Community-Acquired Antimicrobial Resistant Enterobacteriaceae in Central America: A One Health Systematic Review.

Community-acquired antimicrobial resistant Enterobacteriaceae (CA-ARE) are an increasingly important issue around the world. Characterizing the distribution of regionally specific patterns of resistance is important to contextualize and develop locally relevant interventions. This systematic review adopts a One Health framework considering the health of humans, animals, and the environment to describe CA-ARE in Central America. Twenty studies were identified that focused on antimicrobial resistance (AMR) in Enterobacteriaceae. Studies on CA-ARE in Central America characterized resistance from diverse sources, including humans ( = 12), animals ( = 4), the environment ( = 2), and combinations of these categories ( = 2). A limited number of studies assessed prevalence of clinically important AMR, including carbapenem resistance ( = 3), third generation cephalosporin resistance ( = 7), colistin resistance ( = 2), extended spectrum beta-lactamase (ESBL) production ( = 4), or multidrug resistance ( = 4). This review highlights significant gaps in our current understanding of CA-ARE in Central America, most notably a general dearth of research, which requires increased investment and research on CA-ARE as well as AMR more broadly.