Burden of multidrug-resistant bacteria among HIV-positive individuals in Ethiopia: A systematic review and meta-analysis.

Abstract

BackgroundMultidrug-resistant (MDR) bacteria are a significant cause of severe infections, particularly in human immunodeficiency virus (HIV)-positive individuals because of their weakened immunity. Since there was no previous pooled representative data regarding the MDR bacteria among HIV-positive individuals in Ethiopia, this systematic review and meta-analysis is required.MethodsThis study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Medline, EMBASE, Google Scholar, Hinari, Web of Science, Science Direct, and African Journals Online databases. Data were extracted using Microsoft Excel 2019 and analyzed using STATA version 11.0 software. A random-effects model was used to estimate the pooled effect size of outcome variables across studies with a 95% confidence interval. The I2 statistic was used to check for heterogeneity. The presence of publication bias was determined using a funnel plot and Egger's test with a p-value ResultsThe pooled prevalence of MDR was 58.02% (95% CI: 46.32-69.73%) with high heterogeneity (I2 = 97.1%, (p ConclusionOur study indicates a high burden of MDR among HIV-positive individuals in Ethiopia. The Oromia region, HIV patients with multiple infections, Pseudomonas spp., and Enterococci showed the highest MDR in the subgroup analysis. Therefore, regional hospitals should implement strategies to tackle MDR such as vaccination program, appropriate use of antibiotics, and further study on the associated factors of MDR bacteria in HIV are required.