Background. Studies have reported that the existence of CP bacteria in Africa, but, in general, comprehensive data about the molecular epidemiology of CP organisms are limited. Therefore, this systematic review and meta-analysis expound the pooled prevalence of CP P. aeruginosa and CP A. baumannii clinical isolates in Africa. It also identified the diversity of carbapenemases or their encoding genes among the isolates in Africa. Lastly, the review observed the trends of these CP isolates in Africa. Methods. A comprehensive search was performed between July 2019 and October 2019 in the following databases: PubMed, Google Scholar, and African Journal online. The included articles were published only in English. The screening was done by two authors independently. The data extracted on Excel spreadsheet were transferred to STATA 11 software for analysis. Results. From a total of 1,454 articles searched, 42 articles were eligible. Most of the studies were conducted in the North Africa region. But there was no report from Central Africa. The pooled prevalence of CP P. aeruginosa and CP A. baumannii among the clinical specimens in Africa was 21.36% and 56.97%, respectively. OXA-23 and VIM were the most prevailing carbapenemase among P. aeruginosa and A. baumannii, respectively. The cumulative meta-analysis revealed a relative increment of the prevalence of CP P. aeruginosa over time in Africa but it showed a higher prevalence of CP A. baumannii isolates across years. Conclusion. The review revealed a high pooled prevalence of CP A. baumannii clinical isolates in Africa which needs urgent action. Moreover, the emergence of concomitant carbapenemases, especially OXA-23 + NDM among CP A. baumannii, was also an alarming problem.
Background: Surgical site infection is the third most commonly reported nosocomial infection. Different primary studies on Surgical site infection (SSI) were conducted in Ethiopia. However, variation among those studies was seen. This study was aimed to estimate the national prevalence of SSI, its bacterial profile and associated factors of SSI in Ethiopia. Methods: PubMed, Cochrane library, and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was applied to check heterogeneity of studies. A weighted inverse variance random-effects model was applied to estimate the national prevalence of SSI, its bacterial profile and the effect size of associated factors. The subgroup analysis was conducted by region, study design, and year of study conducted. Result: A total of 18 studies were used for prevalence of SSI, its bacterial profile and associated factors. The pooled prevalence of SSI was 11.58 (95% CI 9.78, 13.38). The pooled prevalence of culture positive SSI infection among patients who develop clinical sign and symptoms of SSI was also 80.42% (95% CI 70.86, 89.99). SSI was majorly caused by S. aureus (28.47%) and E. coli (15.93%). Drinking an alcohol (AOR = 6.28; 95%CI: 2.9–13.3); women’s having chorioaminities (AOR = 8.67; 95%CI: 4.63–16.27); patients living in rural areas (AOR = 3.10; 95%CI: 1.57–6.14); patients who undergo previous surgery (AOR = 3.94; 95%CI: 1.7–7.17) and women’s who had rupture of membrane >12 hour (AOR=5.29; 95%CI: 2.73–10.25) were identified factors of SSI. Conclusions: The prevalence of SSI in Ethiopia was high. This indicates calling for the need of better allocating resources and implementing a program for controlling Surgical site infections in Ethiopia.
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