Abstract

IREK, Emmanuel O.; AMUPITAN, Adewale A.; OBADARE, Temitope O.  and  ABODERIN, Aaron O.. A systematic review of healthcare-associated infections in Africa: An antimicrobial resistance perspective. Afr. J. Lab. Med. [online]. 2018, vol.7, n.2, pp.1-9. ISSN 2225-2010.  http://dx.doi.org/10.4102/ajlm.v7i2.796.

BACKGROUND: Healthcare-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. OBJECTIVE: This review provides an update on the occurrence of HCAI, as well as the contribution of emerging AMR on healthcare delivery in Africa. METHODS: We 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. RESULTS: Of 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. CONCLUSION: This 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.

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