Multidrug-Resistant Pathogen Clonal Spread in Nigeria: A Systematic Review and Meta-Analysis

Area of Science:

• Microbiology
• Public Health
• Infectious Diseases

Background:

• The increasing prevalence of multidrug-resistant (MDR) bacterial clones presents a significant global health challenge.
• Understanding the epidemiology of these clones in specific regions, such as Nigeria, is vital for implementing targeted control measures.

Purpose of the Study:

• To systematically review and track the prevalence of MDR bacterial clones circulating in Nigeria.
• To identify predominant MDR clones and their sequence types within the Nigerian context.

Main Methods:

• A comprehensive literature search was conducted across Scopus, PubMed, Web of Science, and Google Scholar for studies published between January 2010 and April 2025.
• The Newcastle-Ottawa Scale was adapted for assessing the risk of bias in included cross-sectional studies.
• Meta-analysis was performed using R-Studio software (version 4.4.3) with the metaprop package.

Main Results:

• Twenty-three studies were included, reporting a pooled prevalence of MDR bacteria at 81.5%.
• Predominant MDR clones identified include *Escherichia coli*-ST692 (54.0%), *Staphylococcus aureus*-ST1 (53.5%), *Klebsiella pneumoniae*-ST307 (29.6%), *Acinetobacter baumannii*-ST2 (23.9%), and *Pseudomonas aeruginosa*-ST773 (24.2%).
• Pooled prevalence for specific MDR clones ranged from 6.5% for *E. coli* and *A. baumannii* to 25.9% for *S. aureus*.

Conclusions:

• This review highlights the presence of significant MDR clones, including international high-risk types, in Nigeria.
• The identified clones (*E. coli* ST692, *S. aureus* ST1, *K. pneumoniae* ST307, *A. baumannii* ST2, *P. aeruginosa* ST773) necessitate urgent public health attention.
• Developing robust systems for tracking and controlling MDR pathogen clones is essential for mitigating future health risks in Nigeria.