Diop Moustapha, Bassoum Oumar, Ndong Abdourahmane, Wone Fatimata, Ghogomu Tamouh Ajuamendem, Ndoye Maguette, Youbong Tracie, Mbacké Daffé Sokhna Moumy, Radji Romziath Olouwakemi, Gueye Mamadou Wagué, Lakhe Ndeye Aissatou, Fall Bécaye, Ba Papa Samba, Faye Adama
Department of Infectious and Tropical Diseases, Dakar Principal Hospital, Dakar, Senegal.
Health and Development Institute, Cheikh Anta DIOP University, Dakar, Senegal.
BMC Infect Dis. 2025 Feb 28;25(1):292. doi: 10.1186/s12879-025-10562-w.
Multidrug-resistant (MDR) bacteria are a global health threat, notably in low- and middle-income countries. The aim of this review was to estimate the prevalence of multidrug-resistant bacteria in healthcare and community settings in West Africa.
In accordance with PRISMA guidelines, we searched PubMed, CINAHL, African Index Medicus, and other databases for studies published from 2010 onward. Data on MDR bacterial prevalence, study characteristics, and infection types were extracted and analyzed via R software. Subgroup analyses were performed to explore differences in prevalence across infection settings and sample types.
Out of the 5,320 articles identified, 50 studies from 13 West African countries met the inclusion criteria, with the majority from Nigeria (34%) and Ghana (22%). Among the 35,820 bacteria isolated in these studies, gram-negative bacteria (GNB), particularly Escherichia coli and Klebsiella sp., were the most frequently isolated species, accounting for 63.3% of the bacteria. The overall prevalence of MDR bacteria was 59% (95% CI: 48-69%), with significant heterogeneity between studies (I² = 98%, p < 0.001). Subgroup analysis revealed a 7% increase in MDR bacteria prevalence from the first five-year period to the last two five-year periods, and a greater prevalence of MDR bacteria in nosocomial infections (65%, 95% CI: 45-81%) than in community-acquired infections (53%, 95% CI: 31-74%). The prevalence of MDR bacteria in mixed infection settings was 58% (95% CI: 44-71%). The MDR prevalence was highest in the urine samples (72%, 95% CI: 57-84%) and superficial skin samples (69%, 95% CI: 29-92%), whereas it was lowest in the nasopharyngeal samples (26%, 95% CI: 21-33%).
The high prevalence of MDR bacteria in West Africa underscores the need for strengthened infection control measures, improved surveillance, and stricter antibiotic use policies. Enhanced regional collaboration is essential to mitigate the spread of AMR in both healthcare and community settings.
CRD42023470363.
多重耐药（MDR）细菌是全球健康威胁，在低收入和中等收入国家尤为显著。本综述的目的是评估西非医疗保健和社区环境中多重耐药细菌的流行情况。
按照PRISMA指南，我们在PubMed、CINAHL、非洲医学索引及其他数据库中检索了2010年以后发表的研究。通过R软件提取并分析了关于多重耐药细菌流行率、研究特征和感染类型的数据。进行亚组分析以探讨不同感染环境和样本类型中流行率的差异。
在确定的5320篇文章中，来自13个西非国家的50项研究符合纳入标准，其中大多数来自尼日利亚（34%）和加纳（22%）。在这些研究中分离出的35820株细菌中，革兰氏阴性菌（GNB），尤其是大肠杆菌和克雷伯菌属，是最常分离出的菌种，占细菌总数的63.3%。多重耐药细菌的总体流行率为59%（95%置信区间：48 - 69%），研究之间存在显著异质性（I² = 98%，p < 0.001）。亚组分析显示，从第一个五年期到最后两个五年期，多重耐药细菌的流行率增加了7%，医院感染中多重耐药细菌的流行率（65%，95%置信区间：45 - 81%）高于社区获得性感染（53%，95%置信区间：31 - 74%）。混合感染环境中多重耐药细菌的流行率为58%（95%置信区间：44 - 71%）。尿液样本（72%，95%置信区间：57 - 84%）和浅表皮肤样本（69%，95%置信区间：29 - 92%）中多重耐药率最高，而鼻咽样本中最低（26%，95%置信区间：21 - 33%）。
西非多重耐药细菌的高流行率凸显了加强感染控制措施、改善监测和制定更严格抗生素使用政策的必要性。加强区域合作对于减轻医疗保健和社区环境中抗菌药物耐药性的传播至关重要。
PROSPERO注册号：CRD42023470363。
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