{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:43:06Z","timestamp":1792226586048,"version":"4.4.0"},"reference-count":66,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>People living with HIV are vulnerable to antibiotic-resistant bacterial infections because of frequent healthcare visits, the consumption of many antimicrobials, and the weakened immune system to fight infections. Our objective was to provide comprehensive data about ESBL-producing <jats:italic>Enterobacterales<\/jats:italic> among HIV-positive individuals across the globe.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To select eligible articles published between January 1, 2010, and May 12, 2024, a literature search was performed on available electronic databases such as PubMed, Hinari, Google Scholar, and Scopus. The quality of the included studies was assessed via the Joanna Briggs Institute critical appraisal tool. The data were extracted from the eligible studies via Microsoft Excel 2019 and analyzed via STATA version 17. A random effects model was constructed via the DerSimonian and Laird method. The heterogeneity was checked through the Cochrane Q statistic, and the magnitude was quantitatively measured via I<jats:sup>2<\/jats:sup> statistics. To determine the possible sources of heterogeneity, a subgroup analysis was performed. Additionally, a sensitivity analysis was conducted, and publication bias was checked via funnel plots and Egger\u2019s regression tests. A p value of less than 0.05 was considered evidence of heterogeneity and small study effects according to the Cochrane Q statistic and Egger\u2019s test, respectively. The protocol was registered previously (PROSPERO ID: CRD42024557981).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 5305 HIV-positive individuals from 20 studies were included in our meta-analysis. The overall pooled prevalence of ESBL-producing <jats:italic>Enterobacterales<\/jats:italic> among HIV-positive individuals was 20.30% (931\/5305; 95% CI: 15.13<jats:bold>\u2013<\/jats:bold>25.47%, P\u2009<jats:italic>&lt;\u2009<\/jats:italic>0.001), with a high level of heterogeneity (I<jats:sup>2<\/jats:sup><jats:italic>\u2009<\/jats:italic>=\u200997.82%, P\u2009<jats:italic>&lt;\u2009<\/jats:italic>0.001). The predominant ESBL producers were <jats:italic>K. pneumoniae<\/jats:italic>, with a pooled prevalence of 40.84% (76\/217; 95% CI: 26.87\u201354.81%), followed closely by <jats:italic>E. coli<\/jats:italic> at 40.14% (348\/985; 95% CI: 27.83\u201352.45%). In the subgroup analysis, the highest magnitude of ESBL-producing pathogens was observed in Asia (195\/715; 28.55%), followed by Africa (666\/3981; 19.12%). Additionally, the highest pooled prevalence of ESBL-producing pathogens among HIV-positive individuals was reported to be colonization 23.78% (613\/2455; 95% CI: 15.36\u201332.19, I\u00b2\u2009=\u200996.78%, p\u2009&lt;\u20090.001), followed by infection 15.77% (318\/2850; 95% CI: 10.06\u201321.49, I\u00b2\u2009=\u200997.45%, p\u2009&lt;\u20090.001). Among the different types of ESBL enzyme-encoding genes, bla<jats:sub>CTX-M<\/jats:sub> was the most common (73 out of 150 isolates, 48.7%), followed by bla<jats:sub>TEM<\/jats:sub> (49 out of 150, 32.7%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion and recommendations<\/jats:title>\n<jats:p>This study demonstrated that HIV-positive individuals are commonly colonized and infected with ESBL-producing <jats:italic>Enterobacterales<\/jats:italic>. The highest prevalence of these pathogens was reported in Asia and Africa. To reduce mortality from severe bacterial infections in HIV patients, resources should be distributed equitably across all regions. Particular attention should be given to high-prevalence areas, where early detection of colonization and infection with antibiotic-resistant pathogens is critical. Enhanced surveillance of ESBL-producing organisms among HIV-positive individuals is also strongly recommended.