Carbapenem-resistant Enterobacterales in Lebanon: a systematic review and meta-analysis of prevalence and mechanisms
Year: 2026
Type: study-registration
Study design: Study Protocol
Abstract: Review title: Carbapenem-resistant Enterobacterales in Lebanon: a systematic review and meta-analysis of prevalence and mechanisms Type and method of review: Meta analysis Stage of review at time of this submission: Review ongoing — the protocol has been finalised and the peer-reviewed search prepared; formal screening not yet started. Review question: In Patients with Enterobacterales isolates in Lebanon, what is the effect of Carbapenem resistance and carbapenemase genes (e.g. OXA-48, NDM, KPC) compared with None (prevalence estimate) on Pooled prevalence of carbapenem resistance (primary); distribution of resistance mechanisms (secondary)? Searches: The following sources will be searched: Europe PMC (PubMed, MEDLINE & preprints), PubMed / MEDLINE, Embase, Cochrane CENTRAL, Scopus, Google Scholar. Additional records may be imported from other databases. No date or language restrictions are applied unless otherwise stated. The search strategy underwent peer review (PRESS) before execution. Condition or domain being studied: Patients with Enterobacterales isolates in Lebanon Participants / population: Patients with Enterobacterales isolates in Lebanon Intervention(s), exposure(s): Carbapenem resistance and carbapenemase genes (e.g. OXA-48, NDM, KPC) Comparator(s) / control: None (prevalence estimate) Types of study to be included: Inclusion criteria: Clinical or colonisation Enterobacterales isolates from patients in Lebanon; Carbapenem resistance by standard susceptibility testing and/or carbapenemase genes by molecular methods; Reports prevalence of carbapenem resistance or resistance mechanisms or data allowing its calculation; Cross-sectional or surveillance studies; Full-text article published in English. Exclusion criteria: Environmental, animal or food isolates only; Populations outside Lebanon without separately reported data; Reviews, editorials, letters, case reports or conference abstracts; Overlapping samples (the largest or most recent report is kept) Main outcome(s): Pooled prevalence of carbapenem resistance (primary); distribution of resistance mechanisms (secondary) Data extraction (selection and coding): Two reviewers will independently screen titles/abstracts and full texts, blinded to each other’s decisions, and extract data in duplicate using a standardised, piloted form. Disagreements will be resolved by discussion or a third reviewer. Risk of bias (quality) assessment: The risk of bias of each included study will be assessed independently by two reviewers using a study-design-appropriate tool. Disagreements will be resolved by consensus. Risk of bias in the review itself will be appraised with ROBIS. Strategy for data synthesis: Results will be synthesised narratively. Where studies are sufficiently homogeneous, effect estimates will be pooled in a meta-analysis using a fixed- or random-effects model as indicated by heterogeneity (I²). The certainty of the evidence will be rated using GRADE.
Source: Open Science Framework
Author: Karim Haffar
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225082166