Jahromi Abdolreza Sotoodeh, Namavari Negin, Jokar Mohammad, Sharifi Nader, Soleimanpour Samira, Naserzadeh Negin, Rahmanian Vahid
Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
School of Medicine, Peymaniye Hospital, Jahrom University of Medical Science, Jahrom, Iran.
Antimicrob Resist Infect Control. 2025 May 13;14(1):47. doi: 10.1186/s13756-025-01562-1.
The rising prevalence of antimicrobial resistance (AMR) poses a critical global health challenge. Healthcare workers (HCWs) play a pivotal role in combating AMR by implementing effective preventive strategies and adhering to good practices. This study aimed to evaluate the global knowledge, attitudes, and practices (KAP) of HCWs towards AMR.
A comprehensive search of PubMed/MEDLINE, ScienceDirect, Scopus, Web of Science, Cochrane Library, and Google Scholar was conducted for English-language articles published up to August 2024. Inclusion criteria were observational studies reporting KAP data among HCWs related to AMR. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. Statistical analyses, including heterogeneity (I² statistic, Cochran Q), were conducted using STATA version 14. Random-effects models were applied for pooled estimates, and subgroup analyses, meta-regression, and sensitivity analyses were performed. Publication bias was assessed via Egger's test and adjusted using the trim-and-fill method. Geographical distribution was analyzed with ArcGIS 10.3 software, and evidence certainty was evaluated using the GRADE framework.
A meta-analysis of 108 studies involving 29,433 HCWs assessed their knowledge of AMR. Additionally, 51 studies with 13,660 HCWs evaluated attitudes, and 43 studies with 10,569 HCWs examined practices regarding AMR. The pooled proportion of HCWs with good knowledge of AMR was 56.5% (95% CI: 50.4-62.6%, I² = 99.5%), with the highest prevalence in Europe (70.3%) and the lowest in the Western Pacific (45.9%). Positive attitudes towards AMR were reported in 60.4% (95% CI: 48.5-72.3%, I² = 99.8%), with the highest prevalence in the Eastern Mediterranean Region (64.5%) and among those with less than five years of experience (77.8%). Good practices were observed in 48.5% (95% CI: 36.5-60.5%, I² = 99.7%), with the highest adherence in Europe (56.6%) and the lowest in Africa (39.1%). Subgroup analysis revealed that younger HCWs (under 30 years) showed better KAP scores across all domains.
The findings underscore the need for targeted interventions to enhance the knowledge, attitudes, and practices of HCWs regarding AMR. Priority should be given to designing and implementing robust training programs tailored to the specific needs of HCWs in resource-constrained settings. Strengthening AMR-related education and practice among HCWs is crucial for combating the global AMR crisis effectively.
抗菌药物耐药性（AMR）的日益流行对全球卫生构成了严峻挑战。医护人员通过实施有效的预防策略和遵循良好做法在对抗AMR中发挥着关键作用。本研究旨在评估医护人员对AMR的全球知识、态度和实践（KAP）。
对PubMed/MEDLINE、ScienceDirect、Scopus、Web of Science、Cochrane图书馆和谷歌学术进行全面检索，以查找截至2024年8月发表的英文文章。纳入标准是报告医护人员中与AMR相关的KAP数据的观察性研究。使用乔安娜·布里格斯研究所的批判性评价清单评估研究质量。使用STATA 14版本进行统计分析，包括异质性（I²统计量、 Cochr an Q）。采用随机效应模型进行合并估计，并进行亚组分析、元回归和敏感性分析。通过Egger检验评估发表偏倚，并使用修剪填充法进行调整。使用ArcGIS 10.3软件分析地理分布，并使用GRADE框架评估证据确定性。
对涉及29433名医护人员的108项研究进行的荟萃分析评估了他们对AMR的知识。此外，对13660名医护人员的51项研究评估了态度，对10569名医护人员的43项研究考察了关于AMR的实践。对AMR有良好知识的医护人员的合并比例为56.5%（95%CI：50.4 - 62.6%，I² = 99.5%），欧洲患病率最高（70.3%），西太平洋地区最低（45.9%）。对AMR持积极态度的报告比例为60.4%（95%CI：48.5 - 72.3%，I² = 99.8%），东地中海地区患病率最高（64.5%），经验少于五年的人群中患病率最高（77.8%）。良好实践的观察比例为48.5%（95%CI：36.5 - 60.5%，I² = 99.7%），欧洲依从性最高（56.6%），非洲最低（39.1%）。亚组分析显示，年轻医护人员（30岁以下）在所有领域的KAP得分更高。
研究结果强调需要有针对性地进行干预，以提高医护人员对AMR的知识、态度和实践。应优先设计和实施针对资源有限环境中医护人员特定需求的强有力培训计划。加强医护人员中与AMR相关的教育和实践对于有效应对全球AMR危机至关重要。
