LAUSR

The emergence and spread of extended‐spectrum beta‐lactamase producing Enterobacteriaceae (ESBL‐PE) are complex and of the public health concern across the globe. This review aimed at assessing the ESBL‐PE clones circulating in humans, animals and the environment to provide evidence‐based insights for combating ESBL‐PE using One Health approach. Systematic search from Medline/PubMed, Google Scholar and African Journals Online was carried out and retrieved nine eligible articles (of 131) based on phenotypic and genotypic detection of ESBL‐PE between 2005 and 2016 in Tanzania. Analysis was performed using STATA 11.0 software to delineate the prevalence of ESBL‐PE, phenotypic resistance profiles and clones circulating in the three interfaces. The overall prevalence of ESBL‐PE in the three interfaces was 22.6% (95% CI: 21.1–24.2) with the predominance of Escherichia coli (E. coli) strains (51.6%). The majority of ESBL‐PE were resistant to the commonly used antimicrobials such as trimethoprim–sulfamethoxazole and tetracycline/doxycycline, 38%–55% were resistant to ciprofloxacin and all were sensitive to meropenem/imipenem. ESBL‐PE infections were more associated with deaths compared to non‐ESBL‐PE infections. Strikingly, E. coli ST38, ST131 and ST2852 were found to intersect variably across the three interfaces. The predominant allele, blaCTX‐M‐15, was found mostly in the conjugative IncF plasmids connoting transmission potential. The high prevalence of ESBL‐PE and shared clones across the three interfaces, including the global E. coli ST131 clone, indicates wide and inter‐compartmental spread that calls for One Health genomic‐driven studies to track the resistome flow.