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Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis

BACKGROUND: Antimicrobial resistance (AMR) is widely acknowledged as a global health problem, yet in many parts of the world its magnitude is not well elucidated. A baseline assessment of the AMR prevalence is a priority for implementation of laboratory-based AMR surveillance This review, focused on...

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Autores principales: Mouiche, Mohamed Moctar Mouliom, Moffo, Frédéric, Akoachere, Jane-Francis Tatah Kihla, Okah-Nnane, Ndode Herman, Mapiefou, Nabilah Pemi, Ndze, Valantine Ngum, Wade, Abel, Djuikwo-Teukeng, Félicité Flore, Toghoua, Dorine Godelive Tseuko, Zambou, Henri René, Feussom, Jean Marc Kameni, LeBreton, Matthew, Awah-Ndukum, Julius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700798/
https://www.ncbi.nlm.nih.gov/pubmed/31426792
http://dx.doi.org/10.1186/s12889-019-7450-5
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author Mouiche, Mohamed Moctar Mouliom
Moffo, Frédéric
Akoachere, Jane-Francis Tatah Kihla
Okah-Nnane, Ndode Herman
Mapiefou, Nabilah Pemi
Ndze, Valantine Ngum
Wade, Abel
Djuikwo-Teukeng, Félicité Flore
Toghoua, Dorine Godelive Tseuko
Zambou, Henri René
Feussom, Jean Marc Kameni
LeBreton, Matthew
Awah-Ndukum, Julius
author_facet Mouiche, Mohamed Moctar Mouliom
Moffo, Frédéric
Akoachere, Jane-Francis Tatah Kihla
Okah-Nnane, Ndode Herman
Mapiefou, Nabilah Pemi
Ndze, Valantine Ngum
Wade, Abel
Djuikwo-Teukeng, Félicité Flore
Toghoua, Dorine Godelive Tseuko
Zambou, Henri René
Feussom, Jean Marc Kameni
LeBreton, Matthew
Awah-Ndukum, Julius
author_sort Mouiche, Mohamed Moctar Mouliom
collection PubMed
description BACKGROUND: Antimicrobial resistance (AMR) is widely acknowledged as a global health problem, yet in many parts of the world its magnitude is not well elucidated. A baseline assessment of the AMR prevalence is a priority for implementation of laboratory-based AMR surveillance This review, focused on a One health approach, aimed at describing the current status of AMR in Cameroon. METHODS: PubMed, Google Scholar and African Journals Online databases were searched for articles published in English and French in accordance with the PRISMA guidelines. Retrieval and screening of article was done using a structured search string with strict inclusion/exclusion criteria. Free-text and grey literature were obtained by contacting the authors directly. The pooled prevalence and 95% confidence intervals were calculated for each pathogen–antibiotic pairs using random-effects models. RESULT: Amongst 97 full-text articles reviewed, 66 met the eligibility criteria. The studies originated from the Centre (24; 36.4%), South-West (16; 24.2%), West (13; 19.7%), Littoral (9; 13.6%) and other (4; 6.1%) regions of Cameroon. These studies reported AMR in human (45; 68.2%), animals (9; 13.6%) and the environment (12; 18.2%). Overall, 19 species of bacteria were tested against 48 antibiotics. These organisms were resistant to all classes of antibiotics and showed high levels of multidrug resistance. Escherichia coli, Klebsiella pneumoniae and Staphylococcus spp were reported in 23, 19 and 18 of the human studies and revealed multidrug resistance (MDR) rates of 47.1% [95% CI (37.3–57.2%)], 51.0% [95% CI (42.0–59.9)] and 45.2% [95% CI (38.0–54.7)], respectively. Salmonella spp was reported in 6 of the animal studies and showed a MDR rate of 46.2% [95% CI (39.2–53.5%)] while Staphylococcus spp in 8 of environment studies showed MDR rate of 67.1% [95% CI (55.2–77.2%)]. CONCLUSION: This review shows that resistance to commonly prescribed antibiotics in Cameroon is high. The findings emphasize the urgent need to address gaps in the standardization of AMR diagnostics, reporting and use of available information to optimize treatment guidelines for the arsenal of antibiotics. Effective AMR surveillance through continued data sharing, large-scale collaboration, and coordination of all stakeholders is essential to understand and manage the AMR national burden.
