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

The rapid dissemination of multidrug-resistant (MDR) bacterial clones poses a global health threat and limits treatment options. Understanding the dynamics of bacterial clones in Nigeria is essential for developing effective control strategies. This systematic review aimed to track MDR pathogen clones in Nigeria.

The search of studies published from 1 January 2010 to 30 April 2025 reporting on MDR bacterial clones in Nigeria was done in Scopus, PubMed and Web of Science databases, complemented with a search in Google Scholar. The Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies was used to evaluate the risk of bias. The meta-analysis was performed using the R-Studio software version 4.4.3 and the metaprop package.

Twenty-three studies met the inclusion criteria and reported MDR bacterial species. The MDR bacteria had a pooled prevalence of 81.5% (95% CI: 71.4-91.6). The predominant MDR clones reported were 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%). The overall pooled prevalence of MDR clones was 6.5% (95% CI: 4.8-8.1) for E. coli, 25.9% (95% CI: 1.5-50.4) for S. aureus, 8.0% (95% CI: 4.7-11.3) for K. pneumoniae, 6.5% (95% CI: 3.8-9.2) for A. baumannii, and 11.4% (95% CI: 2.8-19.9) for P. aeruginosa.

This systematic review provides up-to-date data on MDR clones that might be spreading in Nigeria. Public health priority pathogens were reported to harbor international clone sequence types which includes; E. coli ST692, S. aureus ST1, K. pneumoniae ST307, A. baumannii ST2, and P. aeruginosa ST773 as the major predominant clones in Nigeria. The presence of these high-risk clones in Nigeria requires the development of a resilient system capable of effectively tracking and controlling MDR pathogen clones.