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0321873","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T17:39:54Z","timestamp":1749577194000},"page":"e0321873","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Extended-spectrum \u03b2-lactamase-producing Enterobacterales among people living with human immunodeficiency virus across the globe: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5532-6097","authenticated-orcid":true,"given":"Mitkie","family":"Tigabie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0363-3254","authenticated-orcid":true,"given":"Abebe","family":"Birhanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muluneh","family":"Assefa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1199-1479","authenticated-orcid":true,"given":"Getu","family":"Girmay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kebebe","family":"Tadesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"pone.0321873.ref001","author":"World Health Organization","year":"2019"},{"issue":"10459","key":"pone.0321873.ref002","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/S0140-6736(24)01867-1","article-title":"Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050","volume":"404","author":"M Naghavi","year":"2024","journal-title":"Lancet"},{"issue":"7","key":"pone.0321873.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004264","article-title":"Antimicrobial resistance: addressing a global threat to humanity","volume":"20","author":"TR Walsh","year":"2023","journal-title":"PLoS Med"},{"issue":"2","key":"pone.0321873.ref004","article-title":"The burden of bacterial antimicrobial resistance in the WHO African region in 2019: a cross-country systematic analysis","volume":"12","author":"B GA Sartorius","year":"2024","journal-title":"Lancet Glob Health"},{"issue":"11","key":"pone.0321873.ref005","article-title":"The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis","volume":"7","author":"T AG Mestrovic","year":"2022","journal-title":"Lancet Public Health"},{"issue":"2","key":"pone.0321873.ref006","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1080\/14787210.2021.1951705","article-title":"Antimicrobial resistance in low- and middle-income countries: current status and future directions","volume":"20","author":"G Sulis","year":"2022","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"3","key":"pone.0321873.ref007","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jiph.2016.04.009","article-title":"Bacterial resistance and immunological profiles in HIV-infected and non-infected patients at Mbouda AD LUCEM Hospital in Cameroon","volume":"10","author":"WJ Marbou","year":"2017","journal-title":"J Infect Public Health"},{"issue":"12","key":"pone.0321873.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0168024","article-title":"High prevalence of faecal carriage of ESBL-producing enterobacteriaceae among children in Dar es Salaam, Tanzania","volume":"11","author":"MG Tellevik","year":"2016","journal-title":"PLoS One"},{"issue":"1","key":"pone.0321873.ref009","doi-asserted-by":"crossref","first-page":"18","DOI":"10.21010\/ajid.v11i1.3","article-title":"Effect of trimethoprim-sulfamethoxazole prophylaxis on faecal carriage rates of resistant isolates of Escherichia coli in HIV-infected adult patients in Lagos","volume":"11","author":"CC Egwuatu","year":"2016","journal-title":"Afr J Infect Dis"},{"key":"pone.0321873.ref010","author":"World Health Organization","year":"2024"},{"key":"pone.0321873.ref011","article-title":"Drug-resistant bacterial infections in HIV patients","volume":"83","author":"MR Rameshkumar","year":"2018","journal-title":"AICA"},{"issue":"6","key":"pone.0321873.ref012","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/j.cmi.2021.03.026","article-title":"The association between antimicrobial resistance and HIV infection: a systematic review and meta-analysis","volume":"27","author":"ID Olaru","year":"2021","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"pone.0321873.ref013","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/nrmicro3380","article-title":"Molecular mechanisms of antibiotic resistance","volume":"13","author":"JMA Blair","year":"2015","journal-title":"Nat Rev Microbiol"},{"issue":"14","key":"pone.0321873.ref014","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1007\/s40265-019-01180-3","article-title":"Extended-spectrum \u03b2-Lactamase-producing enterobacteriaceae: update on molecular epidemiology and treatment options","volume":"79","author":"G Peirano","year":"2019","journal-title":"Drugs"},{"issue":"2","key":"pone.0321873.ref015","doi-asserted-by":"crossref","DOI":"10.1128\/CMR.00079-17","article-title":"Treatment of infections caused by extended-spectrum-beta-lactamase-, AmpC-, and carbapenemase-producing enterobacteriaceae","volume":"31","author":"J Rodr\u00edguez-Ba\u00f1o","year":"2018","journal-title":"Clin Microbiol Rev"},{"issue":"5","key":"pone.0321873.ref016","article-title":"Efficacy and safety of intravenous combined with aerosolised polymyxin versus intravenous polymyxin alone in the treatment of multidrug-resistant gram-negative bacterial pneumonia: a systematic review and meta-analysis","volume":"9","author":"D Lu","year":"2023","journal-title":"Heliyon"},{"issue":"1","key":"pone.0321873.