A meta-analysis of the proportion of antimicrobial resistant human Salmonella isolates in Ethiopia.

Getachew Tadesse

doi:10.1186/2050-6511-15-51

Abstract

BackgroundAntimicrobial resistant Salmonella is a global problem and recently, a strain on the verge of pan-resistance was reported. In Ethiopia, the therapeutic management of Salmonellosis is difficult because drug sensitivity tests are not routinely carried out and treatment alternatives are not available in most health care facilities. The objectives of this study were to estimate the temporal changes and proportions of drug resistant isolates in Ethiopia.MethodsPublished studies on drug resistant Salmonella isolates were searched in Medline, Google Scholar and the lists of references of articles. Eligible studies were selected by using inclusion and exclusion criteria. Generic, methodological and statistical information were extracted from the eligible studies. The extracted data included the proportions of ampicillin, co-trimoxazole, chloramphenicol, ceftriaxone, ciprofloxacin and multi-drug resistant isolates. Pooled proportions were estimated by a random effects model.ResultsThe odds of multi-drug resistant isolates in the 2000s was higher than before the 1990s (OR =18.86, 95% CI = 13.08, 27.19). The pooled proportions of ampicillin, co-trimoxazole, chloramphenicol, ciprofloxacin and multi-drug resistant isolates in the 2000s were 86.01%, 68.01%, 62.08%, 3.61% and 79.56% respectively. S. Concord (>97%) was resistant to ampicillin, co-trimoxazole, chloramphenicol and ceftriaxone.ConclusionThe proportion of drug resistant isolates has increased since the 1970s. All drugs currently used for the treatment of Salmonellosis but ciprofloxacin are not reliable for an empirical therapy. Alternative drugs should be included in the essential drug list and measures should be taken to re-enforce the drug use policy.

Highlights

Antimicrobial resistant Salmonella is a global problem and recently, a strain on the verge of pan-resistance was reported
Typhi [42], a review on the antimicrobial resistance features of human Salmonella isolates in Ethiopia was not found
The proportion of drug resistant Salmonella has increased since the 1970s and a considerable proportion of the isolates are multi-drug resistant

Summary

Introduction

Antimicrobial resistant Salmonella is a global problem and recently, a strain on the verge of pan-resistance was reported. Antimicrobial resistant Salmonella is one of the global problems in present day clinical practices and recently, a strain on the verge of pan-resistance was reported [2]. S. Concord was isolated from a bone processing plant [10], an immigrant in Ireland [11], diarrheal and/or febrile patients [12,13] and Ethiopian adoptees in Europe and the USA [14,15,16] but its occurrence in other countries in SSA is reportedly low [17]. S. Typhimurium is prevalent in SSA [17,18,19], highly invasive [20,21,22] and causes high mortality in AIDS patients [23]

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