PDF(Pubmed)
Abstract：
BACKGROUND: Due to the rising incidence of multidrug-resistant (MDR) pathogens, especially in Low-Middle-Income Countries (LMIC), post-partum infections represent a significant treatment challenge.
METHODS: We performed a systematic review of the literature from January 2005 to February 2023 to quantify the frequency of maternal post-partum infections due to MDR pathogens in LMICs, focusing on methicillin-resistant Staphylococcus aureus (MRSA) and/or extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales.
OBJECTIVE: description of antimicrobials\' prescriptions.
RESULTS: We included 22 studies with 14,804 total bacterial isolates from 12 countries, mostly from WHO African-Region. Twelve papers described wound- and 10 puerperal-infections. Seven were high-quality articles. Seventeen studies reported data on MRSA, and 18 on ESBL-producing Enterobacterales. Among high-quality studies, MRSA ranged from 9.8% in Ghana to 91.2% in Uganda; ESBL-producing Enterobacterales ranged from 22.8% in Ukraine to 95.2% in Uganda. Nine articles, mostly on C-sections, described different protocols for antibiotic prophylaxis and/or post-partum treatment.
CONCLUSIONS: We described a high burden of post-partum infections caused by MRSA and/or ESBL-producing Enterobacterales in LMICs, but only a few studies met quality standards. There is an urgent need for high-quality studies to better describe the real burden of antimicrobial resistance in low-resource settings and inform policies to contain the spread of multidrug-resistant organisms.
METHODS: We performed a systematic review of the literature from January 2005 to February 2023 to quantify the frequency of maternal post-partum infections due to MDR pathogens in LMICs, focusing on methicillin-resistant Staphylococcus aureus (MRSA) and/or extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales.
OBJECTIVE: description of antimicrobials\' prescriptions.
RESULTS: We included 22 studies with 14,804 total bacterial isolates from 12 countries, mostly from WHO African-Region. Twelve papers described wound- and 10 puerperal-infections. Seven were high-quality articles. Seventeen studies reported data on MRSA, and 18 on ESBL-producing Enterobacterales. Among high-quality studies, MRSA ranged from 9.8% in Ghana to 91.2% in Uganda; ESBL-producing Enterobacterales ranged from 22.8% in Ukraine to 95.2% in Uganda. Nine articles, mostly on C-sections, described different protocols for antibiotic prophylaxis and/or post-partum treatment.
CONCLUSIONS: We described a high burden of post-partum infections caused by MRSA and/or ESBL-producing Enterobacterales in LMICs, but only a few studies met quality standards. There is an urgent need for high-quality studies to better describe the real burden of antimicrobial resistance in low-resource settings and inform policies to contain the spread of multidrug-resistant organisms.
摘要：
背景：由于多药耐药（MDR）病原体的发病率上升，特别是在中低收入国家(LMIC)，产后感染是一个重大的治疗挑战。
方法：我们对2005年1月至2023年2月的文献进行了系统回顾，以量化LMIC中由于MDR病原体引起的产妇产后感染的频率，重点是耐甲氧西林金黄色葡萄球菌（MRSA）和/或产超广谱β-内酰胺酶（ESBL）的肠杆菌。
目的：抗菌药物处方的描述。
结果：我们纳入了22项研究，共有来自12个国家的14,804株细菌。主要来自世卫组织非洲区域。12篇论文描述了伤口和10例产褥期感染。七是高质量的文章。17项研究报告了MRSA的数据，和18在产ESBL肠杆菌上。在高质量的研究中，MRSA的范围从加纳的9.8％到乌干达的91.2％；产生ESBL的肠杆菌的范围从乌克兰的22.8％到乌干达的95.2％。九篇文章,主要是剖腹产，描述了抗生素预防和/或产后治疗的不同方案。
结论：我们描述了在LMIC中由MRSA和/或ESBL产生的肠杆菌引起的产后感染的高负担，但只有少数研究符合质量标准。迫切需要高质量的研究，以更好地描述低资源环境中抗菌素耐药性的实际负担，并为遏制多药耐药生物传播的政策提供信息。
方法：我们对2005年1月至2023年2月的文献进行了系统回顾，以量化LMIC中由于MDR病原体引起的产妇产后感染的频率，重点是耐甲氧西林金黄色葡萄球菌（MRSA）和/或产超广谱β-内酰胺酶（ESBL）的肠杆菌。
目的：抗菌药物处方的描述。
结果：我们纳入了22项研究，共有来自12个国家的14,804株细菌。主要来自世卫组织非洲区域。12篇论文描述了伤口和10例产褥期感染。七是高质量的文章。17项研究报告了MRSA的数据，和18在产ESBL肠杆菌上。在高质量的研究中，MRSA的范围从加纳的9.8％到乌干达的91.2％；产生ESBL的肠杆菌的范围从乌克兰的22.8％到乌干达的95.2％。九篇文章,主要是剖腹产，描述了抗生素预防和/或产后治疗的不同方案。
结论：我们描述了在LMIC中由MRSA和/或ESBL产生的肠杆菌引起的产后感染的高负担，但只有少数研究符合质量标准。迫切需要高质量的研究，以更好地描述低资源环境中抗菌素耐药性的实际负担，并为遏制多药耐药生物传播的政策提供信息。
