Geographical mapping and temporal trends of Acinetobacter baumannii carbapenem resistance: A comprehensive meta-analysis

PLoS One. 2024 Dec 16;19(12):e0311124. doi: 10.1371/journal.pone.0311124. eCollection 2024.

Abstract

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is of critical concern in healthcare settings, leading to limited treatment options. In this study, we conducted a comprehensive meta-analysis to assess the prevalence of CRAB by examining temporal, geographic, and bias-related variations.

Methods: We systematically searched prominent databases, including Scopus, PubMed, Web of Science, and EMBASE. Quality assessment was performed using the JBI checklist. Subgroup analyses were performed based on the COVID-19 timeframes, years, countries, continents, and bias levels, antimicrobial susceptivity test method and guidelines.

Results: Our comprehensive meta-analysis, which included 795 studies across 80 countries from 1995 to 2023, revealed a surge in carbapenem resistance among A. baumannii, imipenem (76.1%), meropenem (73.5%), doripenem (73.0%), ertapenem (83.7%), and carbapenems (74.3%). Temporally, 2020-2023 witnessed significant peaks, particularly in carbapenems (81.0%) and meropenem (80.7%), as confirmed by meta-regression, indicating a steady upward trend.

Conclusion: This meta-analysis revealed an alarmingly high resistance rate to CRAB as a global challenge, emphasizing the urgent need for tailored interventions. Transparency, standardized methodologies, and collaboration are crucial for the accurate assessment and maintenance of carbapenem efficacy.

Publication types

  • Meta-Analysis

MeSH terms

  • Acinetobacter Infections* / drug therapy
  • Acinetobacter Infections* / epidemiology
  • Acinetobacter Infections* / microbiology
  • Acinetobacter baumannii* / drug effects
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • COVID-19 / epidemiology
  • Carbapenems* / pharmacology
  • Carbapenems* / therapeutic use
  • Drug Resistance, Bacterial
  • Geographic Mapping
  • Humans

Substances

  • Carbapenems
  • Anti-Bacterial Agents

Grants and funding

The author(s) received no specific funding for this work.