Antimicrobial-resistant genes among Klebsiella pneumoniae in the Arabian Gulf Countries: A systemic review and meta-analysis

Abstract

Klebsiella is the common pathogen which causes pneumonia, UTI, and bloodstream infections. The vast majority of Klebsiella infections are hospital-acquired. Since the recognition of this as bacteria, it has always been a challenge for the clinicians to find effective treatment against their infections. Several studies are addressing increased antimicrobial resistance rates and different antimicrobial genes in various areas of the Arabian Gulf. Here we aimed to look upon the prevalence of six AMR genes (CTX M, TEM, SHV, NDM, OXA, VIM genes) in this province. We performed a systematic review and meta-analysis of the published studies from the Arabian Gulf countries and analysed the antimicrobial resistance genes pattern present in Klebsiella pneumoniae. Materials and methods The present study used the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) as a guideline for reporting findings. An electronic search was conducted in online databases such as PubMed/MEDLINE, EMBASE, Scopus, Cochrane, Google Scholar, Science Direct, and Web of Science from December 2017 to February 2019 following the inclusion and exclusion criteria. Results Of 160 initially searched studies, 28 entries met the inclusion criteria and were subjected to meta-analysis. Critical appraisal of studies or quality assessment revealed mean quality score was 4.2, with an SD of 1.6. The analysis revealed predominant antimicrobial resistance genes were OXA followed by CTX-M, SHV, TEM, NDM, and VIM in the Arabian Gulf region. Conclusion The antibiotic resistance gene prevalences in Klebsiella pneumoniae in countries of the Arabian Gulf have been reviewed in this study. These countries share a high prevalence of OXA, CTX-M followed by SHV, TEM, NDM, and VIM genes. Antimicrobial-resistant in K. pneumoniae is a threat to public health and this needs strong surveillance to curb this threat.