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijantimicag.2017.01.027","article-title":"Complications associated with antibiotic administration: neurological adverse events and interference with antiepileptic drugs","volume":"50","author":"S Esposito","year":"2017","journal-title":"Int J Antimicrob Agents"},{"issue":"1","key":"pone.0321873.ref018","first-page":"11909","article-title":"Extended-spectrum \u03b2-lactamases-producing enterobacteria and antimicrobial resistance pattern among HIV\/AIDS patients in the university of gondar specialized hospital, Ethiopia","volume":"6","author":"D Endalamaw","year":"2020","journal-title":"Recent Adv Biol Med"},{"issue":"12","key":"pone.0321873.ref019","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1016\/j.jiph.2021.11.008","article-title":"Occurrence of extended-spectrum \u03b2-lactamase, AmpC, and carbapenemase-producing genes in gram-negative bacterial isolates from human immunodeficiency virus infected patients","volume":"14","author":"MR Rameshkumar","year":"2021","journal-title":"J Infect Public Health"},{"key":"pone.0321873.ref020","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jgar.2023.07.021","article-title":"Faecal carriage of multidrug-resistant and extended-spectrum \u03b2-lactamase-producing Enterobacterales in people living with HIV in Yaound\u00e9, Cameroon","volume":"35","author":"BD Dimani","year":"2023","journal-title":"J Glob Antimicrob Resist"},{"issue":"1","key":"pone.0321873.ref021","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3126\/jmcjms.v9i1.34419","article-title":"Antibiotic susceptibility patterns and extended spectrum beta-lactamase (ESBL) production in Enterobactericeae isolated from stool samples of HIV and AIDS patients in Ibadan, Nigeria","volume":"9","author":"OI Falodun","year":"2021","journal-title":"Janaki Med Coll J Med Sci"},{"key":"pone.0321873.ref022","doi-asserted-by":"crossref","first-page":"101159","DOI":"10.1016\/j.genrep.2021.101159","article-title":"Prevalence of extended beta-lactamase-producing Pseudomonas aeruginosa isolated from human immunodeficiency virus patients in Ibadan, Nigeria","volume":"23","author":"OI Falodun","year":"2021","journal-title":"Gene Reports"},{"issue":"12","key":"pone.0321873.ref023","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1089\/mdr.2020.0066","article-title":"High prevalence of fecal carriage of extended spectrum \u03b2-lactamase-producing enterobacteriaceae among newly HIV-Diagnosed adults in a community setting in Tanzania","volume":"26","author":"J Manyahi","year":"2020","journal-title":"Microb Drug Resist"},{"issue":"9","key":"pone.0321873.ref024","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1093\/cid\/ciac218","article-title":"Evidence of sexual transmission of extended-spectrum \u03b2-lactamase-producing enterobacterales: a cross-sectional and prospective study","volume":"75","author":"L Surgers","year":"2022","journal-title":"Clin Infect Dis"},{"issue":"5","key":"pone.0321873.ref025","doi-asserted-by":"crossref","first-page":"196","DOI":"10.5897\/AJMR2022.9624","article-title":"Prevalence and multidrug-resistant ESBL-producing E. coli in urinary tract infection cases of HIV patients attending Federal Teaching Hospital, Abakaliki, Nigeria","volume":"16","author":"BN John-Onwe","year":"2022","journal-title":"Afr J Microbiol Res"},{"issue":"1","key":"pone.0321873.ref026","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1186\/s12879-022-07503-2","article-title":"Multidrug-resistant bacteria with ESBL genes: a growing threat among people living with HIV\/AIDS in Nepal","volume":"22","author":"R Maharjan","year":"2022","journal-title":"BMC Infect Dis"},{"issue":"3","key":"pone.0321873.ref027","first-page":"334","article-title":"Incidence and antibiotic susceptibility profile of uropathogenic Escherichia coli positive for extended spectrum \u03b2-lactamase among HIV\/AIDS patients in Awka metropolis, Nigeria","volume":"14","author":"CJ Nwokolo","year":"2022","journal-title":"Iran