A systematic review of healthcare-associated infections in Africa : an antimicrobial resistance perspective

• Published in: African journal of laboratory medicine Vol. 7; no. 2; pp. 1 - 9
• Main Authors: Irek, Emmanuel O., Aboderin, Aaron O., Amupitan, Adewale A., Obadare, Temitope O.
• Format: Journal Article
• Language: English
• Published: Cape Town AOSIS 2018; AOSIS (Pty) Ltd; African Society for Laboratory Medicine (Ethiopia)
• Subjects: Africa; Antibiotics; Antimicrobial agents; antimicrobial resistance; CRE bacteria; Developing countries; Disease control; Disease prevention; Drug resistance; Health facilities; healthcare associated infection; Hospitals; Infectious diseases; Internet; LDCs; Low income groups; Medical laboratories; Medical Laboratory Technology; Multidrug resistant organisms; nosocomial; Nosocomial infections; Patient safety; Pneumonia; Review; Staphylococcus infections; Systematic review; Urinary tract infections; Urogenital system; Ventilators; Atlanta Georgia; United States > US; Africa
• ISSN: 2225-2002; 2225-2010; 2225-2010
• DOI: 10.4102/ajlm.v7i2.796

Background: Healthcare-associated infection (HCAI) is a global health challenge, not only as an issue of patient safety but also as a major driver of antimicrobial resistance (AMR). It is a major cause of morbidity and mortality with economic consequences.Objective: This review provides an update on the occurrence of HCAI, as well as the contribution of emerging AMR on healthcare delivery in Africa.Methods: We searched PubMed, Cochrane database, African Journals Online and Google Scholar for relevant articles on HCAI in Africa between 2010 and 2017. Preferred reporting items of systematic reviews and meta-analyses guidelines were followed for selection. Thirtyfive eligible articles were considered for the qualitative synthesis.Results: Of the 35 eligible articles, more than half (n = 21, 60%) were from East Africa. Klebsiella spp., Staphylococcus aureus, Escherichia coli and Pseudomonas spp. were the common pathogens reported in bloodstream infection, (catheter-associated) urinary tract infection, surgical site infection and healthcare-associated pneumonia. Among these various subtypes of HCAI, methicillin-resistant S. aureus (3.9% – 56.8%) and extended-spectrum beta-lactamase producing Gram-negative bacilli (1.9% – 53.0%) were the most reported antimicrobial resistant pathogens.Conclusion: This review shows a paucity of HCAI surveillance in Africa and an emergence of AMR priority pathogens. Hence, there is a need for a coordinated national and regional surveillance of both HCAI and AMR in Africa.