Abstract：
BACKGROUND: This systematic review aimed to determine the antimicrobial resistance pattern of the extended-spectrum β-lactamases producing Escherichia coli (ESBL-EC) in urine samples in Nepal.
METHODS: Systematic literature review was conducted to locate all articles reporting ESBL-EC in urine samples published between January 2012 to December 2022. The Egger\'s weighted regression analysis was done to assess the publication bias. A random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval due to significant between-study heterogeneity. The strength of correlation between multidrug resistance and ESBL production in E.coli strains was determined using Pearson\'s correlation coefficient. The data were analyzed using R-language 4.2.2. software.
RESULTS: The combined prevalence of E.coli in urine samples was found to be 14 % (95% CI, 11-18), while the overall pooled prevalence of ESBL E.coli and MDR E.coli were 30% (95% CI, 20-42) and 70% (95% CI, 38-90) respectively. A strong positive correlation of 0.99 (95% CI, 0.89-1.0) was found between ESBL production and MDR among E.coli isolates. Imipenem was the drug of choice against ESBL-E.coli in urine specimens.
CONCLUSIONS: Our analyses showed the overall ESBL-EC and MDR-EC burden in Nepal is considerably high. Likewise, the study also infers an increasing trend of antibiotic resistance pattern of ESBL-EC in urine samples.
METHODS: Systematic literature review was conducted to locate all articles reporting ESBL-EC in urine samples published between January 2012 to December 2022. The Egger\'s weighted regression analysis was done to assess the publication bias. A random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval due to significant between-study heterogeneity. The strength of correlation between multidrug resistance and ESBL production in E.coli strains was determined using Pearson\'s correlation coefficient. The data were analyzed using R-language 4.2.2. software.
RESULTS: The combined prevalence of E.coli in urine samples was found to be 14 % (95% CI, 11-18), while the overall pooled prevalence of ESBL E.coli and MDR E.coli were 30% (95% CI, 20-42) and 70% (95% CI, 38-90) respectively. A strong positive correlation of 0.99 (95% CI, 0.89-1.0) was found between ESBL production and MDR among E.coli isolates. Imipenem was the drug of choice against ESBL-E.coli in urine specimens.
CONCLUSIONS: Our analyses showed the overall ESBL-EC and MDR-EC burden in Nepal is considerably high. Likewise, the study also infers an increasing trend of antibiotic resistance pattern of ESBL-EC in urine samples.
摘要：
背景：本系统综述旨在确定尼泊尔尿液样本中产生超广谱β-内酰胺酶的大肠杆菌（ESBL-EC）的抗菌耐药性模式。
方法：进行了系统文献综述，以查找2012年1月至2022年12月期间发表的所有报告ESBL-EC的尿液样本中的文章。进行Egger加权回归分析以评估发表偏倚。由于研究之间的显着异质性，使用随机效应模型来计算合并的患病率和相应的95％置信区间。使用Pearson相关系数确定了多药耐药性与大肠杆菌中ESBL产生之间的相关性强度。使用R语言4.2.2分析数据。软件。
结果：发现尿液样本中大肠杆菌的合并患病率为14％（95％CI，11-18），而ESBL大肠杆菌和MDR大肠杆菌的总体合并患病率分别为30%(95%CI,20-42)和70%(95%CI,38-90)。在大肠杆菌分离株中，ESBL生产与MDR之间存在0.99（95％CI，0.89-1.0）的强正相关。亚胺培南是对抗ESBL-E的首选药物。尿液标本中的大肠杆菌。
结论：我们的分析显示，尼泊尔的ESBL-EC和MDR-EC总体负担相当高。同样，该研究还推断尿液样本中ESBL-EC的抗生素耐药模式有增加的趋势.
方法：进行了系统文献综述，以查找2012年1月至2022年12月期间发表的所有报告ESBL-EC的尿液样本中的文章。进行Egger加权回归分析以评估发表偏倚。由于研究之间的显着异质性，使用随机效应模型来计算合并的患病率和相应的95％置信区间。使用Pearson相关系数确定了多药耐药性与大肠杆菌中ESBL产生之间的相关性强度。使用R语言4.2.2分析数据。软件。
结果：发现尿液样本中大肠杆菌的合并患病率为14％（95％CI，11-18），而ESBL大肠杆菌和MDR大肠杆菌的总体合并患病率分别为30%(95%CI,20-42)和70%(95%CI,38-90)。在大肠杆菌分离株中，ESBL生产与MDR之间存在0.99（95％CI，0.89-1.0）的强正相关。亚胺培南是对抗ESBL-E的首选药物。尿液标本中的大肠杆菌。
结论：我们的分析显示，尼泊尔的ESBL-EC和MDR-EC总体负担相当高。同样，该研究还推断尿液样本中ESBL-EC的抗生素耐药模式有增加的趋势.
