Bacterial profile and antimicrobial resistance patterns of common bacteria among pregnant women with bacteriuria in Ethiopia: a systematic review and meta-analysis

Abstract

AbstractBackgroundGlobally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug resistant. This review is aimed at providing contemporary bacterial profile and antimicrobial resistance pattern among pregnant women with significant bacteriuria.MethodsElectronic biomedical databases and indexing services such as PubMed/MEDLINE, Web of Science, EMBASE and Google Scholar were searched. Original records of research articles, available online from 2008 to 2021, addressing the prevalence of significant bacteriuria and AMR pattern among pregnant women and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measure analyses and subgrouping.ResultsThe data of 5894 urine samples from 20 included studies conducted in 8 regions of the country were pooled. The overall pooled estimate of bacteriuria was 15% (95% CI 13–17%,I2 = 77.94%,p < 0.001) with substantial heterogeneity. The pooled estimate ofEscherichia colirecovered from isolates of 896 urine samples was 41% (95% CI 38–45%) followed by coagulase-negativeStaphylococci, 22% (95% CI 18–26%),Staphylococcus aureus, 15% (95% CI 12–18%),Staphylococcus saprophytic, 12% (95% CI 6–18%)Proteus mirabilis, 7% (95% CI 4–10%),Enterococcusspecies, 6% (0–12%),Pseudomonas aeruginosa, 4% (2–6%),Citrobacterspecies, 4% (95% CI 2–4%), Group B streptococcus, 3% (1–5%), andEnterobacterspecies, 2% (1–4%). Multidrug resistance proportions ofE. coli,Klebsiellaspecies,Staphylococcus aureusandCoagulase negative staphylococci, 83% (95% CI 76–91%), 78% (95% CI 66–90%), 89% (95% CI 83–96%), and 78% (95% CI 67–88%), respectively.ConclusionThe result of current review revealed the occurrence of substantial bacteriuria among pregnant women in Ethiopia. Resistance among common bacteria (E. coli,Klebsiellaspecies,Staphylococcispecies) causing UTIs in pregnant women is widespread to commonly used antibiotics. The high rate of drug resistance in turn warrants the need for regular epidemiological surveillance of antibiotic resistance and implementation of an efficient infection control and stewardship program.