SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Drug-resistant enteric fever worldwide, 1990 to 2018: a systematic review and meta-analysis.

Browne, AJ; Kashef Hamadani, BH; Kumaran, EAP; Rao, P; Longbottom, J; Harriss, E; Moore, CE; Dunachie, S; Basnyat, B; Baker, S; et al. Browne, AJ; Kashef Hamadani, BH; Kumaran, EAP; Rao, P; Longbottom, J; Harriss, E; Moore, CE; Dunachie, S; Basnyat, B; Baker, S; Lopez, AD; Day, NPJ; Hay, SI; Dolecek, C (2020) Drug-resistant enteric fever worldwide, 1990 to 2018: a systematic review and meta-analysis. BMC Med, 18 (1). p. 1. ISSN 1741-7015 https://doi.org/10.1186/s12916-019-1443-1
SGUL Authors: Moore, Catrin Elisabeth

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution.

Download (5MB) | Preview
[img] Microsoft Word (.docx) (Additional file 1) Published Version
Available under License Creative Commons Attribution.

Download (6MB)
[img] Archive (ZIP) (Additional file 2) Published Version
Available under License Creative Commons Attribution.

Download (158kB)

Abstract

BACKGROUND: Antimicrobial resistance (AMR) is an increasing threat to global health. There are > 14 million cases of enteric fever every year and > 135,000 deaths. The disease is primarily controlled by antimicrobial treatment, but this is becoming increasingly difficult due to AMR. Our objectives were to assess the prevalence and geographic distribution of AMR in Salmonella enterica serovars Typhi and Paratyphi A infections globally, to evaluate the extent of the problem, and to facilitate the creation of geospatial maps of AMR prevalence to help targeted public health intervention. METHODS: We performed a systematic review of the literature by searching seven databases for studies published between 1990 and 2018. We recategorised isolates to allow the analysis of fluoroquinolone resistance trends over the study period. The prevalence of multidrug resistance (MDR) and fluoroquinolone non-susceptibility (FQNS) in individual studies was illustrated by forest plots, and a random effects meta-analysis was performed, stratified by Global Burden of Disease (GBD) region and 5-year time period. Heterogeneity was assessed using the I2 statistics. We present a descriptive analysis of ceftriaxone and azithromycin resistance. FINDINGS: We identified 4557 articles, of which 384, comprising 124,347 isolates (94,616 S. Typhi and 29,731 S. Paratyphi A) met the pre-specified inclusion criteria. The majority (276/384; 72%) of studies were from South Asia; 40 (10%) articles were identified from Sub-Saharan Africa. With the exception of MDR S. Typhi in South Asia, which declined between 1990 and 2018, and MDR S. Paratyphi A, which remained at low levels, resistance trends worsened for all antimicrobials in all regions. We identified several data gaps in Africa and the Middle East. Incomplete reporting of antimicrobial susceptibility testing (AST) and lack of quality assurance were identified. INTERPRETATION: Drug-resistant enteric fever is widespread in low- and middle-income countries, and the situation is worsening. It is essential that public health and clinical measures, which include improvements in water quality and sanitation, the deployment of S. Typhi vaccination, and an informed choice of treatment are implemented. However, there is no licenced vaccine for S. Paratyphi A. The standardised reporting of AST data and rollout of external quality control assessment are urgently needed to facilitate evidence-based policy and practice. TRIAL REGISTRATION: PROSPERO CRD42018029432.

Item Type: Article
Additional Information: © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Antimicrobial drug resistance, Azithromycin resistance, Ceftriaxone resistance, Drug-resistant infections, ESBL-producing, Enteric fever, Fluoroquinolone resistance, Harmonisation of breakpoints, Meta-analysis, Multidrug resistance, Paratyphoid fever, Prevalence of resistance, Salmonella Paratyphi A, Salmonella Typhi, Typhoid fever, Anti-Bacterial Agents, Azithromycin, Drug Resistance, Bacterial, Global Health, Humans, Paratyphoid Fever, Prevalence, Salmonella paratyphi A, Salmonella typhi, Typhoid Fever, Humans, Salmonella paratyphi A, Salmonella typhi, Paratyphoid Fever, Typhoid Fever, Azithromycin, Anti-Bacterial Agents, Prevalence, Drug Resistance, Bacterial, Global Health, Enteric fever, Typhoid fever, Paratyphoid fever, Salmonella Typhi, Salmonella Paratyphi A, Antimicrobial drug resistance, Harmonisation of breakpoints, Prevalence of resistance, Meta-analysis, Drug-resistant infections, Multidrug resistance, Fluoroquinolone resistance, Ceftriaxone resistance, ESBL-producing, Azithromycin resistance, 11 Medical and Health Sciences, General & Internal Medicine
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: BMC Med
ISSN: 1741-7015
Language: eng
Dates:
DateEvent
3 January 2020Published
2 October 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
AMR - 1704CR001/VP1Department of Health and Social Care, UKUNSPECIFIED
209142/Z/17/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
OPP1176062Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
PubMed ID: 31898501
Web of Science ID: WOS:000513501500001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/114452
Publisher's version: https://doi.org/10.1186/s12916-019-1443-1

Actions (login required)

Edit Item Edit Item