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Source publication
Background:
Empirical antibiotic therapy is the mainstay of management of adult community-acquired pneumonia (CAP) globally. Knowledge of prevalent pathogen (bacterial) profile and drug susceptibility pattern is very essential for appropriate management of CAP cases, which again calls for regular update of pathogen profile in a given locality. Thi...
Context in source publication
Context 1
... K. pneumoniae, and E. coli) have emerged as causes of CAP. [22,23] Our results [Tables 2, 3 and Figure 2] are very much in tune with this fact, attributable to the ever-increasing number of elderly CAP patients harboring colonizers (mainly GNBs), as well as suffering severe forms of disease requiring hospitalization, ICU admission, etc. [19,23] K. pneumonia isolates showed [Supplementary Table 1] high resistance to penicillin/beta-lactamase inhibitors (43.2%-40.1%). Third and fourth-generation cephalosporins resistance ranged from 60% to 37%. ...
Citations
... This finding is comparable with a previous review reporting the pooled prevalence of bacterial pneumonia in Sudan (33.33%), and a systematic review and meta-analysis of pneumonia in east African children (34%) [35], Sudan (42%) [36], Asian countries (44.8%) [37], Iran (44%) [38] and India (46.3%) [39]. On the contrary, the finding of the present systematic review and meta-analysis is massively higher than systematic review and meta-analysis on the pooled magnitude of pneumonia among under-five children in Ethiopia which accounted 18.03 [40] and lower than the study in Ghana 84.5% [41], Nigeria 69.6% and 45.2% [42,43], Zambia 59% [44], Egypt 50.4% [45], Pakistan 75% (37), in different regions of India 52.83% and 58.8%, 83% [46,47], Bangladesh 61.83% [48], multicenter study in China 74.4% [49], Spain 50.7% [50], and Vietnam 61.8% [51]. This could be due to differences in the study setting, genetic background of the study population, and sample size. ...
Background Bacterial pneumonia can affect all age groups, but people with weakened immune systems, young children, and the elderly are at a higher risk. Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa are the most common causative agents of pneumonia, and they have developed high MDR in recent decades in Ethiopia. This systematic review and meta-analysis aimed to determine the pooled prevalence of bacterial pneumonia and multidrug resistance in Ethiopia. Methods The articles were searched extensively in the electronic databases and grey literature using entry terms or phrases. Studies meeting the eligibility criteria were extracted in MS Excel and exported for statistical analysis into STATA version 14 software. The pooled prevalence of bacterial pneumonia and multidrug resistance were calculated using a random-effects model. Heterogeneity was assessed by using the I 2 value. Publication bias was assessed using a funnel plot and Egger's test. A sensitivity analysis was done to assess the impact of a single study on the pooled effect size. Result Of the 651 studies identified, 87 were eligible for qualitative analysis, of which 11 were included in the meta-analysis consisting of 1154 isolates. The individual studies reported prevalence of bacterial pneumonia ranging from 6.19 to 46.3%. In this systematic review and metanalysis, the pooled prevalence of bacterial pneumonia in Ethiopia was 37.17% (95% CI 25.72-46.62), with substantial heterogeneity (I 2 = 98.4%, p < 0.001) across the studies. The pooled prevalence of multidrug resistance in bacteria isolated from patients with pneumonia in Ethiopia was 67.73% (95% CI: 57.05-78.40). The most commonly isolated bacteria was Klebsiella pneumoniae, with pooled prevalence of 21.97% (95% CI 16.11-27.83), followed by Streptococcus pneumoniae, with pooled prevalence of 17.02% (95% CI 9.19-24.86), respectively.2
... This finding is comparable with a previous review reporting the pooled prevalence of bacterial pneumonia in Sudan (33.33%), and a systematic review and meta-analysis of pneumonia in east African children (34%) [35], Sudan (42%) [36], Asian countries (44.8%) [37], Iran (44%) [38] and India (46.3%) [39]. On the contrary, the finding of the present systematic review and meta-analysis is massively higher than systematic review and meta-analysis on the pooled magnitude of pneumonia among under-five children in Ethiopia which accounted 18.03 [40] and lower than the study in Ghana 84.5% [41], Nigeria 69.6% and 45.2% [42,43], Zambia 59% [44], Egypt 50.4% [45], Pakistan 75% (37), in different regions of India 52.83% and 58.8%, 83% [46,47], Bangladesh 61.83% [48], multicenter study in China 74.4% [49], Spain 50.7% [50], and Vietnam 61.8% [51]. This could be due to differences in the study setting, genetic background of the study population, and sample size. ...