J Microbiol"},{"issue":"6","key":"pone.0321873.ref028","first-page":"505","article-title":"Prevalence of extended spectrum \u03b2-lactamase genes among the oral gram negative rods isolated from HIV infected patients","volume":"11","author":"M Singh","year":"2020","journal-title":"Indian J Public Health"},{"issue":"5","key":"pone.0321873.ref029","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1099\/jmm.0.000474","article-title":"Carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in HIV-infected children in Zimbabwe","volume":"66","author":"SMS Wilmore","year":"2017","journal-title":"J Med Microbiol"},{"issue":"2","key":"pone.0321873.ref030","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0212042","article-title":"Low rate of gut colonization by extended-spectrum \u03b2-lactamase producing Enterobacteriaceae in HIV infected persons as compared to healthy individuals in Nepal","volume":"14","author":"S Hosuru Subramanya","year":"2019","journal-title":"PLoS One"},{"issue":"2","key":"pone.0321873.ref031","first-page":"230","article-title":"Occurrence of extended spectrum producing gram negative bacteria in HIV\/AIDS infected patients with urinary and gastrointestinal tract infections in Benin metropolis","volume":"2","author":"F Osazuwa","year":"2011","journal-title":"Res J Pharm Biol Chem Sci"},{"issue":"1","key":"pone.0321873.ref032","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s12879-020-05749-2","article-title":"HIV infection and multidrug resistant tuberculosis: a systematic review and meta-analysis","volume":"21","author":"ZZ Sultana","year":"2021","journal-title":"BMC Infect Dis"},{"issue":"3","key":"pone.0321873.ref033","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.ajic.2018.06.023","article-title":"The global and regional prevalence, burden, and risk factors for methicillin-resistant Staphylococcus aureus colonization in HIV-infected people: a systematic review and meta-analysis","volume":"47","author":"P Sabbagh","year":"2019","journal-title":"Am J Infect Control"},{"key":"pone.0321873.ref034","author":"Joanna Briggs Institute","year":"2024"},{"issue":"6","key":"pone.0321873.ref035","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/01.NAJ.0000450430.97383.64","article-title":"JBI\u2019s systematic reviews: study selection and critical appraisal","volume":"114","author":"K Porritt","year":"2014","journal-title":"AJN Am J Nurs"},{"issue":"3","key":"pone.0321873.ref036","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"R LN DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"issue":"2","key":"pone.0321873.ref037","doi-asserted-by":"crossref","first-page":"453","DOI":"10.7758\/9781610448864.23","article-title":"Heterogeneity in meta-analysis","volume":"3","author":"M Borenstein","year":"2019","journal-title":"The handbook of research synthesis meta-analysis"},{"issue":"2","key":"pone.0321873.ref038","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1002\/jrsm.1468","article-title":"Investigating and dealing with publication bias and other reporting biases in meta-analyses of health research: a review","volume":"12","author":"MJ Page","year":"2021","journal-title":"Res Synth Methods"},{"issue":"1","key":"pone.0321873.ref039","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12981-021-00347-x","article-title":"Fecal carriage of extended spectrum beta-lactamase producing Enterobacteriaceae among HIV infected children at the University of Gondar Comprehensive Specialized Hospital Gondar, Ethiopia","volume":"18","author":"B Bayleyegn","year":"2021","journal-title":"AIDS Res Ther"},{"issue":"1","key":"pone.0321873.ref040","first-page":"029","article-title":"Prevalence of ESBL-producing and multi-drug resistant Escherichia coli isolated from urine of HIV patients in General Hospital Gboko, Benue State","volume":"8","author":"A Jerry","year":"2021","journal-title":"WJBPHS"},{"issue":"1","key":"pone.0321873.ref041","first-page":"54","article-title":"Detection of extended-spectrum \u03b2 lactamases and AmpC \u03b2-lactamase production in Escherichia coli causing urinary tract infection among HIV and non-HIV patients","volume":"2","author":"K KPaSR Padmavathy","year":"2011","journal-title":"Am Med J"},{"issue":"1","key":"pone.0321873.ref042","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1186\/s12879-017-2286-z","article-title":"Elevated prevalence of multidrug-resistant