LAUSR

OBJECTIVES Maternal colonization by extended-spectrum beta-lactamase (ESBL) producing organisms can transmit such pathogens to the neonates which can result in considerable morbidity. We intended to determine the global prevalence of maternal colonization with ESBL-producing Enterobacteriaceae. METHODS A systematic review of the PubMed, Embase, Scopus, WOS (Web of Science), ProQuest and the grey literature was done. Studies that reported the prevalence of ESBL colonization during pregnancy or post-partum period were included. The prevalence data was grouped by geographical regions. The pooled prevalence with 95% confidence intervals (95% CI) was estimated by meta-analysis using the random-effects model. RESULTS Nineteen studies with reports from 16 countries (7 studies from Africa, one study from South America, two studies from Asia, and nine European studies) that reported data on 7,352 pregnant/postpartum women were included. The pooled prevalence of ESBL colonization was 8% (95% CI, 5 to 10%). The prevalence estimates (95% CIs) were 15% (5% to 24%) in Africa, 6% (4% to 10%) in South America, 5% (4% to 6%) in Asia, and 4% (2% to 5%) in Europe. The pooled prevalence (95% CI) was higher in studies with low risk of bias (10%, 7 to 13%) compared to those with high risk of bias (3%, 2 to 3%). CONCLUSIONS There was heterogeneity regarding ESBL colonization rates in different continents. The pooled prevalence rate was higher in Africa compared to other areas. Given that the highest rate was observed in African studies, considering implementing screening efforts for ESBL colonization during pregnancy may be justified.