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Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review

BACKGROUND: Antimicrobial resistance (AMR) in urinary tract infections (UTI) is a global public health problem. However, estimates of the prevalence of AMR, required for empirical treatment guidelines, are lacking for many regions. OBJECTIVES: To perform a systematic review and summarize the availab...

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Autores principales: Sugianli, Adhi Kristianto, Ginting, Franciscus, Parwati, Ida, de Jong, Menno D, van Leth, Frank, Schultsz, Constance
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210283/
https://www.ncbi.nlm.nih.gov/pubmed/34223081
http://dx.doi.org/10.1093/jacamr/dlab003
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author Sugianli, Adhi Kristianto
Ginting, Franciscus
Parwati, Ida
de Jong, Menno D
van Leth, Frank
Schultsz, Constance
author_facet Sugianli, Adhi Kristianto
Ginting, Franciscus
Parwati, Ida
de Jong, Menno D
van Leth, Frank
Schultsz, Constance
author_sort Sugianli, Adhi Kristianto
collection PubMed
description BACKGROUND: Antimicrobial resistance (AMR) in urinary tract infections (UTI) is a global public health problem. However, estimates of the prevalence of AMR, required for empirical treatment guidelines, are lacking for many regions. OBJECTIVES: To perform a systematic review and summarize the available information about AMR prevalence among urinary Escherichia coli and Klebsiella pneumoniae, the two priority uropathogens, in the Asia-Pacific region (APAC). METHODS: PubMed, EBSCO and Web of Science databases were searched for articles (2008–20), following PRISMA guidelines. The prevalence of resistance was calculated and reported as point estimate with 95% CI for antimicrobial drugs recommended in WHO treatment guidelines. Data were stratified by country and surveillance approach (laboratory- or population-based surveillance). The quality of included articles was assessed using a modified Newcastle-Ottawa Quality Assessment Scale. RESULTS: Out of 2400 identified articles, 24 studies, reporting on 11 (26.8%) of the 41 APAC countries, met the inclusion criteria. Prevalence of resistance against trimethoprim/sulfamethoxazole, ciprofloxacin, and ceftriaxone ranged between 33% and 90%, with highest prevalence reported from Bangladesh, India, Sri Lanka and Indonesia. Resistance against nitrofurantoin ranged between 2.7% and 31.4%. Two studies reported data on fosfomycin resistance (1.8% and 1.7%). Quality of reporting was moderate. CONCLUSIONS: We show very high prevalence estimates of AMR against antibiotics commonly used for the empirical treatment of UTI, in the limited number of countries in the APAC for which data are available. Novel feasible and affordable approaches that facilitate population-based AMR surveillance are needed to increase knowledge on AMR prevalence across the region.
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spelling pubmed-82102832021-07-02 Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review Sugianli, Adhi Kristianto Ginting, Franciscus Parwati, Ida de Jong, Menno D van Leth, Frank Schultsz, Constance JAC Antimicrob Resist Systematic Review BACKGROUND: Antimicrobial resistance (AMR) in urinary tract infections (UTI) is a global public health problem. However, estimates of the prevalence of AMR, required for empirical treatment guidelines, are lacking for many regions. OBJECTIVES: To perform a systematic review and summarize the available information about AMR prevalence among urinary Escherichia coli and Klebsiella pneumoniae, the two priority uropathogens, in the Asia-Pacific region (APAC). METHODS: PubMed, EBSCO and Web of Science databases were searched for articles (2008–20), following PRISMA guidelines. The prevalence of resistance was calculated and reported as point estimate with 95% CI for antimicrobial drugs recommended in WHO treatment guidelines. Data were stratified by country and surveillance approach (laboratory- or population-based surveillance). The quality of included articles was assessed using a modified Newcastle-Ottawa Quality Assessment Scale. RESULTS: Out of 2400 identified articles, 24 studies, reporting on 11 (26.8%) of the 41 APAC countries, met the inclusion criteria. Prevalence of resistance against trimethoprim/sulfamethoxazole, ciprofloxacin, and ceftriaxone ranged between 33% and 90%, with highest prevalence reported from Bangladesh, India, Sri Lanka and Indonesia. Resistance against nitrofurantoin ranged between 2.7% and 31.4%. Two studies reported data on fosfomycin resistance (1.8% and 1.7%). Quality of reporting was moderate. CONCLUSIONS: We show very high prevalence estimates of AMR against antibiotics commonly used for the empirical treatment of UTI, in the limited number of countries in the APAC for which data are available. Novel feasible and affordable approaches that facilitate population-based AMR surveillance are needed to increase knowledge on AMR prevalence across the region. Oxford University Press 2021-02-27 /pmc/articles/PMC8210283/ /pubmed/34223081 http://dx.doi.org/10.1093/jacamr/dlab003 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Systematic Review
Sugianli, Adhi Kristianto
Ginting, Franciscus
Parwati, Ida
de Jong, Menno D
van Leth, Frank
Schultsz, Constance
Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review
title Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review
title_full Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review
title_fullStr Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review
title_full_unstemmed Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review
title_short Antimicrobial resistance among uropathogens in the Asia-Pacific region: a systematic review
title_sort antimicrobial resistance among uropathogens in the asia-pacific region: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210283/
https://www.ncbi.nlm.nih.gov/pubmed/34223081
http://dx.doi.org/10.1093/jacamr/dlab003
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