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Risk factors for fecal carriage of drug-resistant Escherichia coli: a systematic review and meta-analysis
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Risk factors for fecal carriage of drug-resistant Escherichia coli: a systematic review and meta-analysis
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Risk factors for fecal carriage of drug-resistant Escherichia coli: a systematic review and meta-analysis
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Journal Article
Risk factors for fecal carriage of drug-resistant Escherichia coli: a systematic review and meta-analysis
2020
Overview
Background
Antimicrobial resistance is a serious public health problem. Fecal carriage of drug-resistant bacteria has been suggested as an important source of antimicrobial resistant genes (ARGs). We aimed to identify risk factors associated with fecal carriage of drug-resistant commensal
Escherichia coli
among healthy adult population.
Methods
We conducted a systematic review and meta-analysis following the PRISMA guideline. We identified observational studies published from 2014 to 2019 through PubMed, Embase, and Web of Science. Studies were eligible if they investigated and reported risk factors and accompanying measure of associations for fecal carriage of drug-resistant
E. coli
for healthy population aged 18-65. Data on risk factors assessed in three or more studies were extracted.
Results
Fifteen of 395 studies involving 11480 healthy individuals were included. The pooled prevalence of drug-resistant Enterobacteriaceae was 14% (95% confidence interval [CI] 8-23%). Antimicrobial use within the 12 months prior to stool culture (odds ratio [OR] 1.84 [95%CI 1.35-2.51]), diarrhea symptoms (OR 1.56 [95%CI 1.09-2.25]), travel to India (OR 4.15 [95%CI 2.54-6.78]), and vegetarian diet (OR 1.60 [95%CI 1.00(1.0043)-2.56(2.5587)]) were associated with increased risk of fecal carriage of drug-resistant
E. coli
. Among travellers, antimicrobial use (OR 2.81 [95%CI 1.47-5.36]), diarrhea symptoms (OR 1.65 [95%CI 1.02-2.68]), travel to India (OR 3.80 [95%CI 2.23-6.47]), and vegetarian diet (OR 1.92 [95%CI 1.13-3.26]) were associated with increased risk. Among general adult population, antimicrobial use (OR 1.51 [95%CI 1.17-1.94]), diarrhea symptoms (OR 1.53 [95%CI 1.27-1.84]), and travel to Southeast Asia (OR 1.67 [95%CI 1.02-2.73]) were associated with the increased risk of drug-resistant
E. coli
carriage.
Conclusions
The findings indicate that dietary habit as well as past antimicrobial use and travel to high-risk country are associated with the risk of fecal carriage of drug-resistant commensal
E. coli
.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Adult
/ Aged
/ Anti-Bacterial Agents - therapeutic use
/ Bacteria
/ Biomedical and Life Sciences
/ Carbapenem-Resistant Enterobacteriaceae - drug effects
/ Citation management software
/ Diarrhea
/ Drug Resistance, Bacterial - genetics
/ E coli
/ Escherichia coli Infections - epidemiology
/ Escherichia coli Infections - transmission
/ Feces
/ Food contamination & poisoning
/ Genes
/ Humans
/ India
/ Studies
/ Travel
