Bacterial Pathogens and Their Antimicrobial Resistance Patterns of Inanimate Surfaces and Equipment in Ethiopia: A Systematic Review and Meta-analysis

Abstract

Background. Hospital-acquired infections have remained a serious cause of mortality, morbidity, and extended hospitalization. Bacterial contamination of inanimate surfaces of the hospital environment and equipment is considered a major contributing factor to the development of several nosocomial infections worldwide. The hospital environment and many devices are an important reservoir of many clinically important bacterial agents including multidrug-resistant pathogens. Therefore, this systematic review and meta-analysis are aimed at investigating bacterial pathogens and their antimicrobial resistance patterns of inanimate surfaces and equipment in Ethiopia. Methods. An exhaustive literature search was carried out using the major electronic databases including PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, Google Scholar, Cochrane Library, Scopus, and Wiley online library to identify potentially relevant studies without date restriction. Original articles which address the research question were identified, screened, and included using the PRISMA flow diagram. Data extraction was prepared in Microsoft Excel, and data quality was assessed by using 9-point Joanna Briggs Institute critical appraisal tools. Then, data were exported to STATA 16.0 software for analyses of pooled estimation of outcome measures. Estimation of outcome measures at a 95% confidence interval was performed using DerSimonian-Laird’s random-effects model. Finally, results were presented via text, figures, and tables. Results. A total of 18 studies with 3058 bacterial isolates recovered from 3423 swab specimens were included for systematic review and meta-analysis. The pooled prevalence of bacterial contamination of inanimate surfaces and equipment was found 70% (95% CI: 59, 82). Among the Gram-negative bacterial species, the prevalence of ampicillin-resistant K. pneumoniae was the highest 80% (95% CI: 78, 92) followed by Citrobacter species 78% (95% CI: 57, 83). Conclusion. This study has shown a high prevalence of bacterial contamination of inanimate surfaces and equipment in Ethiopia.