Bacterial profile and multi-drug resistance pattern of bacterial isolates among septicemia suspected cases: a meta-analysis report in Ethiopia

Background: Bloodstream infections (BSIs) are one of the most common infections seen in all age groups and in all locations. The current knowledge on the patterns of bacterial profile, and its antibiotic resistance are essential to design and implement appropriate interventions. This study was conducted to assess the prevalence and multidrug resistance pattern of bacterial isolates among septicemia and/or bacteremia suspected cases in Ethiopia. Methods: Searching was conducted in databases of PubMed, Research Gate, Scopus and Google Scholar. In addition, manual searching is also conducted in bibliographies of included studies and in other meta-analysis studies. Required data were extracted from articles published up to 2020 on the bacterial profile of septicemia in Ethiopia, and analyzed using comprehensive metaanalysis version 3.3.0 software. Results: A total of 5,823 septicemia suspected cases were extracted from 18 included studies and the overall blood culture positive rate of 31.9%(95% CI: 0.261-0.382). Of these, the overall Gram positive and Gram negative isolates was 57.8% (95% CI: 0.534-0.584) and 42.2% (95% CI: 0.4160.466), respectively. Among Gram positives, predominantly reported isolates was Staphylococcus aureus (47.9%: 480 of 1,003), followed by Coagulase-Negative Staphylococcus (42.7%: 428 of 1,003), whereas among Gram negatives, the most frequently reported isolates was Klebsiella species (29.8%: 218 of 731), followed by Escherichia coli (23.1%: 169 of 731). Significant levels of resistance was reported against ampicillin, amoxicillin, ceftriaxone, co-trimoxazole and tetracycline with a pooled resistance range of 40.6-55.3% in Grampositive and 52.8-85.7% inGramnegative isolates. The pooled estimates of multi-drugs resistance (MDR) was (66.8%) among Gram positives and (80.5%) among Gram negatives, with the overall MDR rate of (74.2%). Conclusions: The reported blood culture positive rates among septicemia cases were relatively high. Second, the level of drug and multi-drug resistant isolates against commonly prescribed antibiotics was significant. However, the scarcity of data on culture confirmed septicemia cases as well as patterns of antimicrobial resistance may overshadow the problem.