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Abstract：
BACKGROUND: Bacterial pneumonia can affect all age groups, but people with weakened immune systems, young children, and the elderly are at a higher risk. Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa are the most common causative agents of pneumonia, and they have developed high MDR in recent decades in Ethiopia. This systematic review and meta-analysis aimed to determine the pooled prevalence of bacterial pneumonia and multidrug resistance in Ethiopia.
METHODS: The articles were searched extensively in the electronic databases and grey literature using entry terms or phrases. Studies meeting the eligibility criteria were extracted in MS Excel and exported for statistical analysis into STATA version 14 software. The pooled prevalence of bacterial pneumonia and multidrug resistance were calculated using a random-effects model. Heterogeneity was assessed by using the I2 value. Publication bias was assessed using a funnel plot and Egger\'s test. A sensitivity analysis was done to assess the impact of a single study on the pooled effect size.
RESULTS: Of the 651 studies identified, 87 were eligible for qualitative analysis, of which 11 were included in the meta-analysis consisting of 1154 isolates. The individual studies reported prevalence of bacterial pneumonia ranging from 6.19 to 46.3%. In this systematic review and metanalysis, the pooled prevalence of bacterial pneumonia in Ethiopia was 37.17% (95% CI 25.72-46.62), with substantial heterogeneity (I2 = 98.4%, p < 0.001) across the studies. The pooled prevalence of multidrug resistance in bacteria isolated from patients with pneumonia in Ethiopia was 67.73% (95% CI: 57.05-78.40). The most commonly isolated bacteria was Klebsiella pneumoniae, with pooled prevalence of 21.97% (95% CI 16.11-27.83), followed by Streptococcus pneumoniae, with pooled prevalence of 17.02% (95% CI 9.19-24.86), respectively.
CONCLUSIONS: The pooled prevalence of bacterial isolates from bacterial pneumonia and their multidrug resistance were high among Ethiopian population. The initial empirical treatment of these patients remains challenging because of the strikingly high prevalence of antimicrobial resistance.
METHODS: The articles were searched extensively in the electronic databases and grey literature using entry terms or phrases. Studies meeting the eligibility criteria were extracted in MS Excel and exported for statistical analysis into STATA version 14 software. The pooled prevalence of bacterial pneumonia and multidrug resistance were calculated using a random-effects model. Heterogeneity was assessed by using the I2 value. Publication bias was assessed using a funnel plot and Egger\'s test. A sensitivity analysis was done to assess the impact of a single study on the pooled effect size.
RESULTS: Of the 651 studies identified, 87 were eligible for qualitative analysis, of which 11 were included in the meta-analysis consisting of 1154 isolates. The individual studies reported prevalence of bacterial pneumonia ranging from 6.19 to 46.3%. In this systematic review and metanalysis, the pooled prevalence of bacterial pneumonia in Ethiopia was 37.17% (95% CI 25.72-46.62), with substantial heterogeneity (I2 = 98.4%, p < 0.001) across the studies. The pooled prevalence of multidrug resistance in bacteria isolated from patients with pneumonia in Ethiopia was 67.73% (95% CI: 57.05-78.40). The most commonly isolated bacteria was Klebsiella pneumoniae, with pooled prevalence of 21.97% (95% CI 16.11-27.83), followed by Streptococcus pneumoniae, with pooled prevalence of 17.02% (95% CI 9.19-24.86), respectively.
CONCLUSIONS: The pooled prevalence of bacterial isolates from bacterial pneumonia and their multidrug resistance were high among Ethiopian population. The initial empirical treatment of these patients remains challenging because of the strikingly high prevalence of antimicrobial resistance.
摘要：
背景：细菌性肺炎可影响所有年龄组，但是免疫系统较弱的人，年幼的孩子,老年人的风险更高。肺炎链球菌,肺炎克雷伯菌,流感嗜血杆菌,铜绿假单胞菌是肺炎最常见的病原体，近几十年来，他们在埃塞俄比亚发展了很高的MDR。本系统评价和荟萃分析旨在确定埃塞俄比亚细菌性肺炎和多药耐药性的汇总患病率。
方法：使用条目或短语在电子数据库和灰色文献中广泛搜索了文章。在MSExcel中提取符合资格标准的研究,并导出到STATA版本14软件中进行统计分析。使用随机效应模型计算细菌性肺炎和多药耐药性的合并患病率。使用I2值评估异质性。使用漏斗图和Egger检验评估发表偏倚。进行敏感性分析以评估单个研究对合并效应大小的影响。
结果：在确定的651项研究中，87人符合定性分析条件，其中11个纳入由1154个分离株组成的荟萃分析.个别研究报告细菌性肺炎的患病率为6.19％至46.3％。在这篇系统的综述和元分析中，埃塞俄比亚细菌性肺炎的合并患病率为37.17%（95%CI25.72-46.62），具有实质性异质性(I2=98.4%，p<0.001)。埃塞俄比亚肺炎患者分离出的细菌中多药耐药的合并患病率为67.73％（95％CI：57.05-78.40）。最常见的细菌是肺炎克雷伯菌，合并患病率为21.97%（95%CI16.11-27.83），其次是肺炎链球菌，合并患病率为17.02%（95%CI9.19-24.86），分别。
结论：在埃塞俄比亚人群中，细菌性肺炎细菌分离株的合并流行率及其多药耐药性较高。这些患者的初始经验治疗仍然具有挑战性，因为抗菌药物耐药性的患病率非常高。
方法：使用条目或短语在电子数据库和灰色文献中广泛搜索了文章。在MSExcel中提取符合资格标准的研究,并导出到STATA版本14软件中进行统计分析。使用随机效应模型计算细菌性肺炎和多药耐药性的合并患病率。使用I2值评估异质性。使用漏斗图和Egger检验评估发表偏倚。进行敏感性分析以评估单个研究对合并效应大小的影响。
结果：在确定的651项研究中，87人符合定性分析条件，其中11个纳入由1154个分离株组成的荟萃分析.个别研究报告细菌性肺炎的患病率为6.19％至46.3％。在这篇系统的综述和元分析中，埃塞俄比亚细菌性肺炎的合并患病率为37.17%（95%CI25.72-46.62），具有实质性异质性(I2=98.4%，p<0.001)。埃塞俄比亚肺炎患者分离出的细菌中多药耐药的合并患病率为67.73％（95％CI：57.05-78.40）。最常见的细菌是肺炎克雷伯菌，合并患病率为21.97%（95%CI16.11-27.83），其次是肺炎链球菌，合并患病率为17.02%（95%CI9.19-24.86），分别。
结论：在埃塞俄比亚人群中，细菌性肺炎细菌分离株的合并流行率及其多药耐药性较高。这些患者的初始经验治疗仍然具有挑战性，因为抗菌药物耐药性的患病率非常高。
