OBJECTIVES: To evaluate the prevalence of ESBL among clinical K. pneumoniae isolates in Nigeria (2007 – 2017).

METHODS:

Eligibility criteria: Only studies that report prevalence of ESBL K. pneumoniae in at least 30 non-duplicate specimens collected from patients in Nigeria were included.

Data Source: Pubmed, Scopus and Google scholar electronic databases were searched to identify studies. Search terms used include Extended Spectrum Beta-Lactamse, ESBL, Klebsiella pneumoniae, enterobacteriaceae, and Nigeria.

Study selection: An independent reviewer screened the abstract and full text of identified studies for inclusion. A small portion of the identified studies were screened by the second reviewer.

Data extraction: Study characteristics and prevalence of ESBL K. pneumoniae isolates were extracted by one reviewer, using a data collection form. This was checked by the second reviewer in an attempt to minimize error and bias. Disagreement between the reviewers was resolved by dialogue.

RESULTS: A total of 283 articles were screened and 7 studies met the inclusion criteria. Three and four studies were conducted in Southern and Northern Nigeria respectively. All the studies were prospective in nature. The studies include 744 K. pneumoniae isolates with 237 ESBL phenotypes. Prevalence of ESBL K. pneumoniae in Northern and Southern Nigeria is rising, albeit regional variations. Prevalence in the South-West increased from 12.7% (2005 – 2007) to 37.5% (2011) and from 14.8% (2010 – 2011) to 62.9% in (2012 – 2014) in North-Western Nigeria. In addition, prevalence in the South-South region (43.8%) is higher than the North-East region (33.1%) which in turn is higher compared to North-Central Nigeria (26.7%). Higher prevalence was observed in surgical wounds and urine isolates of K. pneumoniae CONCLUSIONS: Prevalence of ESBL K. pneumoniae infections in Nigeria is high and rate is increasing. This observation underlines the importance of surveillance system, and interventions to reduced the prevalence of ESBL K. pneumoniae infections in Nigeria.