Worldwide prevalence of extended-spectrum β-lactamases-producing uropathogenic Escherichia coli isolates among kidney transplant patients: a systematic review and meta-analysis

Infez Med. 2023 Dec 1;31(4):466-475. doi: 10.53854/liim-3104-5. eCollection 2023.

Abstract

A significant proportion of urinary tract infections (UTIs), typically affecting kidney transplant patients (KTPs), is attributed to the presence of extended-spectrum β-lactamases (ESBLs) and multi-drug resistance (MDR) in Escherichia coli strains. For this reason, the current meta-analysis was conducted to summarize the frequency of ESBL-producing UPEC among KTPs. A systematic search was conducted to identify studies in the Web of Science, PubMed, Embase, and Scopus electronic databases between 2000 and 2021. Finally, 16 articles were selected for data extraction, and meta-analysis was performed using the metaprop command in the STATA (version 11) software. From those studies, the pooled prevalence of ESBL-producing uropathogenic E. coli (UPEC) isolates was 40%. The subcategory analysis results based on continent indicated that Asian countries had the highest rate of ESBL-producing isolates with 45%, followed by 40%, 28%, and 16% in Europe, South America and North America, respectively. Uncomfortably, high level of UPEC isolates in the current investigation was ESBL-producing isolates. These isolates pose a high serious threat to public health because they can contribute to the spread of antimicrobial resistance in the local population and hasten the ineffectiveness of the majority of commonly prescribed antibiotics for the treatment of UTI in KTPs and other patients.

Keywords: ESBL; KTP; Uropathogenic Escherichia coli; kidney transplant patients.

Publication types

  • Review

Grants and funding

This work was supported by Babol University of Medical Sciences (grant number: 724134528).