Antimicrobial resistance in Africa: A retrospective analysis of data from 14 countries, 2016–2019

作者：Gilbert Osena, Geetanjali Kapoor, Erta Kalanxhi, Timothée Ouassa, Edwin Shumba, Sehr Brar, Yewande Alimi, Manuel Moreira, Martin Matu, Abdourahmane Sow, Eili Klein, Pascale Ondoa, Ramanan Laxminarayan, the MAAP Study Group · 发表于：PLoS Medicine · 年份：2025 · DOI：10.1371/journal.pmed.1004638 · 被引用次数：25 · 研究领域：Antibiotic Use and Resistance、Antibiotic Resistance in Bacteria、Pharmaceutical and Antibiotic Environmental Impacts

BACKGROUND: Antimicrobial resistance (AMR) is a major global health issue that exacerbates the burden of infectious diseases and healthcare costs. However, the scarcity of national-level AMR data in African countries hampers our understanding of its scale and contributing factors in the region. To gain insights into AMR prevalence in Africa, we collected and analyzed retrospective AMR data from 14 countries. METHODS AND FINDINGS: We estimated bacterial AMR prevalence, defined as the proportion of resistant human isolates tested from antimicrobial susceptibility (AST) data collected retrospectively for 2016-2019 from 205 laboratories across 14 African countries. We generated 95% confidence intervals (CIs) for aggregated AMR estimates to account for data quality disparities across countries; the median data quality score was 73.1%, ranging from 56.4% to 80.8%. We assessed 819,584 culture records covering 9,266 pathogen-drug combinations, of which 187,832 (22.9%) were positive cultures with AST results. The most frequently cultured specimens were urine (32.0%) and purulent samples (28.1%), and the most frequently isolated pathogens were Escherichia coli (22.2%) and Staphylococcus aureus (15.0%). Aggregated AMR estimates did not change significantly across the years studied (p > 0.337); however, there were significant variations in AMR prevalence estimates in culture-positive samples across countries, regions, patient departments (inpatient/outpatient), and specimen sources (p < ...