The prevalence of antimicrobial drug resistance of non-typhoidal Salmonella in human infections in sub-Saharan Africa: a systematic review and meta-analysis.

IF 4.2 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2024-06-26 DOI:10.1080/14787210.2024.2368989

Yonatan Amir, Muna Omar, Amos Adler, Sereen Abu-Moch, Eric S Donkor, Dani Cohen, Khitam Muhsen

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引用次数: 0

Abstract

Introduction: Non-typhoidal Salmonella (NTS) bacteremia is common in sub-Saharan Africa. We examined the prevalence of antibiotic resistance to fluoroquinolones, third-generation cephalosporins, and multi-drug resistance (MDR) in NTS human isolates from sub-Saharan Africa.

Methods: A systematic review was conducted using a search in Ovid Medline, Embase, and African Index Medicus of publications between 2000 and 2021. A random-effects model meta-analysis was performed using data from 66 studies that included 29,039 NTS blood and 1,065 stool isolates.

Results: The pooled prevalence proportions of MDR were 0.685 (95% CI 0.574-0.778) and 0.214 (0.020-0.785) in blood vs. stool isolates. The corresponding estimates of fluoroquinolones resistance were 0.014 (0.008-0.025) vs. 0.021 (0.012-0.036) and third-generation cephalosporins resistance 0.019 (0.012-0.031) vs. 0.035 (0.006-0.185). Similar results were found for children and adults. Resistance prevalence to these antibiotics in blood isolates increased between 2000-2010 and 2011-2021. The guidelines employed to determine antimicrobial resistance and epidemiological characteristics (e.g. sample size, study duration) correlated with the resistance prevalence.

Conclusions: The prevalence of MDR and resistance to fluoroquinolones and third-generation cephalosporins in NTS in sub-Saharan Africa is alarming.

Expert opinion: Standardized surveillance of antimicrobial drug resistance in NTS in sub-Saharan Africa is warranted to guide healthcare policymaking and antibiotic stewardship programs.

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撒哈拉以南非洲人类感染的非伤寒沙门氏菌的抗菌药物耐药性流行情况：系统回顾和荟萃分析。

导言：非伤寒沙门氏菌（NTS）菌血症在撒哈拉以南非洲地区很常见。我们研究了撒哈拉以南非洲地区的 NTS 人类分离株对氟喹诺酮类、第三代头孢菌素的抗生素耐药性以及多重耐药性 (MDR) 的流行情况：通过在 Ovid Medline、Embase 和 African Index Medicus 中检索 2000 年至 2021 年间的出版物，进行了系统综述。利用来自 66 项研究的数据进行了随机效应模型荟萃分析，这些数据包括 29 039 份 NTS 血液分离物和 1 065 份粪便分离物：血液与粪便分离物中 MDR 的汇总流行比例分别为 0.685（95% CI 0.574-0.778）和 0.214（0.020-0.785）。氟喹诺酮类药物耐药性的相应估计值为 0.014 (0.008-0.025) vs. 0.021 (0.012-0.036)，第三代头孢菌素耐药性的相应估计值为 0.019 (0.012-0.031) vs. 0.035 (0.006-0.185)。儿童和成人的结果相似。2000-2010年和2011-2021年期间，血液分离物对这些抗生素的耐药率有所上升。用于确定抗菌药耐药性的指南和流行病学特征（如样本大小、研究持续时间）与耐药性流行率相关：结论：撒哈拉以南非洲地区 NTS 中 MDR 的流行率以及对氟喹诺酮类和第三代头孢菌素的耐药性令人担忧：专家意见：有必要对撒哈拉以南非洲地区 NTS 的抗菌药物耐药性进行标准化监测，以指导医疗决策和抗生素管理计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.

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