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Prevalence of antibiotic-resistant Shigella spp. in Bangladesh: a systematic review and meta-analysis of 44,519 samples

Ahmed, Saleh
Chowdhury, Md Imrul Hasan
Sultana, Shabiha
Alam, Sayeda Sadia
Marzan, Mahfuza
Alternative
Abstract
Shigella is the leading global etiological agent of shigellosis, especially in poor and underdeveloped or developing nations with insufficient sanitation such as Bangladesh. Antibiotics are the only treatment option for the shigellosis caused by Shigella spp. as no effective vaccine exists. However, the emergence of antimicrobial resistance (AMR) poses a serious global public health concern. Therefore, a systematic review and meta-analysis were conducted to establish the overall drug resistance pattern against Shigella spp. in Bangladesh. The databases of PubMed, Web of Science, Scopus, and Google Scholar were searched for relevant studies. This investigation comprised 28 studies with 44,519 samples. Forest and funnel plots showed any-drug, mono-drug, and multi-drug resistance. Any fluoroquinolone had a resistance rate of 61.9% (95% CI: 45.7–83.8%), any trimethoprim–sulfamethoxazole—60.8% (95% CI: 52.4–70.5%), any azithromycin—38.8% (95% CI: 19.6–76.9%), any nalidixic acid—36.2% (95% CI: 14.2–92.4%), any ampicillin—34.5% (95% CI: 25.0–47.8%), and any ciprofloxacin—31.1% (95% CI: 11.9–81.3%). Multi-drug-resistant Shigella spp. exhibited a prevalence of 33.4% (95% CI: 17.3–64.5%), compared to 2.6% to 3.8% for mono-drug-resistant strains. Since resistance to commonly used antibiotics and multidrug resistance were higher, a judicious use of antibiotics, the promotion of infection control measures, and the implementation of antimicrobial surveillance and monitoring programs are required to tackle the therapeutic challenges of shigellosis.
Citation
Ahmed S, Chowdhury MIH, Sultana S, Alam SS, Marzan M, Islam MA. Prevalence of Antibiotic-Resistant Shigella spp. in Bangladesh: A Systematic Review and Meta-Analysis of 44,519 Samples. Antibiotics. 2023; 12(5):817. https://doi.org/10.3390/antibiotics12050817
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Research Unit
PubMed ID
37237720 (pubmed)
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Journal article
Language
en
Description
© 2023 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/antibiotics12050817
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ISSN
2079-6382
EISSN
2079-6382
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Licence for published version: Creative Commons Attribution 4.0 International
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