Prevalence of Antibiotic-Resistant Shigella spp. in Bangladesh: A Systematic Review and Meta-Analysis of 44,519 Samples

Author:

Ahmed Saleh1ORCID,Chowdhury Md Imrul Hasan2,Sultana Shabiha3,Alam Sayeda Sadia4,Marzan Mahfuza56,Islam Md Asiful7ORCID

Affiliation:

1. Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA

2. Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, TX 77555, USA

3. Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA

4. Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh

5. Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh

6. Department of Chemistry, University of South Florida, 4202 E Fowler Ave, Tampa, FL 33620, USA

7. WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK

Abstract

Shigella is the leading global etiological agent of shigellosis, especially in poor and underdeveloped or developing nations with insufficient sanitation such as Bangladesh. Antibiotics are the only treatment option for the shigellosis caused by Shigella spp. as no effective vaccine exists. However, the emergence of antimicrobial resistance (AMR) poses a serious global public health concern. Therefore, a systematic review and meta-analysis were conducted to establish the overall drug resistance pattern against Shigella spp. in Bangladesh. The databases of PubMed, Web of Science, Scopus, and Google Scholar were searched for relevant studies. This investigation comprised 28 studies with 44,519 samples. Forest and funnel plots showed any-drug, mono-drug, and multi-drug resistance. Any fluoroquinolone had a resistance rate of 61.9% (95% CI: 45.7–83.8%), any trimethoprim–sulfamethoxazole—60.8% (95% CI: 52.4–70.5%), any azithromycin—38.8% (95% CI: 19.6–76.9%), any nalidixic acid—36.2% (95% CI: 14.2–92.4%), any ampicillin—34.5% (95% CI: 25.0–47.8%), and any ciprofloxacin—31.1% (95% CI: 11.9–81.3%). Multi-drug-resistant Shigella spp. exhibited a prevalence of 33.4% (95% CI: 17.3–64.5%), compared to 2.6% to 3.8% for mono-drug-resistant strains. Since resistance to commonly used antibiotics and multidrug resistance were higher, a judicious use of antibiotics, the promotion of infection control measures, and the implementation of antimicrobial surveillance and monitoring programs are required to tackle the therapeutic challenges of shigellosis.

Publisher

MDPI AG

Subject

Pharmacology (medical),Infectious Diseases,Microbiology (medical),General Pharmacology, Toxicology and Pharmaceutics,Biochemistry,Microbiology

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