Obadare Temitope O, Adeyemo Adeyemi T, Ibrahim Oluwaseun A, Sule Naheemot O, Adeyemo Mayowa M, Alatise Olusegun I
Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Department of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Afr J Lab Med. 2025 Aug 26;14(1):2816. doi: 10.4102/ajlm.v14i1.2816. eCollection 2025.
Febrile neutropaenia (FN) is an oncology emergency, but there is a paucity of data on it in Africa.
This study aimed to review and aggregate data on FN in the context of antibiotic resistance.
Published original articles between 1991 and 2024 were systematically searched in Google Scholar, PubMed, and African Journals Online databases (grey literature excluded). 'Febrile neutropenia' was combined by Boolean terms 'OR' and 'AND' with individual countries for the searched terms. Data aggregation on bacteria isolates and antibiotics was done using Microsoft Excel.
Of 16 637 articles retrieved, 15 (from nine countries) with 1216 non-duplicate isolates were included in the analyses after exclusion of irrelevant and duplicate articles. There were 57.0% (698/1225) Gram-positive and 43.3% (527/1225) Gram-negative bacteria. Aggregated resistance to antibiotics for Gram-positive bacteria was 71.8% (163/227), for ampicillin, 74.3% (226/304), for cefoxitin, 64.1% (25/39), and 54.0% (47/87) for oxacillin, while that of Gram-negative bacteria was 35.5% (184/519) for ciprofloxacin, 60.6% (168/277) for ceftriaxone, 65.9% (89/135) for cefuroxime, and 38.2% (153/401) for imipenem. had 68.8% (22/32) resistance to oxacillin/methicillin and 10% (1/10) resistance to vancomycin. spp. was 50% (9/18) resistant to quinolones, 75.9% (22/29) resistant to third-generation cephalosporins, and 25.0% (4/16) resistant to carbapenems, while spp. was 85.7% (6/7) resistant to gentamycin.
This review highlighted the paucity of data and the emergence of multidrug resistance in FN in Africa. There is a need for antibiotic-resistance surveillance and antibiotic stewardship to optimise therapy in FN in Africa.
To the best of our knowledge, this is the first systematic review of FN in Africa in the context of available laboratory resources across the African regions.
发热性中性粒细胞减少症（FN）是一种肿瘤急症，但非洲关于它的数据匮乏。
本研究旨在回顾并汇总抗生素耐药背景下的FN数据。
在谷歌学术、PubMed和非洲期刊在线数据库中系统检索1991年至2024年发表的原创文章（排除灰色文献）。“发热性中性粒细胞减少症”与各个国家名称通过布尔逻辑词“OR”和“AND”组合用于检索词。使用Microsoft Excel对细菌分离株和抗生素的数据进行汇总。
在检索到的16637篇文章中，排除不相关和重复文章后，纳入分析的有15篇（来自9个国家），共1216株非重复分离株。革兰氏阳性菌占57.0%（698/1225），革兰氏阴性菌占43.3%（527/1225）。革兰氏阳性菌对抗生素的总体耐药率为：对氨苄西林71.8%（163/227），对头孢西丁74.3%（226/304），对苯唑西林54.0%（47/87）；而革兰氏阴性菌对环丙沙星的耐药率为35.5%（184/519），对头孢曲松60.6%（168/277），对头孢呋辛65.9%（89/135），对亚胺培南38.2%（153/401）。[未提及的细菌名称]对苯唑西林/甲氧西林的耐药率为68.8%（22/32），对万古霉素的耐药率为10%（1/10）。[未提及的细菌名称]对喹诺酮类药物的耐药率为50%（9/18），对第三代头孢菌素的耐药率为75.9%（22/29），对碳青霉烯类药物的耐药率为25.0%（4/16），而[未提及的细菌名称]对庆大霉素的耐药率为85.7%（6/7）。
本综述凸显了非洲FN数据的匮乏以及多重耐药的出现。在非洲，需要进行抗生素耐药监测和抗生素管理以优化FN的治疗。
据我们所知，这是在非洲各地区现有实验室资源背景下对FN进行的首次系统综述。
