Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysis

Individuals colonised with extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are at high risk of ESBL-PE infection. Eating a vegetarian diet may influence ESBL-PE gut colonisation due to reduced exposure to contaminated meat. We systematically reviewed studies exploring whether...

Full description

Saved in:
Bibliographic Details
Main Authors: David C Boettiger, Maddison Ord, Parvathy Ananthan, Grace Dennis, James Williams, Shawn Ng, Vanessa E Murphy, Joshua S Davis
Format: Article
Language:English
Published: Elsevier 2024-06-01
Series:CMI Communications
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2950590924000076
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849344440279236608
author David C Boettiger
Maddison Ord
Parvathy Ananthan
Grace Dennis
James Williams
Shawn Ng
Vanessa E Murphy
Joshua S Davis
author_facet David C Boettiger
Maddison Ord
Parvathy Ananthan
Grace Dennis
James Williams
Shawn Ng
Vanessa E Murphy
Joshua S Davis
author_sort David C Boettiger
collection DOAJ
description Individuals colonised with extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are at high risk of ESBL-PE infection. Eating a vegetarian diet may influence ESBL-PE gut colonisation due to reduced exposure to contaminated meat. We systematically reviewed studies exploring whether vegetarian diet is associated with ESBL-PE gut colonisation. Combining terms for ESBL-PE and vegetarian diet we searched Embase, Medline, CINAHL, and Web of Science for studies from January 2000 to July 2023 to identify studies that compare ESBL-PE gut colonisation in vegetarians and non-vegetarians. We estimated a pooled odds ratio (OR) using a random-effects model. We also did subgroup analyses of studies conducted in the general population and in recent travellers and assessed study heterogeneity. We identified 2,471 papers, 14 were included in our meta-analysis (11 recruited from the general population; 3 recruited recent travellers). Overall, included studies provided information on ESBL-PE colonisation for 1,396 vegetarians and 11,411 non-vegetarians. There was moderate heterogeneity in study outcomes overall (I2 = 52.4 %), low heterogeneity among studies in the general population (I2 = 14.7 %), and high heterogeneity among studies in recent travellers (I2 = 81.7 %). Vegetarians had similar odds of ESBL-PE gut colonisation compared with non-vegetarians (pooled OR 1.25, 95 %CI 0.84-1.87). This finding was consistent in studies of the general population (pooled OR 1.30, 95 %CI 0.95-1.79) and in recent travellers (pooled OR 1.27, 95 %CI 0.34-4.73). Vegetarians and non-vegetarians have a similar risk of ESBL-PE gut colonisation. Further studies using a precise definition of vegetarianism which are large enough to adjust for known and potential confounders could add greater certainty to this conclusion.
format Article
id doaj-art-99b4d44cb0cb4779b2584e5d0a67cee7
institution Kabale University
issn 2950-5909
language English
publishDate 2024-06-01
publisher Elsevier
record_format Article
series CMI Communications
spelling doaj-art-99b4d44cb0cb4779b2584e5d0a67cee72025-08-20T03:42:40ZengElsevierCMI Communications2950-59092024-06-011110000710.1016/j.cmicom.2024.100007Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysisDavid C Boettiger0Maddison Ord1Parvathy Ananthan2Grace Dennis3James Williams4Shawn Ng5Vanessa E Murphy6Joshua S Davis7Kirby Institute, University of New South Wales, Sydney, Australia; Corresponding author at: Kirby Institute, UNSW Sydney, Australia.School of Medicine and Public Health, University of Newcastle, Newcastle, AustraliaSchool of Medicine and Public Health, University of Newcastle, Newcastle, AustraliaSchool of Medicine and Public Health, University of Newcastle, Newcastle, AustraliaSchool of Medicine and Public Health, University of Newcastle, Newcastle, AustraliaSchool of Medicine and Public Health, University of Newcastle, Newcastle, AustraliaSchool of Medicine and Public Health, University of Newcastle, Newcastle, AustraliaSchool of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Infection Research Program, Hunter Medical Research Institute, Newcastle, AustraliaIndividuals colonised with extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are at high risk of ESBL-PE infection. Eating a vegetarian diet may influence ESBL-PE gut colonisation due to reduced exposure to contaminated meat. We systematically reviewed studies exploring whether vegetarian diet is associated with ESBL-PE gut colonisation. Combining terms for ESBL-PE and vegetarian diet we searched Embase, Medline, CINAHL, and Web of Science for studies from January 2000 to July 2023 to identify studies that compare ESBL-PE gut colonisation in vegetarians and non-vegetarians. We estimated a pooled odds ratio (OR) using a random-effects model. We also did subgroup analyses of studies conducted in the general population and in recent travellers and assessed study heterogeneity. We identified 2,471 papers, 14 were included in our meta-analysis (11 recruited from the general population; 3 recruited recent travellers). Overall, included studies provided information on ESBL-PE colonisation for 1,396 vegetarians and 11,411 non-vegetarians. There was moderate heterogeneity in study outcomes overall (I2 = 52.4 %), low heterogeneity among studies in the general population (I2 = 14.7 %), and high heterogeneity among studies in recent travellers (I2 = 81.7 %). Vegetarians had similar odds of ESBL-PE gut colonisation compared with non-vegetarians (pooled OR 1.25, 95 %CI 0.84-1.87). This finding was consistent in studies of the general population (pooled OR 1.30, 95 %CI 0.95-1.79) and in recent travellers (pooled OR 1.27, 95 %CI 0.34-4.73). Vegetarians and non-vegetarians have a similar risk of ESBL-PE gut colonisation. Further studies using a precise definition of vegetarianism which are large enough to adjust for known and potential confounders could add greater certainty to this conclusion.http://www.sciencedirect.com/science/article/pii/S2950590924000076Beta-lactamaseEnterobacteriaceaeGutColonisationVegetarian
spellingShingle David C Boettiger
Maddison Ord
Parvathy Ananthan
Grace Dennis
James Williams
Shawn Ng
Vanessa E Murphy
Joshua S Davis
Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysis
CMI Communications
Beta-lactamase
Enterobacteriaceae
Gut
Colonisation
Vegetarian
title Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysis
title_full Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysis
title_fullStr Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysis
title_full_unstemmed Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysis
title_short Gut colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in vegetarians: A systematic review and meta-analysis
title_sort gut colonisation with extended spectrum beta lactamase producing enterobacteriaceae in vegetarians a systematic review and meta analysis
topic Beta-lactamase
Enterobacteriaceae
Gut
Colonisation
Vegetarian
url http://www.sciencedirect.com/science/article/pii/S2950590924000076
work_keys_str_mv AT davidcboettiger gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis
AT maddisonord gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis
AT parvathyananthan gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis
AT gracedennis gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis
AT jameswilliams gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis
AT shawnng gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis
AT vanessaemurphy gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis
AT joshuasdavis gutcolonisationwithextendedspectrumbetalactamaseproducingenterobacteriaceaeinvegetariansasystematicreviewandmetaanalysis