A systematic review and meta-analysis of integrated studies on antimicrobial resistance in Vietnam, with a focus on Enterobacteriaceae, from a One Health perspective

Doan Hoang Phu; Tuempong Wongtawan; Dinh Bao Truong; Nguyen Van Cuong; Juan Carrique-Mas; Thotsapol Thomrongsuwannakij

doi:10.1016/j.onehlt.2022.100465

A systematic review and meta-analysis of integrated studies on antimicrobial resistance in Vietnam, with a focus on Enterobacteriaceae, from a One Health perspective

One Health. 2022 Nov 19:15:100465. doi: 10.1016/j.onehlt.2022.100465. eCollection 2022 Dec.

Authors

Doan Hoang Phu^{1

2

3}, Tuempong Wongtawan^{1

4

5}, Dinh Bao Truong³, Nguyen Van Cuong^{6

7}, Juan Carrique-Mas⁸, Thotsapol Thomrongsuwannakij^{1

4}

Affiliations

¹ Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80160, Thailand.
² College of Graduate Studies, Walailak University, Nakhon Si Thammarat 80160, Thailand.
³ Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh City 70000, Viet Nam.
⁴ Centre for One Health, Walailak University, Nakhon Si Thammarat 80160, Thailand.
⁵ Centre of Excellence Research for Melioidosis and other Microorganism, Walailak University, Nakhon Si Thammarat 80160, Thailand.
⁶ Oxford University Clinical Research Unit, Ho Chi Minh City 70000, Viet Nam.
⁷ Ausvet PTY LTD, Bruce ACT 2617, Canberra, Australia.
⁸ Food and Agriculture Organization of the United Nations, Ha Noi 10000, Viet Nam.

Abstract

Vietnam is a low- and middle-income country (LMIC), a primary food producer, and an antimicrobial resistance (AMR) hotspot. AMR is recognized as a One Health challenge since it may transfer between humans, animals and the environment. This study aimed to apply systematic review and meta-analysis to investigate the phenotypic profiles and correlations of antimicrobial-resistant Enterobacteriaceae across three compartments: humans, animals and the environment in Vietnam. A total of 89 articles found in PubMed, Science Direct, and Google Scholar databases were retrieved for qualitative synthesis. E. coli and non-typhoidal Salmonella (NTS) were the most common bacterial species in studies of all compartments (60/89 studies). Among antimicrobials classified as critically important, the resistance levels were observed to be highest to quinolones, 3rd generation of cephalosporins, penicillins, and aminoglycosides. Of 89 studies, 55 articles reported the resistance prevalence of E. coli and NTS in healthy humans, animals and the environment against ciprofloxacin, ceftazidime, ampicillin, gentamicin, sulfamethoxazole-trimethoprim, chloramphenicol was used for meta-analysis. The pooled prevalence was found highest in E. coli against ampicillin 84.0% (95% CI 73.0-91.0%) and sulfamethoxazole-trimethoprim 66.0% (95% CI 56.0-75.0%) while in NTS they were 34.0% (95% CI 24.0-46.0%), 33.0% (95% CI 25.0-42.0%), respectively. There were no significant differences in the pooled prevalence of E. coli and NTS to these antimicrobials across healthy humans, animals and the environment, except for ceftazidime-resistant E. coli (χ² = 8.29, p = 0.02), chloramphenicol-resistant E.coli (χ² = 9.65, p < 0.01) and chloramphenicol-resistant NTS (χ² = 7.51, p = 0.02). Findings from the multiple meta-regression models indicated that the AMR levels in E. coli (β = 1.887, p < 0.001) and the North (β = 0.798, p = 0.047) had a higher fraction of AMR than NTS and other regions of Vietnam. The outcomes of this study play an important role as the baseline information for further investigation and follow-up intervention strategies to tackle AMR in Vietnam, and more generally, can be adapted to other LMICs.

Keywords: Antimicrobial resistance; Enterobacteriaceae; Meta-analysis; One Health; Systematic review; Vietnam.

Publication types

Review