Descriptive Epidemiology of Klebsiella spp. Urinary Tract Infections in Central Africa.

Objective: Urinary tract infections are the most common bacterial infections encountered in clinical practice. Among the pathogens responsible, bacteria of the Klebsiella spp. are the second most frequently isolated uropathogenic agents worldwide. These bacteria are constantly evolving, both epidemiologically and in terms of the development of antimicrobial resistance. In Central Africa, available data on the spread of Klebsiella spp. are mainly derived from isolated studies, making it difficult to obtain an overview of their epidemiology in the subregion. Consequently, these systematic review and meta-analysis are aimed at estimating the pooled prevalence of urinary tract infections in Central Africa and to describe the epidemiology of the Klebsiella spp. strains responsible for these infections. Methods: Relevant articles were searched in the SCOPUS, PubMed, and Google Scholar databases. The study selection process was conducted in accordance with the PRISMA flowchart recommendations. Systematic review and meta-analysis were used to summarize data on urinary tract infections. Prevalence was determined and visualized using a forest plot with R software Version 4.4.1. Also, finally, geographical mapping of the data distribution was carried out using QGIS software (Version 3.34.15-Prizren). Result: Out of all the articles retrieved, 34 studies were deemed eligible for this analysis. The overall pooled prevalence of urinary tract infections in Central Africa was estimated at 28% (95% IC: 28, 29). The overall isolation rate of Klebsiella spp. responsible for urinary tract infections was 12% (95% IC: 11, 12). Analysis of the distribution of Klebsiella spp. isolation rates in urinary tract infections across Central Africa revealed variability by country, ranging from 10% to 25%. The species Klebsiella pneumoniae was the most frequently isolated, present in 96.15% of the studies. Furthermore, Klebsiella spp. strains responsible for urinary tract infections were predominantly identified in females, with an overall isolation rate of 82.23%, compared to 17.77% in males.