Background
Bacterial pneumonia can affect all age groups, but people with weakened immune systems, young children, and the elderly are at a higher risk. Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa are the most common causative agents of pneumonia, and they have developed high MDR in recent decades in Ethiopia. This systematic review and meta-analysis aimed to determine the pooled prevalence of bacterial pneumonia and multidrug resistance in Ethiopia.
Methods
The articles were searched extensively in the electronic databases and grey literature using entry terms or phrases. Studies meeting the eligibility criteria were extracted in MS Excel and exported for statistical analysis into STATA version 14 software. The pooled prevalence of bacterial pneumonia and multidrug resistance were calculated using a random-effects model. Heterogeneity was assessed by using the I² value. Publication bias was assessed using a funnel plot and Egger’s test. A sensitivity analysis was done to assess the impact of a single study on the pooled effect size.
Result
Of the 651 studies identified, 87 were eligible for qualitative analysis, of which 11 were included in the meta-analysis consisting of 1154 isolates. The individual studies reported prevalence of bacterial pneumonia ranging from 6.19 to 46.3%. In this systematic review and metanalysis, the pooled prevalence of bacterial pneumonia in Ethiopia was 37.17% (95% CI 25.72–46.62), with substantial heterogeneity (I² = 98.4%, p < 0.001) across the studies. The pooled prevalence of multidrug resistance in bacteria isolated from patients with pneumonia in Ethiopia was 67.73% (95% CI: 57.05–78.40). The most commonly isolated bacteria was Klebsiella pneumoniae, with pooled prevalence of 21.97% (95% CI 16.11–27.83), followed by Streptococcus pneumoniae, with pooled prevalence of 17.02% (95% CI 9.19–24.86), respectively.
Conclusion
The pooled prevalence of bacterial isolates from bacterial pneumonia and their multidrug resistance were high among Ethiopian population. The initial empirical treatment of these patients remains challenging because of the strikingly high prevalence of antimicrobial resistance.
... Meta-analysis results showed that the pooled prevalence of bacterial etiology of CAP among adult patients was 39.18% (36.34-42.02). This report was in line with a study conducted in Sudan 42% [32] and lower than that in Ghana, 84.5% [33] Nigeria, 69.6% and 45.2% [34,35], Zambia 59% [36], Egypt 50.4% [37], Saudi Arabia 46.6% [38], Pakistan 75% [39], in a different region of India, 46.3%, 52.83%, 58.8%, 83% [40][41][42][43], Bangladesh 61.83% [44]; a multicenter study in China, 74.4% [31]; Asian countries, 44.8% [11] Iran, 44% [45] Spain, 50.7% [46] Vietnam, 61.8% [47] and Ukraine 100% [48]. This variation may be attributed to differences in the study setting, the characteristics of the study population, and sample size. ...
... In this meta-analysis, the most common cause of CAP among adult patients in Ethiopia is Klebsiella pneumoniae followed by Streptococcus pneumoniae and Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, and other bacteria. This finding is similar to those reported in Sudan [32], Nigeria [51], Tanzania [50], Egypt [37], and India [43]. The overall predominant isolates identified were Klebsiella pneumoniae among HIV infected population suspected with CAP which included in this review. ...
Background and objective
According to the Global Burden of Diseases, Injuries, and Risk Factors, lower respiratory infections cause more than 2.3 million deaths globally, with a majority occurring in sub-Saharan Africa, including Ethiopia.
