Abstract
Vancomycin-Resistant Enterococci (VRE) are on the rise worldwide. Here, we report the first prevalence of VRE in Nigeria using systematic review and meta-analysis. International databases MedLib, PubMed, International Scientific Indexing (ISI), Web of Science, Scopus, Google Scholar, and African journals online (AJOL) were searched. Information was extracted by two independent reviewers, and results were reviewed by the third. Two reviewers independently assessed the study quality using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. OpenMeta analyst was used. The random effect was used, and publication bias was assessed using a funnel plot. Between-study heterogeneity was assessed, and the sources were analysed using the leave-one-out meta-analysis, subgroup analysis, and meta-regression. Nineteen studies met the eligibility criteria and were added to the final meta-analysis, and the study period was from 2009–2018. Of the 2552 isolates tested, 349 were VRE, and E. faecalis was reported the most. The pooled prevalence of VRE in Nigeria was estimated at 25.3% (95% CI; 19.8–30.8%; I2 = 96.26%; p < 0.001). Between-study variability was high (t2 = 0.011; heterogeneity I2 = 96.26% with heterogeneity chi-square (Q) = 480.667, degrees of freedom (df) = 18, and p = 0.001). The funnel plot showed no publication bias, and the leave-one-out forest plot did not affect the pooled prevalence. The South-East region had a moderate heterogeneity though not significant (I2 = 51.15%, p = 0.129). Meta-regression showed that all the variables listed contributed to the heterogeneity except for the animal isolate source (p = 0.188) and studies that were done in 2013 (p = 0.219). Adherence to proper and accurate antimicrobial usage, comprehensive testing, and continuous surveillance of VRE are required.
Highlights
Enterococcus is a Gram-positive and catalase-negative bacterium
We considered all cross-sectional or cohort studies that reported the prevalence of vancomycin resistance in Enterococcus isolates or numbers of Vancomycin-Resistant Enterococci (VRE) and total enterococci isolates in patients suspected of having clinical infection, in poultry, poultry/animal product, farmworkers, and the environment in Nigeria
We designed this study to obtain the pooled prevalence of VRE in Nigeria to provide baseline information to the National antimicrobial resistance (AMR) Technical Working Group
Summary
Enterococcus is a Gram-positive and catalase-negative bacterium. It is an important gastrointestinal tract normal flora of most warm-blooded animals and humans [1,2]. Enterococcus species especially Enterococcus faecium and Enterococcus faecalis are two common causes of urinary tract infection [5,6], inflammation of the lining of the heart and its valves, intra-abdominal abscesses, wound infections, bacteremia, and sepsis in human [7]. It has been proven that Enterococcus is the second leading cause of urinary tract and wound infections and the third leading cause of bacteremia in hospitals [8]. The inherent resistance to several antibiotics and their ability to cause infections has placed enterococci on the pedestal as an important hospital-acquired pathogen [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