gram-negative organisms in HIV positive men","volume":"17","author":"C Reinheimer","year":"2017","journal-title":"BMC Infect Dis"},{"issue":"8","key":"pone.0321873.ref043","doi-asserted-by":"crossref","first-page":"144","DOI":"10.3390\/tropicalmed7080144","article-title":"Extended spectrum \u03b2-Lactamase producing lactose fermenting bacteria colonizing children with human immunodeficiency virus, sickle cell disease and diabetes mellitus in Mwanza City, Tanzania: a cross-sectional study","volume":"7","author":"MM Said","year":"2022","journal-title":"Trop Med Infect Dis"},{"issue":"1","key":"pone.0321873.ref044","doi-asserted-by":"crossref","DOI":"10.2174\/18742858-v16-e2208180","article-title":"Magnitude of multidrug-resistant bacterial uropathogens and associated factors in urinary tract infection suspected adult HIV-positive patients in Southern Ethiopia","volume":"16","author":"E Simeneh","year":"2022","journal-title":"TOMICROJ"},{"issue":"5","key":"pone.0321873.ref045","doi-asserted-by":"crossref","first-page":"504","DOI":"10.3390\/pathogens11050504","article-title":"Multidrug-RESISTANT AND EXTENDED-SPECTRUm \u03b2-Lactamase (ESBL) - producing enterobacterales isolated from carriage samples among HIV infected women in yaound\u00e9, Cameroon","volume":"11","author":"RJ Zemtsa","year":"2022","journal-title":"Pathogens"},{"issue":"6","key":"pone.0321873.ref046","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/j.cmi.2021.03.026","article-title":"The association between antimicrobial resistance and HIV infection: a systematic review and meta-analysis","volume":"27","author":"ID Olaru","year":"2021","journal-title":"Clin Microbiol Infect"},{"key":"pone.0321873.ref047","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1471-2334-14-13","article-title":"A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance","volume":"14","author":"BG Bell","year":"2014","journal-title":"BMC Infect Dis"},{"issue":"1","key":"pone.0321873.ref048","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1186\/s12913-021-06670-3","article-title":"The comorbidity of HIV, hypertension and diabetes: a qualitative study exploring the challenges faced by healthcare providers and patients in selected urban and rural health facilities where the ICDM model is implemented in South Africa","volume":"21","author":"M Godongwana","year":"2021","journal-title":"BMC Health Serv Res"},{"issue":"5","key":"pone.0321873.ref049","doi-asserted-by":"crossref","first-page":"164","DOI":"10.4103\/1755-6783.165844","article-title":"The dynamics of bacteria population on the skin, throat, and gastrointestinal tract of HIV-seropositive patients","volume":"8","author":"KAF Ako-Nai","year":"2015","journal-title":"Ann Trop Med Public Health"},{"issue":"4","key":"pone.0321873.ref050","doi-asserted-by":"crossref","first-page":"951","DOI":"10.3390\/microorganisms11040951","article-title":"Gut bacterial communities in HIV-infected individuals with metabolic syndrome: effects of the therapy with integrase strand transfer inhibitor-based and protease inhibitor-based regimens","volume":"11","author":"TA Baltazar-D\u00edaz","year":"2023","journal-title":"Microorganisms"},{"issue":"1","key":"pone.0321873.ref051","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12894-025-01695-w","article-title":"Extended-spectrum beta-lactamase and carbapenemase-producing Gram-negative bacteria in urinary tract infections in Ethiopia: a systematic review and meta-analysis","volume":"25","author":"M Tigabie","year":"2025","journal-title":"BMC Urol"},{"issue":"4","key":"pone.0321873.ref052","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0316492","article-title":"Colonization with extended-spectrum \u03b2-lactamase and carbapenemase-producing Enterobacterales in Ethiopia: a systematic review and meta-analysis","volume":"20","author":"M Tigabie","year":"2025","journal-title":"PLoS One"},{"issue":"1","key":"pone.0321873.ref053","article-title":"Healthcare associated infections in a resource limited setting","volume":"11","author":"C Bammigatti","year":"2017","journal-title":"J Clin Diagn Res"},{"issue":"8","key":"pone.0321873.ref054","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(22)00120-6","article-title":"Cotrimoxazole guidelines for infants who are HIV-exposed but uninfected: a call for a public health and ethics approach to the evidence","volume":"10","author":"B Daniels","year":"2022","journal-title":"Lancet