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

Simple item page
dc.contributor.authorWalusansa, Abdul
dc.contributor.authorAsiimwe, Savina
dc.contributor.authorNakavuma, Jesca. L.
dc.contributor.authorSsenku, Jamilu. E.
dc.contributor.authorKatuura, Esther
dc.contributor.authorKafeero, Hussein. M.
dc.contributor.authorAruhomukama, Dickson
dc.contributor.authorNabatanzi, Alice
dc.contributor.authorAnywar, Godwin
dc.contributor.authorTugume, Arthur K.
dc.contributor.authorKakudidi, Esezah K.
dc.date.accessioned2022-08-28T13:39:10Z
dc.date.available2022-08-28T13:39:10Z
dc.date.issued2022
dc.description.abstractAntimicrobial 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 I2 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 (I2 = 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 3rd 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.en_US
dc.identifier.citationWalusansa, A., Asiimwe, S., Nakavuma, J., Ssenku, J., Katuura, E., Kafeero, H., ... & Kakudidi, E. K. (2022). Antibiotic-resistance in medically important bacteria isolated from commercial herbal medicines in Africa from 2000 to 2021: a systematic review and meta-analysis. Antimicrobial Resistance & Infection Control, 11(1), 1-20. https://doi.org/10.1186/s13756-022-01054-6en_US
dc.identifier.urihttps://doi.org/10.1186/s13756-022-01054-6
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/4478
dc.language.isoenen_US
dc.publisherAntimicrobial Resistance & Infection Controlen_US
dc.subjectAfricaen_US
dc.subjectAntimicrobial resistanceen_US
dc.subjectBacterial contaminationen_US
dc.subjectHerbal medicineen_US
dc.subjectMeta-analysisen_US
dc.subjectSystematic reviewen_US
dc.titleAntibiotic‑resistance in medically important bacteria isolated from commercial herbal medicines in Africa from 2000 to 2021: a systematic review and meta‑analysisen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Antibiotic-resistance in medically important.pdf
Size:
1.96 MB
Format:
Adobe Portable Document Format
Description:
Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences