BACKGROUND Wound infections are responsible for significant human morbidity and mortality worldwide. Specifically, surgical site infections are the third most commonly reported nosocomial infections accounting approximately a quarter of such infections. This systematic review and meta-analysis is, therefore, aimed to determine microbial profiles cultured from wound samples and their antimicrobial resistance patterns in Ethiopia. METHODS Literature search was carried out through visiting electronic databases and indexing services including PubMed, MEDLINE, EMBASE, CINAHL, and Google Scholar. Original records, available online from 2000 to 2018, addressing the research question and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 15.0 software for analyses of outcome measures and subgrouping. Der-Simonian-Laird's random effects model was applied for pooled estimation of outcome measures at 95% confidence level. Comprehensive meta-analysis version-3 software was used for assessing publication bias across studies. The study protocol is registered on PROSPERO with reference number ID: CRD42019117638. RESULTS A total of 21 studies with 4284 wound samples, 3012 positive wound cultures and 3598 bacterial isolates were included for systematic review and meta-analysis. The pooled culture positivity was found to be 70.0% (95% CI: 61, 79%). Regarding the bacterial isolates recovered, the pooled prevalence of S. aureus was 36% (95% CI: 29, 42%), from which 49% were methicillin resistant strains. The pooled estimate of E. coli isolates was about 13% (95% CI: 10, 16%) followed by P. aeruginosa, 9% (95% CI: 6, 12%), K. pneumoniae, 9% (95% CI: 6, 11%) and P. mirabilis, 8% (95% CI: 5, 11%). Compared to other antimicrobials, S. aureus has showed lower estimates of resistance against ciprofloxacin, 12% (95% CI: 8, 16%) and gentamicin, 13% (95% CI: 8, 18%). E. coli isolates exhibited the highest point estimate of resistance towards ampicillin (P = 84%; 95% CI: 76, 91%). Gentamicin and ciprofloxacin showed relatively lower estimates of resistance with pooled prevalence being 24% (95% CI: 16, 33%) and 27% (95% CI: 16, 37%), respectively. Likewise, P. aeruginosa showed the lowest pooled estimates of resistance against ciprofloxacin (P = 16%; 95% CI: 9, 24%). CONCLUSION Generally, the wound culture positivity was found very high indicating the likelihood of poly-microbial contamination. S. aureus is by far the most common bacterial isolate recovered from wound infection. The high estimate of resistance was observed among β-lactam antibiotics in all bacterial isolates. Ciprofloxacin and gentamicin were relatively effective in treating wound infections with poly-microbial etiology.

中文翻译：

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埃塞俄比亚伤口感染的微生物流行病学和抗菌药物耐药模式：基于实验室的横断面研究的荟萃分析。

背景技术伤口感染是全世界人类显着发病和死亡的原因。具体而言，手术部位感染是第三大最常见的医院感染，约占此类感染的四分之一。因此，这项系统评价和荟萃分析的目的是确定埃塞俄比亚伤口样本培养的微生物概况及其抗菌素耐药性模式。方法 通过访问电子数据库和索引服务（包括 PubMed、MEDLINE、EMBASE、CINAHL 和 Google Scholar）进行文献检索。对 2000 年至 2018 年期间可在线获取的解决研究问题的英文原始记录进行了识别和筛选。使用 Microsoft Excel 中准备的格式从纳入的研究中提取相关数据，并将其导出到 STATA 15.0 软件以分析结果测量和分组。Der-Simonian-Laird 的随机效应模型用于以 95% 置信水平对结果测量进行汇总估计。综合荟萃分析版本 3 软件用于评估研究之间的发表偏倚。该研究方案已在 PROSPERO 上注册，参考号 ID：CRD42019117638。结果 共纳入 21 项研究，涉及 4284 个伤口样本、3012 个阳性伤口培养物和 3598 个细菌分离株，进行系统评价和荟萃分析。合并培养物阳性率为 70.0% (95% CI: 61, 79%)。关于回收的细菌分离株，金黄色葡萄球菌的汇总患病率为 36% (95% CI: 29, 42%)，其中 49% 为甲氧西林耐药菌株。大肠杆菌分离株的汇总估计约为 13% (95% CI: 10, 16%)，其次是铜绿假单胞菌，9% (95% CI: 6, 12%)，肺炎克雷伯菌，9% (95% CI: 6, 11%) 和奇异果, 8% (95% CI: 5, 11%)。与其他抗菌药物相比，金黄色葡萄球菌对环丙沙星的耐药性估计较低，为 12%（95% CI：8, 16%），对庆大霉素的耐药性为 13%（95% CI：8, 18%）。大肠杆菌分离株表现出对氨苄青霉素耐药性的最高点估计值（P = 84%；95% CI：76、91%）。庆大霉素和环丙沙星的耐药性估计值相对较低，汇总患病率分别为 24% (95% CI: 16, 33%) 和 27% (95% CI: 16, 37%)。同样，铜绿假单胞菌对环丙沙星的耐药性汇总估计值最低（P = 16%；95% CI：9、24%）。结论 一般来说，伤口培养阳性率非常高，表明多种微生物污染的可能性。金黄色葡萄球菌是迄今为止从伤口感染中回收的最常见的细菌分离株。在所有细菌分离株中，β-内酰胺类抗生素的耐药性估计值较高。环丙沙星和庆大霉素在治疗多微生物病因的伤口感染方面相对有效。