Abstract
Databases such as PubMed, Scopus and Google Scholar were searched. Data extraction and assessment of study protocol was done by two independent reviewers and the results were reviewed by a third. OpenMeta analyst and comprehensive meta-analysis (CMA) were used for the meta-analysis. The random effect model was used, publication bias and between-study heterogeneity was assessed. Seventeen studies were added to the final meta-analysis. Studies were sampled from 2000–2018 and of the 8684 isolates tested, 2824 were VRE. The pooled prevalence of VRE among poultry in Malaysia was estimated at 24.0% (95% CI; 16.7–33.1%; I2 = 98.14%; p < 0.001). Between-study variability was high (t2 = 0.788; heterogeneity I2 = 98.14% with heterogeneity chi-square (Q) = 858.379, degrees of freedom (df) = 16, and p < 0.001). The funnel plot showed bias which was confirmed by Egger’s test and estimates from the leave-one-out forest plot did not affect the pooled prevalence. Pooled prevalence of VRE in chickens and ducks were 29.2% (CI = 18.8–42.5%) and 11.2%, CI = 9.0–14.0%) respectively. Enterococcus faecalis was reported most with more studies being reported in Peninsular Malaysia Central region and used antibiotic disc diffusion as detection method. Increased surveillance of VRE in poultry in Malaysia is required.
Highlights
Introduction published maps and institutional affilEnterococcus has emerged as a significant nosocomial and community-acquired pathogen as a result of its ability to develop resistance to antimicrobials, vancomycin.Vancomycin is the final treatment option, for Enterococcus [1,2]
The National Pharmaceuticals Regulatory Agency (NPRA) and the Department of Veterinary Services (DVS) in Malaysia have prohibited the use of avoparcin and vancomycin to reduce the spread or prevalence of vancomycin-resistant Enterococcus (VRE)
To have a near accurate estimate of VRE in poultry in Malaysia, studies reporting the prevalence in more than one type of poultry bird, environment or poultry product were analyzed as different studies
Summary
Introduction published maps and institutional affilEnterococcus has emerged as a significant nosocomial and community-acquired pathogen as a result of its ability to develop resistance to antimicrobials, vancomycin.Vancomycin is the final treatment option, for Enterococcus [1,2]. Enterococcus has emerged as a significant nosocomial and community-acquired pathogen as a result of its ability to develop resistance to antimicrobials, vancomycin. As well as their use as growth promoters in the livestock industry, were thought to have resulted in the emergence of enterococcal-resistant strains. A good example is the use of avoparcin as a feed additive to promote livestock growth [3]. DVS has been monitoring veterinary drug residues, including antibiotics, in animal feed since 2013, in accordance with EEC Directive 1990 [4]. This will invariably entail the monitoring of two antibiotic groups: group A, which includes banned substances such as avoparcin, iations
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