Global knowledge, attitudes, and practices towards antimicrobial resistance among healthcare workers: a systematic review and meta-analysis.

IF 4.4 2区 医学 Q1 INFECTIOUS DISEASES
Abdolreza Sotoodeh Jahromi, Negin Namavari, Mohammad Jokar, Nader Sharifi, Samira Soleimanpour, Negin Naserzadeh, Vahid Rahmanian
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引用次数: 0

Abstract

Background: The rising prevalence of antimicrobial resistance (AMR) poses a critical global health challenge. Healthcare workers (HCWs) play a pivotal role in combating AMR by implementing effective preventive strategies and adhering to good practices. This study aimed to evaluate the global knowledge, attitudes, and practices (KAP) of HCWs towards AMR.

Methods: A comprehensive search of PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science, Cochrane Library, and Google Scholar was conducted for English-language articles published up to August 2024. Inclusion criteria were observational studies reporting KAP data among HCWs related to AMR. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. Statistical analyses, including heterogeneity (I² statistic, Cochran Q), were conducted using STATA version 14. Random-effects models were applied for pooled estimates, and subgroup analyses, meta-regression, and sensitivity analyses were performed. Publication bias was assessed via Egger's test and adjusted using the trim-and-fill method. Geographical distribution was analyzed with ArcGIS 10.3 software, and evidence certainty was evaluated using the GRADE framework.

Results: A meta-analysis of 108 studies involving 29,433 HCWs assessed their knowledge of AMR. Additionally, 51 studies with 13,660 HCWs evaluated attitudes, and 43 studies with 10,569 HCWs examined practices regarding AMR. The pooled proportion of HCWs with good knowledge of AMR was 56.5% (95% CI: 50.4-62.6%, I² = 99.5%), with the highest prevalence in Europe (70.3%) and the lowest in the Western Pacific (45.9%). Positive attitudes towards AMR were reported in 60.4% (95% CI: 48.5-72.3%, I² = 99.8%), with the highest prevalence in the Eastern Mediterranean Region (64.5%) and among those with less than five years of experience (77.8%). Good practices were observed in 48.5% (95% CI: 36.5-60.5%, I² = 99.7%), with the highest adherence in Europe (56.6%) and the lowest in Africa (39.1%). Subgroup analysis revealed that younger HCWs (under 30 years) showed better KAP scores across all domains.

Conclusion: The findings underscore the need for targeted interventions to enhance the knowledge, attitudes, and practices of HCWs regarding AMR. Priority should be given to designing and implementing robust training programs tailored to the specific needs of HCWs in resource-constrained settings. Strengthening AMR-related education and practice among HCWs is crucial for combating the global AMR crisis effectively.

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全球卫生保健工作者对抗菌素耐药性的知识、态度和做法:系统回顾和荟萃分析。
背景:抗菌素耐药性(AMR)的日益流行对全球健康构成了严峻的挑战。卫生保健工作者(HCWs)通过实施有效的预防战略和遵守良好做法,在抗击抗生素耐药性方面发挥着关键作用。本研究旨在评估卫生保健工作者对抗生素耐药性的全球知识、态度和实践(KAP)。方法:综合检索PubMed/MEDLINE、ScienceDirect、Scopus、Web of Science、Cochrane Library和谷歌Scholar等网站,检索截止到2024年8月发表的英文文章。纳入标准是报告与AMR相关的医护人员KAP数据的观察性研究。研究质量采用乔安娜布里格斯研究所关键评估清单进行评估。使用STATA version 14进行统计分析,包括异质性(I²统计量,Cochran Q)。采用随机效应模型进行汇总估计,并进行亚组分析、meta回归和敏感性分析。发表偏倚采用Egger检验评估,并采用补齐法进行校正。使用ArcGIS 10.3软件分析地理分布,并使用GRADE框架评估证据确定性。结果:一项涉及29,433名医护人员的108项研究的荟萃分析评估了他们对AMR的认识。此外,51项研究对13660名医护人员进行了态度评估,43项研究对10569名医护人员进行了AMR实践调查。了解AMR的卫生保健工作者的总比例为56.5% (95% CI: 50.4-62.6%, I²= 99.5%),其中欧洲患病率最高(70.3%),西太平洋最低(45.9%)。60.4% (95% CI: 48.5-72.3%, I²= 99.8%)报告了对AMR的积极态度,东地中海地区(64.5%)和经验不足5年的人群(77.8%)的患病率最高。48.5% (95% CI: 36.5-60.5%, I²= 99.7%)观察到良好做法,其中欧洲的依从性最高(56.6%),非洲最低(39.1%)。亚组分析显示,年轻的医护人员(30岁以下)在所有领域都表现出更好的KAP得分。结论:研究结果强调需要有针对性的干预措施,以提高卫生保健工作者对抗菌素耐药性的认识、态度和做法。应优先考虑设计和实施针对资源受限环境下卫生保健工作者具体需求的强有力的培训计划。加强卫生保健工作者与抗微生物药物耐药性相关的教育和实践,对于有效应对全球抗微生物药物耐药性危机至关重要。
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
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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