Vancomycin-Resistant Enterococci (VRE) in Nigeria: The First Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Results
2.1. Search Results and Eligible Studies
2.2. Characteristics of the Eligible Studies
2.3. The Pooled Prevalence of VRE
2.4. Subgroup Meta-Analysis
2.5. Meta-Regression
3. Discussion
4. Materials and Methods
4.1. Study Design and Protocol
4.2. Literature Review
4.3. Inclusion and Exclusion Criteria for Studies
4.4. Data Extraction
4.5. Data Analysis
4.6. Bias and Heterogeneity Analysis
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Author, Publication Year | Study Year | Study Area | Isolate Sources | Sample Size | Number Positive | Prevalence (%) | Detection Method |
---|---|---|---|---|---|---|---|
Olawale et al., 2011 [17] | 2009 | South-West | Clinical specimens | 7 | 3 | 42.9 | Disc diffusion |
Oyedeji et al., 2011 [18] | 2010 | South-West | Environmental | 78 | 14 | 18 | Agar dilution |
Oguntoyinbo & Okueso, 2013 [25] | 2012 | North-Central | Environmental | 95 | 32 | 33.7 | Disc diffusion |
Olawale et al., 2014 [19] | 2012 | South-West | Environmental | 246 | 10 | 4.1 | Disc diffusion |
Anyanwu & Obetta, 2015 [28] | 2015 | South-East | Animal | 75 | 5 | 6.7 | Disc diffusion |
Olawale et al., 2015 [20] | 2013 | South-West | Environmental | 658 | 77 | 11.7 | Disc diffusion |
Ayeni et al., 2016 [21] | 2015 | South-West | Animal | 60 | 39 | 65 | Disc diffusion |
Nsofor et al., 2016 [29] | 2016 | South-East | Clinical | 34 | 7 | 20.59 | Disc diffusion |
Ekuma et al., 2016 [22] | 2013 | South-West | Clinical | 319 | 13 | 4.07 | E test |
Adesida et al., 2017 [23] | 2017 | South-West | Clinical | 65 | 9 | 13.85 | Disc diffusion |
David et al., 2017 [24] | 2017 | South-West | Clinical | 69 | 27 | 39.13 | Disc diffusion |
Enenya et al., 2017 [35] | 2014 | North-West | Environmental | 16 | 4 | 25 | Disc diffusion |
Ndubuisi et al., 2017 [26] | 2017 | North-Central | Clinical | 102 | 34 | 33.3 | Disc diffusion |
Foka et al., 2018 [31] | 2018 | South-South | Environmental | 9 | 8 | 88.9 | Disc diffusion |
Abasiubong et al., 2019 [32] | 2018 | South-South | Clinical | 19 | 13 | 68.4 | Disc diffusion |
Anyanwu et al., 2019 [30] | 2018 | South-East | Animal | 30 | 7 | 23.3 | Disc diffusion |
Igbinosa & Beshiru., 2019 [33] | 2018 | South-South | Animal | 59 | 22 | 37.3 | Disc diffusion |
Igbinosa & Raje, 2019 [34] | 2017 | South-South | Environmental | 64 | 23 | 35.9 | Disc diffusion |
Shettima & Iregbu, 2019 [27] | 2015 | North-Central | Clinical | 545 | 6 | 1.1 | VRE Chromogenic agar |
Author, Publication Year | E. faecium | E. faecalis | E. gallinarum | E. casseliflavus | E. mundti | E. hirae | E. dispar | Total |
---|---|---|---|---|---|---|---|---|
Olawale et al., 2011 [17] | 1 | 2 | - | - | - | - | - | 3 |
Olawale et al., 2014 [19] | - | 10 | - | - | - | - | - | 10 |
Olawale et al., 2015 [20] | - | 77 | - | - | - | - | - | 77 |
Nsofor et al., 2016 [29] | 4 | 3 | - | - | - | - | - | 7 |
Ekuma et al., 2016 [22] | 3 | - | 9 | 1 | - | - | - | 13 |
Adesida et al., 2017 [23] | 6 | 3 | - | - | - | - | - | 9 |
David et al., 2017 [24] | - | 27 | - | - | - | - | - | 27 |
Enenya et al., 2017 [35] | 2 | - | 1 | 1 | - | - | - | 4 |
Ndubuisi et al., 2017 [26] | 12 | 10 | 1 | - | 9 | 1 | 1 | 34 |
Igbinosa & Beshiru., 2019 [33] | 13 | 8 | 1 | - | - | - | - | 22 |
Igbinosa & Raje, 2019 [34] | 7 | 8 | - | 2 | - | 3 | 3 | 23 |
Shettima & Iregbu, 2019 [27] | 3 | - | 2 | 1 | - | - | - | 6 |
51 (21.7%) | 148 (62.98%) | 14 (5.96%) | 5 (2.13%) | 9 (3.83%) | 4 (1.70%) | 4 (1.70%) | 235 |
Study Region | Number of Studies | Prevalence (%) | 95% CI | I2 (%) | Q | Heterogeneity Test | |
