Publication:
Epidemiology of Extended-Spectrum Beta-Lactamase and Carbapenemase-Producing Enterobacterales in the Greater Mekong Subregion: A Systematic-Review and Meta-Analysis of Risk Factors Associated With Extended-Spectrum Beta-Lactamase and Carbapenemase Isolation

dc.contributor.authorShweta R. Singhen_US
dc.contributor.authorAlvin Kuo Jing Teoen_US
dc.contributor.authorKiesha Premen_US
dc.contributor.authorRick Twee Hee Ongen_US
dc.contributor.authorElizabeth A. Ashleyen_US
dc.contributor.authorH. Rogier van Doornen_US
dc.contributor.authorDirek Limmathurotsakulen_US
dc.contributor.authorPaul Turneren_US
dc.contributor.authorLi Yang Hsuen_US
dc.contributor.otherFaculty of Tropical Medicine, Mahidol Universityen_US
dc.contributor.otherOxford University Clinical Research Uniten_US
dc.contributor.otherLondon School of Hygiene & Tropical Medicineen_US
dc.contributor.otherNUS Yong Loo Lin School of Medicineen_US
dc.contributor.otherNational University of Singaporeen_US
dc.contributor.otherMahosot Hospital, Laoen_US
dc.contributor.otherNuffield Department of Medicineen_US
dc.contributor.otherAngkor Hospital for Childrenen_US
dc.date.accessioned2022-08-04T08:47:00Z
dc.date.available2022-08-04T08:47:00Z
dc.date.issued2021-11-26en_US
dc.description.abstractBackground: Despite the rapid spread of extended-spectrum beta-lactamase (ESBL) producing-Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE), little is known about the extent of their prevalence in the Greater Mekong Subregion (GMS). In this systematic review, we aimed to determine the epidemiology of ESBL-E and CPE in clinically significant Enterobacterales: Escherichia coli and Klebsiella pneumoniae from the GMS (comprising of Cambodia, Laos, Myanmar, Thailand, Vietnam and Yunnan province and Guangxi Zhuang region of China). Methods: Following a list of search terms adapted to subject headings, we systematically searched databases: Medline, EMBASE, Scopus and Web of Science for articles published on and before October 20th, 2020. The search string consisted of the bacterial names, methods involved in detecting drug-resistance phenotype and genotype, GMS countries, and ESBL and carbapenemase detection as the outcomes. Meta-analyses of the association between the isolation of ESBL from human clinical and non-clinical specimens were performed using the “METAN” function in STATA 14. Results: One hundred and thirty-nine studies were included from a total of 1,513 identified studies. Despite the heterogeneity in study methods, analyzing the prevalence proportions on log-linear model scale for ESBL producing-E. coli showed a trend that increased by 13.2% (95%CI: 6.1–20.2) in clinical blood specimens, 8.1% (95%CI: 1.7–14.4) in all clinical specimens and 17.7% (95%CI: 4.9–30.4) increase in carriage specimens. Under the log-linear model assumption, no significant trend over time was found for ESBL producing K. pneumoniae and ESBL-E specimens. CPE was reported in clinical studies and carriage studies past 2010, however a trend could not be determined because of the small dataset. Twelve studies were included in the meta-analysis of risk factors associated with isolation of ESBL. Recent antibiotic exposure was the most studied variable and showed a significant positive association with ESBL-E isolation (pooled OR: 2.9, 95%CI: 2.3–3.8) followed by chronic kidney disease (pooled OR: 4.7, 95%CI: 1.8–11.9), and other co-morbidities (pooled OR: 1.6, 95%CI: 1.2–2.9). Conclusion: Data from GMS is heterogeneous with significant data-gaps, especially in community settings from Laos, Myanmar, Cambodia and Yunnan and Guangxi provinces of China. Collaborative work standardizing the methodology of studies will aid in better monitoring, surveillance and evaluation of interventions across the GMS.en_US
dc.identifier.citationFrontiers in Microbiology. Vol.12, (2021)en_US
dc.identifier.doi10.3389/fmicb.2021.695027en_US
dc.identifier.issn1664302Xen_US
dc.identifier.other2-s2.0-85120972813en_US
dc.identifier.urihttps://repository.li.mahidol.ac.th/handle/20.500.14594/77193
dc.rightsMahidol Universityen_US
dc.rights.holderSCOPUSen_US
dc.source.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85120972813&origin=inwarden_US
dc.subjectImmunology and Microbiologyen_US
dc.subjectMedicineen_US
dc.titleEpidemiology of Extended-Spectrum Beta-Lactamase and Carbapenemase-Producing Enterobacterales in the Greater Mekong Subregion: A Systematic-Review and Meta-Analysis of Risk Factors Associated With Extended-Spectrum Beta-Lactamase and Carbapenemase Isolationen_US
dc.typeReviewen_US
dspace.entity.typePublication
mu.datasource.scopushttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85120972813&origin=inwarden_US

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