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Received Dec 20, 2017; Revised Mar 14, 2018; Accepted Mar 20, 2018
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Background
Escherichia coli (E. coli) is one of the most widespread bacteria throughout the world. Some strains of E. coli can cause serious illness for humankind [1] including urinary tract infections [2–4], bloodstream infections [5], skin infection, otitis media [6, 7], and diarrhea [8].
E. coli resistance to antimicrobials is creating trouble to the healthcare system worldwide [9, 10]. This complicates treatment outcomes, increases the cost of treatment, and limits the therapeutic options that contribute to the global spectra of a postantimicrobial age in which some of the most effective drugs lose their efficiency [11]. The bacterium is becoming highly resistant to conventionally used antibiotics (to both the newer and older medicines) as evidenced by many previous studies [12–16]. Adaptive resistance was supposed to be the main mechanism for the development of resistance including that to lethal doses of the antimicrobials [17].
Antimicrobial resistance of E. coli in developing countries including Ethiopia is reported to be one major reason for failure of treatment of infectious diseases [18]. A number of studies conducted in Ethiopia from various clinical settings show increments in the prevalence of antimicrobial resistance patterns of E. coli [6, 19, 20]. However, there is no comprehensive and aggregated nationwide study to show the pattern of antimicrobial resistance in E. coli. Hence, the purpose of this meta-analysis was to sum up the available data and to establish the pooled prevalence and antimicrobial resistance of E. coli in Ethiopia.
2. Methods
This study was conducted in a similar approach to Eshetie et al. (2016) [21] and according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Checklist [22] (additional S1 file).
2.1. Study Selection
A systematic literature search was conducted in PubMed and Embase, and also manual search for articles potentially relevant to our study was identified. We built our search strategy by combining the three main arms (Table 1): E. coli, drugs-related terms, and Ethiopia.
Table 1
Searching strategies including search arm and terms used in the...