Glob Health"},{"issue":"3","key":"pone.0321873.ref055","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/S1473-3099(14)71011-4","article-title":"The expanding role of co-trimoxazole in developing countries","volume":"15","author":"JA Church","year":"2015","journal-title":"Lancet Infect Dis"},{"key":"pone.0321873.ref056","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1471-2334-8-40","article-title":"High incidence of antimicrobial resistant organisms including extended spectrum beta-lactamase producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus in nasopharyngeal and blood isolates of HIV-infected children from Cape Town, South Africa","volume":"8","author":"MF Cotton","year":"2008","journal-title":"BMC Infect Dis"},{"issue":"10","key":"pone.0321873.ref057","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1093\/cid\/ciac978","article-title":"Severe bacterial Non-AIDS infections in persons with HIV: the epidemiology and evolution of antibiotic resistance over an 18-year period (2000-2017) in the ANRS CO3 AquiVih-Nouvelle-aquitaine cohort","volume":"76","author":"P Blanc","year":"2023","journal-title":"Clin Infect Dis"},{"issue":"1","key":"pone.0321873.ref058","doi-asserted-by":"crossref","DOI":"10.1017\/ash.2024.35","article-title":"The challenges of implementing infection prevention and antimicrobial stewardship programs in resource-constrained settings","volume":"4","author":"S Abbas","year":"2024","journal-title":"Antimicrob Steward Healthc Epidemiol"},{"key":"pone.0321873.ref059","doi-asserted-by":"crossref","first-page":"587352","DOI":"10.3389\/fmedt.2020.587352","article-title":"Medical device sterilization and reprocessing in the era of multidrug-resistant (MDR) bacteria: issues and regulatory concepts","volume":"2","author":"J Josephs-Spaulding","year":"2021","journal-title":"Front Med Technol"},{"key":"pone.0321873.ref060","doi-asserted-by":"crossref","first-page":"5419874","DOI":"10.1155\/2022\/5419874","article-title":"Multidrug-resistant bacteria: their mechanism of action and prophylaxis","volume":"2022","author":"A Bharadwaj","year":"2022","journal-title":"Biomed Res Int"},{"issue":"2","key":"pone.0321873.ref061","doi-asserted-by":"crossref","first-page":"508","DOI":"10.3892\/etm.2022.11435","article-title":"Phenotypic and genotypic detection methods for antimicrobial resistance in ESKAPE pathogens (Review)","volume":"24","author":"MM Muntean","year":"2022","journal-title":"Exp Ther Med"},{"key":"pone.0321873.ref062","article-title":"Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis","volume":"352","author":"AHA Bryce","year":"2016","journal-title":"BMJ"},{"key":"pone.0321873.ref063","doi-asserted-by":"crossref","first-page":"617378","DOI":"10.3389\/fmed.2021.617378","article-title":"Novel cephalosporins in septic subjects and severe infections: present findings and future perspective","volume":"8","author":"SLT Corcione","year":"2021","journal-title":"Front Med"},{"issue":"11","key":"pone.0321873.ref064","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0206796","article-title":"Ten years of antiretroviral therapy: Incidences, patterns and risk factors of opportunistic infections in an urban Ugandan cohort","volume":"13","author":"D Weissberg","year":"2018","journal-title":"PLoS One"},{"key":"pone.0321873.ref065","doi-asserted-by":"crossref","first-page":"105040","DOI":"10.1016\/j.micpath.2021.105040","article-title":"Genetic basis of molecular mechanisms in \u03b2-lactam resistant gram-negative bacteria","volume":"158","author":"HI Hussain","year":"2021","journal-title":"Microb Pathog"},{"issue":"1","key":"pone.0321873.ref066","first-page":"1","article-title":"Genetic diversity and risk factors for the transmission of antimicrobial resistance across human, animals and environmental compartments in East Africa: a review","volume":"8","author":"BZ Katale","year":"2020","journal-title":"Antimicro Resist Infect Control"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0321873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T17:40:12Z","timestamp":1749577212000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0321873"}},"subtitle":[],"editor":[{"given":"Amir","family":"Nutman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,6,10]]},"references-count":66,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0321873","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,10]]}}}