A systematic review on the detection of carbapenamase-producing Enterobacteriaceae

Abstract

Introduction: Carbapenemase-producing Enterobacteriaceae (CPE) represents one of the most pressing and critical public health challenges associated with antibiotic resistance. Challenges persist in accurately and promptly identifying CPE despite the existence of diverse carbapenemases and multiple detection methods.                                                                          

Aim: This study investigated diagnostic methods used for the detection of CPEs.                                                                                       Methods: The systematic review and meta-analysis were conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Electronic databases like Google Scholar, PubMed, Scopus, and Web of Science were used to find relevant articles. In addition, the Joanna Briggs Institute quality appraisal tool was used to assess the quality of the included studies. STATA 14.0 was used for statistical analysis. Heterogeneity was assessed by using Cochran’s Q test and 12 statistics. In addition, publication bias was assessed using a funnel plot and Egger’s test. A random effect model was used to estimate the pooled prevalence.                                                    

Results: The meta-analysis revealed an overall pooled proportion of 40.53% for phenotypic detection of carbapenemase activity across the 11 studies, with substantial heterogeneity observed. Subgroup analysis highlighted variations in detection proportions based on different methods, with mCIM showing the highest proportion at 58,20%, Carba NP at 27.79%, and MHT at 34,62%. Evaluation of publication bias indicated little impact on the results, maintaining the stability of the meta-analysis outcomes.                                                                                                        

Conclusion: In conclusion, this systematic review showed a high prevalence of CPE across the studies. This study emphasizes the importance of standardized detection methods, global collaboration, and the integration of advanced techniques for accurate CPE detection.