Prevalence of multidrug-, extensive drug-, and pandrug-resistant commensal Escherichia coli isolated from healthy humans in community settings in low- and middle-income countries: a systematic review and meta-analysis

Figures & data

Figure 1. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram of the search results and selection of the included studies in the systematic review and meta-analysis. Additional records were identified by screening the reference lists of the included studies

Table 1. Characteristics of studies included for meta-analysis

Study	Age	Number of Isolates	Number of participants	Gender	Type of study	Country	Strength of evidence	Reference
Bartoloni et al. 1998	6–72 months	321	321	Male = 165, female = 158	Cross-sectional	Bolivia	Medium	[23]
Bartoloni et al. 2004	1–77 years	108	108	Male = 61, female = 47	Cross-sectional	Bolivia	High	[24]
Bartoloni et al. 2006	6–72 months	1080	3174	Male = 1627, female = 1546	Cross-sectional	Bolivia	High	[25]
Dyar et al., 2012	6–60 months	738	818	Male = 445, female = 373	Cross-sectional	Vietnam	Medium	[26]
Kalter et al. 2010	3 months–3 years	522	523	-	Cross-sectional	Peru	Medium	[27]
Mamun et al. 1992	1–5 years	649	64	Male = 33, female = 31	Cohort	Bangladesh	High	[28]
Purohit et al. 2017	1–3 years	127	22	-	Cross-sectional	India	High	[29]
Shakya et al. 2013	3–14 years	529	529	Male = 304, female = 225	Cross-sectional	India	Medium	[30]
Singh et al. 2018	1–14 years	550	550	Male = 396, female = 154	Cohort	India	High	[31]
Sahoo et al. 2012	3–9 years	139	417	Male = 230, female = 187	Cross-sectional	India	Medium	[32]

Table 2. Prevalence and characteristics of included studies not used for meta-analysis

Study	Age	Number of Isolates	Number of participants	Gender	Definition of multi-drug resistance	Pooled prevalence (%)	Lower bound 95% CI	Upper bound 95% CI	Type of study	Country	Strength of evidence	Reference
Aworh et al. 2019	Mean age 30.6 ± 9.7 years	48	122	Male = 121 female = 1	Resistance to three or more classes of antimicrobials	79	66	90	Cross-sectional	Nigeria	Medium	[35]
Al-Dweik and Shehabi, 2009	-	108	108	-	Greater than 2 or 3 of the 14 antimicrobials tested	>2 drugs = 51 >3 drugs = 19	41 12	60 27	Cohort	Jordan	High	[36]
Hoang et al. 2017	20–70 years	103	103	-	Resistance to more than 3 and 5 classes of antimicrobials	>3 classes = 71 >5 classes = 41	62 32	80 51	Cross-sectional	Vietnam	High	[37]
Lamikanra et al. 1996	5–6 years	396	450	-	Resistance to 3, 4, 5, 6, 7, and 8 antibiotics	3 antibiotics = 11 4 antibiotics = 10 5 antibiotics = 10 6 antibiotics = 10 7 antibiotics = 7 8 antibiotics = 8	8 7 7 7 5 5	15 14 14 14 10 10	Cross-sectional	Nigeria	Medium	[38]
Lamikanra et al. 1989	19–25 years	13	35	-	Resistant to at least one other antibiotic	53	22	83	Cross-sectional	Nigeria	Medium	[39]
Mamun et al. 1992	1–5 years	649	64	Male = 33, female = 31	Resistance to 3–5 antibiotics	January to December = 74	60	86	Cohort	Bangladesh	High	[28]
Phongpaichit et al. 2007	12–46 years	143 (non-pig farmers), 7 (pig farmers)	Non-pig farmers (41), Pig farmers (7)	Non-pig farmers male = 211, female = 20	Resistance to at least 1 antimicrobial and multidrug-resistance	Non-pig farmers: at least 1 antimicrobial = 67 multidrug-resistance = 74	60 66	75 81	Cross-sectional	Thailand	High	[40]
Pathak et al. 2012	45 years and above	241	241	Male = 0, female = 241	Resistance to at least 1 or 3 different antibiotics	At least 1 = 94, at least 3 = 35	92 31	96 39	Cross-sectional	India	Medium	[43]

Figure 2. Forest plots showing the prevalence of multidrug-resistance in commensal E. coli isolated from human sources in community settings in low- and middle-income countries. In this analysis, the prevalence of the different antibiotic combinations in a single study were all included

Figure 3. Forest plots showing the prevalence of extensive drug-resistance in commensal E. coli isolated from human sources in community settings in low- and middle-income countries. In this analysis, the prevalence of the different antibiotic combinations in a single study were all included

Figure 4. Forest plots showing the prevalence of pandrug-resistance in commensal E. coli isolated from human sources in community settings in low- and middle-income countries. In this analysis, the prevalence of the different antibiotic combinations in a single study were all included

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