Epidemiological trends in antibiotic resistant Klebsiella pneumoniae in healthcare settings in Burkina Faso: a systematic review and meta-analysis

Abstract

Klebsiella pneumoniae ( K. pneumoniae ) is a major pathogen involved in nosocomial and community-acquired infections, whose multidrug resistance (MDR) constitutes a public health emergency. Data reporting of antibiotic-resistant K. pneumoniae in healthcare settings in Burkina Faso is often insufficient and poorly documented. This study aimed to estimate, through a meta-analysis, the prevalence of phenotypic and molecular resistance to antibiotics of K. pneumoniae in Burkina Faso. A systematic review and meta-analysis were conducted using studies published between 2015 and 2025, identified through PubMed, African Journals Online, Scopus, and Google Scholar, using specific keywords, following the PRISMA guidelines. Data on resistance to different classes of antibiotics and genetic determinants were extracted. A meta-analysis of proportions using a random effects model was used to estimate the pooled resistance rates. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID: CRD420261290027. The pooled prevalence of resistance in K. pneumoniae was 44% (95% CI: 0.36–0.53). The highest resistance rates were observed to penicillin (85%) and third-generation cephalosporins (50%), while carbapenems remained the most effective class (11%). The molecular analysis revealed that aminoglycoside resistance genes were the most prevalent (53%), driven by aac(3)-IIc (78%) and aac(6’)-Ib (62%) genes. Extended Spectrum Betalactamas (ESBL) genes (34%) were dominated by the bla CTX−M−15 variant (up to 100%). Finally, the emergence of carbapenemases was confirmed by the presence of bla NDM (10%) and bla IMP (25%). Our results indicate a burden of multidrug resistance in K. pneumoniae within Burkina Faso, characterized by the co-occurrence of various genotypic resistance markers. These findings call for a review of empirical treatment protocols and urgent reinforcement of molecular surveillance and hospital hygiene to preserve the last remaining treatment options. Not applicable.