---|---|---|---|---|---|---|---|
DF | p | ||||||
South-West | 8 | 20.7 | 13.1–28.2 | 95.5 | 155.404 | 7 | <0.001 |
North-Central | 3 | 22.4 | −3.6–48.3 | 97.81 | 91.227 | 2 | <0.001 |
South-East | 3 | 10.2 | 2.7–17.8 | 51.15 | 4.094 | 2 | 0.129 |
North-West | 1 | 25.0 | 3.8–46.2 | NA | - | - | - |
South-South | 4 | 56.2 | 33.5–79.0 | 88.37 | 25.802 | 3 | <0.001 |
Overall | 19 | 25.3 | 19.8–30.8 | 96.26 | 480.667 | 18 | <0.001 |
Isolate Source | Number of Studies | Prevalence (%) | 95% CI | I2 (%) | Q | Heterogeneity Test | |
---|---|---|---|---|---|---|---|
DF | p | ||||||
Clinical | 8 | 19.9 | 12.5–27.2 | 195.18 | 145.362 | 7 | <0.001 |
Environmental | 7 | 27.2 | 17.3–37.2 | 95.33 | 128.519 | 6 | <0.001 |
Animal | 4 | 32.9 | 5.1–60.7 | 96.37 | 82.535 | 3 | <0.001 |
Overall | 19 | 25.3 | 19.8–30.8 | 96.26 | 480.667 | 18 | <0.001 |
Detection Method | Number of Studies | Prevalence (%) | 95% CI | I2 (%) | Q | Heterogeneity Test | |
---|---|---|---|---|---|---|---|
DF | p | ||||||
Disc diffusion | 15 | 33.8 | 24.3–43.4 | 93.84 | 227.406 | 14 | <0.001 |
Disc diffusion | 1 | 4.1 | 1.6–6.5 | - | - | - | - |
Agar dilution | 1 | 17.9 | 9.4–26.5 | - | - | - | - |
E test | 1 | 1.9 | 1.9–6.2 | - | - | - | - |
VRE chromogenic agar | 1 | 1.1 | 1.1–0.2 | - | - | - | - |
Overall | 19 | 25.3 | 19.8–30.8 | 96.26 | 480.667 | 18 | <0.001 |
Study Period | Number of Studies | Prevalence (%) | 95% CI | I2 (%) | Q | Heterogeneity Test | |
---|---|---|---|---|---|---|---|
DF | p | ||||||
2009 | 1 | 42.9 | 6.2–79.5 | - | - | - | - |
2010 | 1 | 17.9 | 9.4–26.5 | - | - | - | - |
2012 | 2 | 18.5 | −10.4–47.5 | 97.14 | 34.954 | 1 | <0.001 |
2013 | 2 | 7.9 | 4.0–15.3 | 95.19 | 20.806 | 1 | <0.001 |
2014 | 1 | 25.0 | 3.8–46.2 | - | - | - | - |
2015 | 3 | 23.1 | 0.7–45.5 | 98.19 | 110.342 | 2 | <0.001 |
2016 | 1 | 8.3 | −0.7–17.4 | - | - | - | - |
2017 | 4 | 30.2 | 18.0–42.3 | 82.92 | 17.560 | 3 | <0.001 |
2018 | 4 | 53.6 | 26.5–80.7 | 90.54 | 31.711 | 3 | <0.001 |
Overall | 19 | 25.3 | 19.8–30.8 | 96.26 | 480.667 | 18 | <0.001 |
Variable | Coefficient | p-Value | 95% CI |
---|---|---|---|
Study area | |||
South-West | Reference | ||
North-Central | 0.175 | 0.005 | 5.2–29.8 |
North-West | −1.044 | <0.001 | −142.1–−66.7 |
South-East | −0.533 | <0.001 | −65.9–−40.7 |
South-South | −0.286 | 0.003 | −47.7–−9.4 |
Isolates source | |||
Clinical | Reference | ||
Animal | 0.273 | 0.188 | −13.3–67.9 |
Environmental | 0.865 | <0.001 | 38.4–134.6 |
Detection method | |||
Disc diffusion | Reference | ||
Agar dilution | −1.114 | <0.001 | −143.7–−79.2 |
E test | 0.371 | <0.001 | 16.7–57.5 |
VRE chromogenic agar | −0.917 | <0.001 | −113.9–−69.6 |
Study period | |||
2009 | Reference | ||
2010 | −1.132 | <0.001 | −147.8–−78.6 |
2012 | −1.177 | <0.001 | −148.9–−86.5 |
2013 | −0.093 | 0.219 | −24.1–55.0 |
2014 | −0.230 | 0.041 | −45.1–−0.9 |
2015 | −0.688 | <0.001 | −87.9–−49.6 |
Constant | 0.429 | 0.022 | 6.2–79.5 |
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Wada, Y.; Harun, A.B.; Yean, C.Y.; Zaidah, A.R. Vancomycin-Resistant Enterococci (VRE) in Nigeria: The First Systematic Review and Meta-Analysis. Antibiotics 2020, 9, 565. https://doi.org/10.3390/antibiotics9090565
Wada Y, Harun AB, Yean CY, Zaidah AR. Vancomycin-Resistant Enterococci (VRE) in Nigeria: The First Systematic Review and Meta-Analysis. Antibiotics. 2020; 9(9):565. https://doi.org/10.3390/antibiotics9090565
Chicago/Turabian StyleWada, Yusuf, Azian Binti Harun, Chan Yean Yean, and Abdul Rahman Zaidah. 2020. "Vancomycin-Resistant Enterococci (VRE) in Nigeria: The First Systematic Review and Meta-Analysis" Antibiotics 9, no. 9: 565. https://doi.org/10.3390/antibiotics9090565