Burden of Antimicrobial Resistance Among Women with Post-Partum Infections in Low-Middle Income Countries: A Systematic Review.

Journal: Journal of epidemiology and global health

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Affiliated Institutions:  Infectious Diseases Unit, AOU Luigi Vanvitelli, Naples, Italy. Section of Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni , , Naples, Italy. Section of Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni , , Naples, Italy. nicola.coppola@unicampania.it. MACH Centre, University of Milan, Milan, Italy. Department of Infectious Disease Epidemiology, London School Hygiene and Tropical Medicine, London, UK.

Abstract summary 

Due to the rising incidence of multidrug-resistant (MDR) pathogens, especially in Low-Middle-Income Countries (LMIC), post-partum infections represent a significant treatment challenge.We performed a systematic review of the literature from January 2005 to February 2023 to quantify the frequency of maternal post-partum infections due to MDR pathogens in LMICs, focusing on methicillin-resistant Staphylococcus aureus (MRSA) and/or extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales.description of antimicrobials' prescriptions.We included 22 studies with 14,804 total bacterial isolates from 12 countries, mostly from WHO African-Region. Twelve papers described wound- and 10 puerperal-infections. Seven were high-quality articles. Seventeen studies reported data on MRSA, and 18 on ESBL-producing Enterobacterales. Among high-quality studies, MRSA ranged from 9.8% in Ghana to 91.2% in Uganda; ESBL-producing Enterobacterales ranged from 22.8% in Ukraine to 95.2% in Uganda. Nine articles, mostly on C-sections, described different protocols for antibiotic prophylaxis and/or post-partum treatment.We described a high burden of post-partum infections caused by MRSA and/or ESBL-producing Enterobacterales in LMICs, but only a few studies met quality standards. There is an urgent need for high-quality studies to better describe the real burden of antimicrobial resistance in low-resource settings and inform policies to contain the spread of multidrug-resistant organisms.

Authors & Co-authors:  Monari Caterina C Onorato Lorenzo L Coppola Nicola N Raviglione Mario C B MCB Gon Giorgia G

Study Outcome 

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Citations :  Say L, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33. https://doi.org/10.1016/S2214-109X(14)70227-X .
Authors :  5
Identifiers
Doi : 10.1007/s44197-024-00222-8
SSN : 2210-6014
Study Population
Women
Mesh Terms
Other Terms
ESBL;Low-middle-income countries;MDRO;MRSA
Study Design
Study Approach
Systemic Review
Country of Study
Uganda
Publication Country
Switzerland