Epidemiology of multidrug-resistant Klebsiella pneumoniae infection in clinical setting in South-Eastern Asia: a systematic review and meta-analysis.

The rising prevalence of multidrug-resistant (MDR) and extended-spectrum beta lactamase-resistant (ESBL) Klebsiella pneumoniae (K. pneumoniae) is an important global public health challenge. This threat is even more pertinent in clinical settings. Morbidity and mortality associated with this condition are alarming particularly in the developing regions of the world. A comprehensive evaluation of the epidemiology of this phenomenon will assist towards the global effort of reducing its burden. So, this systematic review and meta-analysis was conducted to evaluate the epidemiology of MDR K. pneumoniae in South-Eastern Asia (SEA). The study was done under the PRISMA guidelines and was preceded by the development of a priori protocol. The protocol was then registered in PROSPERO-the public registry for systematic reviews. Seven important outcomes which include the assessment of the overall MDR K. pneumoniae prevalence were designed to be evaluated. A literature search was carried out in five selected electronic databases and 4389 were screened. Of these articles, 21 studies that met the eligibility criteria were included in the review. Relevant data were extracted from the included studies. By conducting a quality effect meta-analysis, the pooled prevalence for MDR and ESBL K. pneumoniae in SEA was estimated at 55% (CI 9-96) and 27% (CI 32-100) respectively. The review also identified ESBL genes types of allodemic situations occurring mostly in respiratory tract infections. The high prevalence of MDR and ESBL K. pneumoniae in this subregion is highly significant and of both public health and clinical relevance. Overall, the findings of this review will assist in the effective prevention and control of this threat in SEA.

A systematic review and meta-analysis of the prevalence of Listeria monocytogenes in South-East Asia; a one-health approach of human-animal-food-environment.

Listeria monocytogenes is an important foodborne intracellular pathogen. The pathogen is the primary cause of human Listeriosis. The main source of human Listeriosis is through consumption of contaminated food products. Other modes of transmission include zoonotic and vertical transmission. The disease often presents in a mild form, but severe and fatal cases, as well as outbreaks, may occur. Despite these challenges, there has been little attempt at enumerating the burden of the disease in countries of Southeast Asia (SEA) and some developing countries. Thus, this study investigated the prevalence of L. monocytogenes in SEA using one health approach through a systematic review and meta-analysis (SR&MA) of the existing literature. In accordance with the PRISMA guidelines, an a priori protocol for the SR&MA was developed and registered in PROSPERO (ID=CRD42021288903). A systematic search of four electronic databases was performed for relevant citations. The identified publications were screened, and 17 studies were included in the review from where data was extracted. The pooling of the prevalence estimate (with the 95% confidence interval [CI]) was done using the random effect model by employing the double transformed arcsine method using MetaXL software. The overall determined prevalence for L. monocytogenes in SEA (in food, animal, and environmental sources) was 16% (95% confidence interval [CI]: 10-23). Further subgroup analysis revealed ready-to-eat food of vegetable origin with the highest prevalence of 21% (CI: 6-41). Also, seven virulence genes were identified to be prevalent in the subregion. The commonest identification method was found to be the polymerase chain reaction (PCR). The knowledge of the high prevalence of L. monocytogenes in SEA is relevant for informed decision making by clinicians, public health practitioners, and policymakers. To achieve the goal of the effective control and prevention of the disease in the subregion.