Community-acquired pneumonia (CAP) is a major contributor to global mortality and morbidity. Understanding the prevalence and common bacterial causes of CAP is crucial for clinicians to accurately diagnose and improve patient satisfaction. The purpose of this systematic review was to report the pooled prevalence and common bacterial etiologies of CAP among adult patients in Ethiopia.
Methods
This review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A comprehensive search of the published articles between January 2000 and October 2022 was performed using open access electronic databases such as PUBMED, Science Direct, CINAHL, HINARI, Google Scholar, and local university repositories. Cochrane Q and I² values were used to assess heterogeneity among the studies. Publication bias was assessed using funnel plots and Egger's test. The random-effects model was used to estimate the pooled prevalence.
Results and conclusions
Of all the publications that were thoroughly searched, 9 studies with 2496 participants met the criteria for analysis. All of the studies were cross-sectionally designed and most of the studies used convenient sampling techniques. The included studies consisted of two conducted among adult patients diagnosed with CAP and living with HIV/AIDS, while the remaining seven studies were conducted among adult patients diagnosed with CAP without HIV/AIDS. The combined prevalence of bacterial causes of community-acquired pneumonia (CAP) among adult patients was found to be 39.18% (CI 36.34–42.02), with an I² of 52.6 and a P value of 0.032. The primary bacterial cause was Klebsiella pneumoniae (9.1%), followed by Streptococcus pneumoniae (8.11%), and Staphylococcus aureus (6.8%). Therefore, it is advisable to introduce a diagnostic tool for identifying specific causative agents and drug resistance, which could lead to improved treatment and better patient outcomes by reducing the need for empirical treatments.
... It was aslo higher than the report in Tanzania 20.8%(49).Based on the etiological agents the predominate bacterial agent causing CAP among adult population in Ethiopia was Klebsiella pneumoniae followed by Streptococcus pneumoniae and Staphylococcus aureus, Escherichia coli, Haemophilus in uenza, and other bacterial species. This nding was similar to a report in Sudan(30), Nigeria (50), Tanzania(49), in Egypt(35), and India(41). ...
Background
Lower respiratory tract infections are the leading cause of morbidity and mortality around the globe. Community-acquired pneumonia (CAP) is among these problems requiring the knowledge of its general international and national burden as well as concerning its etiologic agents. There is no nationally representative information on the prevalence of bacterial CAP with its common etiology. This review was intended to report the pooled prevalence of CAP with common bacterial etiologies among adult populations in the Ethiopia context.
Methodology
A comprehensive search of published literature was made on electronic databases such as PUBMED, Science Direct, CINAHL, HINARI, Google scholar, and the local university repository. This study was done based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. A primary article published in the last two decades that report the bacterial profile of CAP among adult population in Ethiopia was included. The quality of each study was checked by Joanna Briggs Institute (JBI) checklist for cross-sectional studies. Cochrane Q and I² values were used to assess the heterogeneity among studies. Publication bias was assessed by funnel plot and eggers test. The random effect model was used to estimate the pooled prevalence. The protocol for this study was registered in PROSPERO (ID=CRD42022357896).
Result
A total of 1440 articles were screened and only 9 articles were included in the final analysis with a total sample size of 2496. The pooled prevalence of CAP among adult population was 39.18% confidence interval (CI (36.34-42.02), I²=52.6, P=0.032). With respect to bacterial etiologies Klebsiella pneumoniae was the most common isolate (9.1%) followed by Streptococcus pneumoniae (8.11%) and Staphylococcus aureus (6.8%). There was no publication bias as checked by symmetric funnel plot and eggers test (p = 0.15). The estimate of all included studies has laid between CI of the pooled estimate as indicated by sensitivity analysis.
Conclusions
The overall estimate of CAP in this study was 39.18%. Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus aureus were the most common isolate in causing CAP. It is better to provide a tool for the diagnosis of specific etiologic agents for better diagnosis of patients and increase patient outcomes by reducing empirical treatments.
