A systematic review of antibiotic-resistant Escherichia coli and Salmonella data obtained from Tanzanian healthcare settings (2004-2014)

Abstract

Antibiotic-resistant Escherichia coli and Salmonella are an increasing challenge to global health. In Tanzania reliable data is limited for trends of resistance in major hospital-acquired pathogens. Data on the prevalence of antibiotic-resistant E. coli and Salmonella from Tanzanian sources (2004-2014) was extracted from PubMed and Google Scholar databases (April -June, 2015). Descriptive statistics and logistic-regression analysis were used to estimate the prevalence and trends for resistant E. coli and Salmonella to selected antibiotics using R software. A total of 24 articles were availablefor review, of which 21/24 (87.5%) and 7/24 (29.2%) reported the prevalence of antibiotic-resistant E. coli and Salmonella, respectively. Across all studies the average prevalence of resistance to ampicillin and cotrimoxazole was higher for E. coli (81.6 and 77.7%, respectively) than for Salmonella (64.7and 59.3%, respectively). Both groups of pathogens were also resistant to ciprofloxacin (20-22%) and 3rd- generation cephalosporins (2.5-27.8%). A logistic-regression model for published data (2004-2014) indicated that during this period of time there has been a significant increase to amoxicillin/clavulanate, ceftazidime, ciprofloxacin and gentamicin in E. coli (P< 0.001), and a significant increase in resistance to ampicillin for Salmonella (P < 0.05).Decreased E. coli and Salmonella susceptibility to critical antibiotics threatens the effective treatment of these infections in Tanzania. Proactive strategies are needed to preserve these antibiotics that remain largely active against bacterial pathogens in Tanzania.