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Plasmid-Mediated Fluoroquinolone Resistance among Enterobacterales in Africa: Systematic Review
J Abubakar1, M Z Sabitu1, K D Muhammad2
1Department of Microbiology, Usmanu Danfodiyo University Teaching Hospital, Sokoto. Email: Jamojamtu1@.com; 08133080545.
Introduction:
According to the World Health Organization, antimicrobial resistance (AMR) is a silent global pandemic that plagues everyone. It makes therapy of infectious diseases more difficult and eventually increases morbidity and mortality.
Aim:
The purpose of this work is to examine existing data on plasmid-mediated quinolone resistance (PMQR), to assess the prevalence of PMQR genes in Enterobacterales, and to determine any knowledge gaps from sub-Saharan Africa.
Methodology:
The Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) standard was followed when conducting this systematic review. The main internet databases examined for pertinent publications were PubMed, Google Scholar, and Ajol. A set of qualifying criteria were used to evaluate the qualified articles. Using the eligibility criteria, 56 full-text articles were chosen for screening.
Result:
Thirty-two (32) articles with the majority originating from West and North Africa and only one article reporting a study carried out in Central Africa were selected for this review. Escherichia coli and Ciprofloxacin were the most reported Enterobacterales and Quinolone respectively. The PMQR genes include qnr (qnrA,qnrB, qnrC, qnrD, and qnrS), aac (6') Ib, aac (6') Ib-cr, oqxAB and qepA gene. The most prevalent PMQR gene is the aac (6') Ib-cr gene (32%) followed by qnrS (26%).
Conclusion:
This study highlighted the requirement for an efficient antimicrobial resistance surveillance system in the continent and revealed a significant incidence of PMQR genes.
Insights
Antimicrobial resistance (AMR) is a global threat. This review found significant prevalence of plasmid-mediated quinolone resistance (PMQR) genes in Enterobacterales in Africa, highlighting the need for better surveillance.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) is a growing global health crisis, complicating infectious disease treatment and increasing mortality.
- Plasmid-mediated quinolone resistance (PMQR) is a significant driver of AMR, particularly in Gram-negative bacteria.
Purpose of the Study:
- To systematically review existing data on PMQR genes in Enterobacterales.
- To assess the prevalence of PMQR genes in sub-Saharan Africa.
- To identify knowledge gaps in PMQR research within the region.
Main Methods:
- A systematic review adhering to PRISMA guidelines.
- Searches conducted on PubMed, Google Scholar, and Ajol databases.
- Eligibility criteria applied to select 56 full-text articles for analysis.
Main Results:
- Thirty-two articles were included, primarily from West and North Africa; only one study was from Central Africa.
- Escherichia coli was the most frequently reported Enterobacterales, and ciprofloxacin the most common quinolone.
- The most prevalent PMQR genes identified were aac(6')Ib-cr (32%) and qnrS (26%).
Conclusions:
- A significant incidence of PMQR genes in Enterobacterales was observed across Africa.
- The findings underscore the urgent need for robust antimicrobial resistance surveillance systems on the continent.
- Addressing PMQR is critical for effective infectious disease management in Africa.
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