Systematic Review and Meta-analysis of Deaths Attributable to Antimicrobial Resistance, Latin America

Emerg Infect Dis. 2023 Nov;29(11):2335-2344. doi: 10.3201/eid2911.230753.

Abstract

Antimicrobial resistance is a pressing global health concern, leading to 4.95 million deaths in 2019. We conducted a systematic review and meta-analysis to assess the lethality attributed to infections caused by multidrug-resistant organisms (MDROs) in Latin America and the Caribbean. A comprehensive search of major databases retrieved relevant studies from 2000-2022. We included 54 observational studies, primarily from Brazil, Argentina, and Colombia. The most commonly studied organism was methicillin-resistant Staphylococcus aureus. The overall unadjusted case fatality rate related to MDROs was 45.0%; higher adjusted lethality was observed in persons infected with MDROs than in those infected with other pathogens (adjusted odds ratio 1.93, 95% CI 1.58-2.37). A higher lethality rate was seen in patients who did not receive appropriate empirical treatment (odds ratio 2.27, 95% CI 1.44-3.56). These findings underscore the increased lethality associated with antimicrobial resistance in Latin America and the Caribbean.

Keywords: Argentina; Brazil; Caribbean region; Colombia; Latin America; antimicrobial resistance; bacteria; lethality; methicillin-resistant Staphylococcus aureus; mortality.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Drug Resistance, Bacterial
  • Gram-Negative Bacteria
  • Humans
  • Latin America / epidemiology
  • Methicillin-Resistant Staphylococcus aureus*

Substances

  • Anti-Bacterial Agents