• J Glob Antimicrob Resist · Dec 2019

    Meta Analysis

    Colonisation with extended-spectrum β-lactamase-producing Enterobacteriaceae in pregnant/post-partum women: Systematic review and meta-analysis.

    • Nasrin Jalilian, Melika Kooshkiforooshani, Shooba Ahmadi, and Anisodowleh Nankali.
    • Fertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
    • J Glob Antimicrob Resist. 2019 Dec 1; 19: 338-347.

    ObjectivesMaternal colonisation with extended-spectrum β-lactamase (ESBL)-producing micro-organisms can lead to transmission of such pathogens to neonates, resulting in considerable morbidity. The aim of this study was to determine the global prevalence of maternal colonisation with ESBL-producing Enterobacteriaceae (ESBL-E).MethodsA systematic review of PubMed, Embase, Scopus, Web of Science and ProQuest databases as well as the grey literature was performed. Studies reporting the prevalence of ESBL-E colonisation during pregnancy or postpartum period were included. Prevalence data were grouped by geographic region. The pooled prevalence and 95% confidence interval (CI) was estimated by meta-analysis using a random-effects model.ResultsNineteen studies with reports from 16 countries (seven studies from Africa, one study from South America, two studies from Asia and nine studies from Europe) reporting data for 7352 pregnant/postpartum women were included. The pooled prevalence of ESBL-E colonisation was 8% (95% CI 5-10%). Prevalence estimates were 15% (95% CI 5-24%) in Africa, 6% (95% CI 4-10%) in South America, 5% (95% CI 4-6%) in Asia and 4% (95% CI 2-5%) in Europe. The pooled prevalence was higher in studies with low risk of bias (10%; 95% CI 7-13%) compared with those with high risk of bias (3%; 95% CI 2-3%).ConclusionThere was heterogeneity regarding ESBL-E colonisation rates in different continents. The pooled prevalence rate was higher in Africa compared with other areas. Given that the highest rate was observed in Africa, implementing screening efforts for ESBL-E colonisation during pregnancy may be justified.Copyright © 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved.

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