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spelling pubmed-67007982019-08-26 Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis Mouiche, Mohamed Moctar Mouliom Moffo, Frédéric Akoachere, Jane-Francis Tatah Kihla Okah-Nnane, Ndode Herman Mapiefou, Nabilah Pemi Ndze, Valantine Ngum Wade, Abel Djuikwo-Teukeng, Félicité Flore Toghoua, Dorine Godelive Tseuko Zambou, Henri René Feussom, Jean Marc Kameni LeBreton, Matthew Awah-Ndukum, Julius BMC Public Health Research Article BACKGROUND: Antimicrobial resistance (AMR) is widely acknowledged as a global health problem, yet in many parts of the world its magnitude is not well elucidated. A baseline assessment of the AMR prevalence is a priority for implementation of laboratory-based AMR surveillance This review, focused on a One health approach, aimed at describing the current status of AMR in Cameroon. METHODS: PubMed, Google Scholar and African Journals Online databases were searched for articles published in English and French in accordance with the PRISMA guidelines. Retrieval and screening of article was done using a structured search string with strict inclusion/exclusion criteria. Free-text and grey literature were obtained by contacting the authors directly. The pooled prevalence and 95% confidence intervals were calculated for each pathogen–antibiotic pairs using random-effects models. RESULT: Amongst 97 full-text articles reviewed, 66 met the eligibility criteria. The studies originated from the Centre (24; 36.4%), South-West (16; 24.2%), West (13; 19.7%), Littoral (9; 13.6%) and other (4; 6.1%) regions of Cameroon. These studies reported AMR in human (45; 68.2%), animals (9; 13.6%) and the environment (12; 18.2%). Overall, 19 species of bacteria were tested against 48 antibiotics. These organisms were resistant to all classes of antibiotics and showed high levels of multidrug resistance. Escherichia coli, Klebsiella pneumoniae and Staphylococcus spp were reported in 23, 19 and 18 of the human studies and revealed multidrug resistance (MDR) rates of 47.1% [95% CI (37.3–57.2%)], 51.0% [95% CI (42.0–59.9)] and 45.2% [95% CI (38.0–54.7)], respectively. Salmonella spp was reported in 6 of the animal studies and showed a MDR rate of 46.2% [95% CI (39.2–53.5%)] while Staphylococcus spp in 8 of environment studies showed MDR rate of 67.1% [95% CI (55.2–77.2%)]. CONCLUSION: This review shows that resistance to commonly prescribed antibiotics in Cameroon is high. The findings emphasize the urgent need to address gaps in the standardization of AMR diagnostics, reporting and use of available information to optimize treatment guidelines for the arsenal of antibiotics. Effective AMR surveillance through continued data sharing, large-scale collaboration, and coordination of all stakeholders is essential to understand and manage the AMR national burden. BioMed Central 2019-08-19 /pmc/articles/PMC6700798/ /pubmed/31426792 http://dx.doi.org/10.1186/s12889-019-7450-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Mouiche, Mohamed Moctar Mouliom
Moffo, Frédéric
Akoachere, Jane-Francis Tatah Kihla
Okah-Nnane, Ndode Herman
Mapiefou, Nabilah Pemi
Ndze, Valantine Ngum
Wade, Abel
Djuikwo-Teukeng, Félicité Flore
Toghoua, Dorine Godelive Tseuko
Zambou, Henri René
Feussom, Jean Marc Kameni
LeBreton, Matthew
Awah-Ndukum, Julius
Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis
title Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis
title_full Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis
title_fullStr Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis
title_full_unstemmed Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis
title_short Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis
title_sort antimicrobial resistance from a one health perspective in cameroon: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700798/
https://www.ncbi.nlm.nih.gov/pubmed/31426792
http://dx.doi.org/10.1186/s12889-019-7450-5
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