Antibiotic-resistance in medically important bacteria isolated from commercial herbal medicines in Africa from 2000 to 2021: a systematic review and meta-analysis.

Autor: Walusansa A; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda. abdulwalusansa@gmail.com.; Department of Medical Microbiology, Faculty of Health Sciences, Islamic University in Uganda, P. O. Box 2555, Kampala, Uganda. abdulwalusansa@gmail.com.; Department of Medical Microbiology and Immunology, Faculty of Health Sciences, Busitema University, Mbale, Uganda. abdulwalusansa@gmail.com., Asiimwe S; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda., Nakavuma JL; College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P. O. Box 7062, Kampala, Uganda., Ssenku JE; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda., Katuura E; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda., Kafeero HM; Department of Medical Microbiology, Faculty of Health Sciences, Islamic University in Uganda, P. O. Box 2555, Kampala, Uganda., Aruhomukama D; Department of Immunology and Molecular Biology, Faculty of Health Sciences, Makerere University, Kampala, Uganda., Nabatanzi A; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda., Anywar G; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda., Tugume AK; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda., Kakudidi EK; Department of Plant Sciences, Microbiology and Biotechnology, School of Biosciences, Makerere University, Kampala, Uganda.
Jazyk: angličtina
Zdroj: Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2022 Jan 21; Vol. 11 (1), pp. 11. Date of Electronic Publication: 2022 Jan 21.
DOI: 10.1186/s13756-022-01054-6
Abstrakt: Background: Antimicrobial resistance is swiftly increasing all over the world. In Africa, it manifests more in pathogenic bacteria in form of antibiotic resistance (ABR). On this continent, bacterial contamination of commonly used herbal medicine (HM) is on the increase, but information about antimicrobial resistance in these contaminants is limited due to fragmented studies. Here, we analyzed research that characterized ABR in pathogenic bacteria isolated from HM in Africa since 2000; to generate a comprehensive understanding of the drug-resistant bacterial contamination burden in this region.
Methods: The study was conducted according to standards of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We searched for articles from 12 databases. These were: PubMed, Science Direct, Scifinder scholar, Google scholar, HerbMed, Medline, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, Commonwealth Agricultural Bureau Abstracts, African Journal Online, and Biological Abstracts. Prevalence and ABR traits of bacterial isolates, Cochran's Q test, and the I 2 statistic for heterogeneity were evaluated using MedCalcs software. A random-effects model was used to determine the pooled prevalence of ABR traits. The potential sources of heterogeneity were examined through sensitivity analysis, subgroup analysis, and meta-regression at a 95% level of significance.
Findings: Eighteen studies met our inclusion criteria. The pooled prevalence of bacterial resistance to at least one conventional drug was 86.51% (95% CI = 61.247-99.357%). The studies were highly heterogeneous (I 2 = 99.17%; p < 0.0001), with no evidence of publication bias. The most prevalent multidrug-resistant species was Escherichia coli (24.0%). The most highly resisted drug was Ceftazidime with a pooled prevalence of 95.10% (95% CI = 78.51-99.87%), while the drug-class was 3 rd generation cephalosporins; 91.64% (95% CI = 78.64-96.73%). None of the eligible studies tested isolates for Carbapenem resistance. Extended Spectrum β-lactamase genes were detected in 89 (37.2%) isolates, mostly Salmonella spp., Proteus vulgaris, and K. pneumonia. Resistance plasmids were found in 6 (5.8%) isolates; the heaviest plasmid weighed 23,130 Kilobases, and Proteus vulgaris harbored the majority (n = 5; 83.3%).
Conclusions: Herbal medicines in Africa harbor bacterial contaminants which are highly resistant to conventional medicines. This points to a potential treatment failure when these contaminants are involved in diseases causation. More research on this subject is recommended, to fill the evidence gaps and support the formation of collaborative quality control mechanisms for the herbal medicine industry in Africa.
(© 2022. The Author(s).)
Databáze: MEDLINE
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