{Reference Type}: Systematic Review
{Title}: Burden of Antimicrobial Resistance Among Women with Post-Partum Infections in Low-Middle Income Countries: A Systematic Review.
{Author}: Monari C;Onorato L;Coppola N;Raviglione MCB;Gon G;
{Journal}: J Epidemiol Glob Health
{Volume}: 14
{Issue}: 2
{Year}: 2024 Jun 17
{Factor}: 5.959
{DOI}: 10.1007/s44197-024-00222-8
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>OBJECTIVE: </B>description of antimicrobials' prescriptions.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.