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2022-02-04Zeitschriftenartikel
Antibiotic resistance in hospital-acquired ESKAPE-E infections in low- and lower-middle-income countries: a systematic review and meta-analysis
dc.contributor.authorAyobami, Olaniyi
dc.contributor.authorBrinkwirth, Simon
dc.contributor.authorEckmanns, Tim
dc.contributor.authorMarkwart, Robby
dc.date.accessioned2024-08-27T13:21:53Z
dc.date.available2024-08-27T13:21:53Z
dc.date.issued2022-02-04none
dc.identifier.other10.1080/22221751.2022.2030196
dc.identifier.urihttp://edoc.rki.de/176904/11991
dc.description.abstractAntimicrobial resistance (AMR) and hospital-acquired infections (HAIs) are global health challenges. The burden of antibiotic resistance in HAIs is still unclear in low- and lower-middle-income countries (L-LMICs). This study summarizes recent data on antibiotic resistance in priority HAIs (ESKAPE-E) in L-LMICs and compares them with data from high-income countries (HICs). EMBASE, Web of Science, and Global Index Medicus were searched for studies on AMR patterns in HAIs published from 01/2010 to 10/2020. Random-effects meta-analyses were performed to obtain pooled estimates. In total, 163 eligible studies were included in the review and meta-analysis. The pooled methicillin resistance proportion in Staphylococcus aureus was 48.4% (95% confidence interval [95%CI] 41·7-55·2, n = 80). Pooled carbapenem resistance proportions were high in Gram-negative pathogens: Escherichia coli: 16·6% (95%CI 10·7-23·4, n = 60); Klebsiella pneumoniae: 34·9% (95%CI 24·6-45·9, n = 50); Pseudomonas aeruginosa: 37.1% (95%CI 24·6-45·9, n = 56); Enterobacter spp.: 51·2% (95%CI 27·5-74·7, n = 7); and Acinetobacter baumannii (complex): 72·4% (95%CI 62·1-81·7%, n = 36). A higher resistance proportions were observed for third-generation cephalosporins: Klebsiella pneumoniae: 78·7% (95%CI 71·5-85·2, n = 46); Escherichia coli: 78·5% (95%CI 72·1-84·2%, n = 58); and Enterobacter spp.: 83·5% (95%CI 71·9-92·8, n = 8). We observed a high between-study heterogeneity (I2  >  80%), which could not be explained by our set of moderators. Pooled resistance proportions for Gram-negative pathogens were higher in L-LMICs than regional and national estimates from HICs. Patients in resource-constrained regions are particularly affected by AMR. To combat the high resistance to critical antibiotics in L-LMICs, and bridge disparities in health, it is crucial to strengthen local surveillance and the health systems in general.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectantibiotic resistanceeng
dc.subjecthospital-acquired infectionseng
dc.subjectlow-resource countrieseng
dc.subjecthealth equityeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleAntibiotic resistance in hospital-acquired ESKAPE-E infections in low- and lower-middle-income countries: a systematic review and meta-analysisnone
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/11991-4
dc.type.versionpublishedVersionnone
local.edoc.container-titleEmerging Microbes & Infectionsnone
local.edoc.container-issn2222-1751none
local.edoc.pages9none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://www.tandfonline.com/journals/temi20none
local.edoc.container-publisher-nameTaylor & Francisnone
local.edoc.container-volume11none
local.edoc.container-issue1none
local.edoc.container-reportyear2022none
local.edoc.container-firstpage443none
local.edoc.container-lastpage451none
dc.description.versionPeer Reviewednone

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