture and susceptibility tests and well-designed infection control programs are important measures.