Bacterial Bloodstream Infections in Cameroon: A Systematic Review and Meta-Analysis of Prevalence and Antibiotic Resistance

Abstract

AbstractBackgroundThe paucity of data on the epidemiology of bloodstream infection (BSI) in low and middle-income countries (LMICs) limits its effective prevention and management. This review sought to determine the prevalence, bacteriological and antimicrobial resistance profiles of bacteria implicated in BSI in Cameroon.MethodsPubMed and Google Scholar databases were searched to identify relevant articles, which were screened according to the PRISMA guidelines. The data were analysed using comprehensive meta-analysis software. The I2was used to evaluate heterogeneity between studies, Begg’s and Egger’s regression tests were used to evaluate publication bias, and random effects analysis was used to calculate the pooled prevalence.ResultsA total of 4223 blood cultures were obtained from the 10 included studies. The overall pooled prevalence of bacterial BSI was 26.31% (95% CI= 17.01%–38.35%).Escherichia coli(23.09%; 95% CI= 9.21%–47.05%),Klebsiellaspp. (22.95%; 95% CI= 13.09%–37.07%), andStaphylococcus aureus(16.09%; 95% CI= 8.11%–29.43%) were the most common bacteria species.E. coliandKlebsiellaspp. displayed the highest resistance to amoxicillin (82.65%; 95% CI= 63.25%–92.95% vs 86.42%; 95% CI= 55.90%–96.97%), amoxicillin + clavulanic acid (71.74%; 43.96–89.15% vs 73.06%; 95% CI= 38.70%–92.09%) and cotrimoxazole (76.22%; 95% CI= 51.33%–90.79% vs 65.81%; 95% CI= 45.08–81.86%). However, meropenem (26.73%; 95% CI= 20.76%–33.68%) and fosfomycin (14.85%; 95% CI= 9.07%–23.37%) were the least resistant inE. coliandKlebsiellaspp., respectively.Staphylococcus aureusstrains exhibited highest resistance to penicillin (84.37%; 95% CI= 68.13%–93.16%), erythromycin (44.80%; 95% CI= 33.37%–56.79%) and oxacillin (37.35%; 95% CI= 8.76%–78.74%) and lowest resistance to rifampicin (2.94%; 95% CI= 0.59%–13.39%), fusidic acid (6.73%; 95% CI= 2.55%–16.62%) and vancomycin (13.18%; 95% CI= 2.26%–49.86%).ConclusionThis study reports a high prevalence of bacterial BSIs in Cameroon and the high resistance of these bacteria to common antibiotics. There is a pressing need to conduct BSI surveillance studies in all regions of Cameroon to generate data for evidence-based measures regarding BSI prevention and management.Prospero registration numberCRD42023482760