A systematic review of healthcare-associated infections in Africa: An antimicrobial resistance perspective

Abstract

BackgroundHealthcare-associated infection (HCAI) is a global health challenge, not only as an issue of patient safety but also as a major driver of antimicrobial resistance (AMR). It is a major cause of morbidity and mortality with economic consequences.ObjectiveThis review provides an update on the occurrence of HCAI, as well as the contribution of emerging AMR on healthcare delivery in Africa.MethodsWe searched PubMed, Cochrane database, African Journals Online and Google Scholar for relevant articles on HCAI in Africa between 2010 and 2017. Preferred reporting items of systematic reviews and meta-analyses guidelines were followed for selection. Thirty-five eligible articles were considered for the qualitative synthesis.ResultsOf the 35 eligible articles, more than half (n = 21, 60%) were from East Africa. Klebsiella spp., Staphylococcus aureus, Escherichia coli and Pseudomonas spp. were the common pathogens reported in bloodstream infection, (catheter-associated) urinary tract infection, surgical site infection and healthcare-associated pneumonia. Among these various subtypes of HCAI, methicillin-resistant S. aureus (3.9% – 56.8%) and extended-spectrum beta-lactamase producing Gram-negative bacilli (1.9% – 53.0%) were the most reported antimicrobial resistant pathogens.ConclusionThis review shows a paucity of HCAI surveillance in Africa and an emergence of AMR priority pathogens. Hence, there is a need for a coordinated national and regional surveillance of both HCAI and AMR in Africa.

High Contribution and Impact of Resistant Gram Negative Pathogens Causing Surgical Site infections at a Multi-Hospital Healthcare System in Saudi Arabia, 2007-2016

“…Similar to studies done in developed [5,7,14,15] and developing countries [1,28], the most frequent pathogen in the current study was Staphylococcus aureus, a common skin colonizer. For example, it was approximately 23% in the current study compared with 20% to 30% in these studies [1,5,14,15].…”

High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007–2016

“…While it is challenging to compare the distribution of SSI pathogens between different studies covering different surgical procedures, Staphylococcus aureus was the most frequent pathogen in the current study as well as studies done in developed [5,8,9] and developing countries [1,21]. For example, it was approximately 23% in the current study compared with 20 to 30% in these studies [1,5,8,9].…”

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

“…The current studies have reported dramatic increase of antimicrobial resistance especially in resources limited countries [5]. There is a growing body of literature that accents the significance of resistance to antibiotics that are commonly prescribed in lagging countries [6]. Therefore, there is an urgent need to address antimicrobial resistance in developing countries especially in Africa due to the fact that it is being overlooked and yet highly linked high morbidity and mortality [7].…”

“…Therefore, there is an urgent need to address antimicrobial resistance in developing countries especially in Africa due to the fact that it is being overlooked and yet highly linked high morbidity and mortality [7]. A great demand of broad-spectrum agents due to ineffectiveness of certain antibiotics on which specific pathogens have developed resistance [6,8], poses an economic burden on developing countries [7].…”