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Maternal colonization or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in Africa: A systematic review and meta-analysis

Authors :
Andre N.H. Bulabula
Angela Dramowski
Shaheen Mehtar
Source :
International Journal of Infectious Diseases, Vol 64, Iss , Pp 58-66 (2017)
Publication Year :
2017
Publisher :
Elsevier, 2017.

Abstract

Objective: To summarize published studies on the prevalence of and risk factors for maternal bacterial colonization and/or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in pregnant and/or post-partum women in Africa. Methods: A systematic review was conducted using the PubMed, Scopus, and Google Scholar databases. Bibliographies of included eligible studies were manually searched to identify additional relevant articles. No language restriction was applied. The timeframe of the search included all records from electronic database inception to July 15, 2017. A random-effects meta-analysis was performed to summarize the prevalence and the 95% confidence intervals (CI) of ESBL-E colonization or infection in pregnant or post-partum women in Africa. The meta-analysis was conducted using STATA IC 13.1 software and the metaprop function/plugin. Results: Ten studies (seven on pregnant women and three on post-partum women) were included, documenting a 17% prevalence of maternal colonization with ESBL-E in Africa (95% CI 10â23%). The prevalence of ESBL-E in community isolates exceeded that in isolates from the hospital setting (22% vs. 14%). The most frequently reported ESBL-encoding gene was CTX-M (cefotaxime hydrolyzing capabilities). Data on risk factors for maternal ESBL-E colonization and infection are very limited. Conclusions: The prevalence of colonization and/or infection with ESBL-E in pregnant and post-partum women in Africa exceeds that reported from high- and middle-income settings, representing a risk for subsequent neonatal colonization and/or infection with ESBL-E. Keywords: Prevalence, Maternal colonization, ESBL, Enterobacteriaceae, Pregnant women, Post-partum, Systematic review, Meta-analysis Africa

Details

Language :
English
ISSN :
12019712
Volume :
64
Issue :
58-66
Database :
Directory of Open Access Journals
Journal :
International Journal of Infectious Diseases
Publication Type :
Academic Journal
Accession number :
edsdoj.b62a5eab141b434a900a9d5b08ccdcfc
Document Type :
article
Full Text :
https://doi.org/10.1016/j.ijid.2017.08.015