Antimicrobial Resistance in the WHO African Region: A Systematic Literature Review 2016–2020
Laetitia Gahimbare,
Claude Mambo Muvunyi,
Nathalie Aya Kouadio Guessennd,
Jean Pierre Rutanga,
Pierre Gashema,
Walter Fuller,
Ambele Judith Mwamelo,
Sheick Oumar Coulibaly,
Fausta Shakiwa Mosha,
Olga Perovic,
Hassiba Tali-Maamar,
Ali Ahmed Yahaya
Affiliations
Laetitia Gahimbare
World Health Organization Regional Office for Africa Cité du Djoué, Brazzaville P.O. Box 06, Congo
Claude Mambo Muvunyi
AMR Consultants, Kigali P.O. Box 3286, Rwanda
Nathalie Aya Kouadio Guessennd
AMR Consultants, Kigali P.O. Box 3286, Rwanda
Jean Pierre Rutanga
CHU de Québec-Université Laval, L’ Hôtel-Dieu de Québec, Laboratoire de Microbiologie, Québec City, QC G1R 2J6, Canada
Pierre Gashema
Repolicy Research Centre, Kigali P.O. Box 7584, Rwanda
Walter Fuller
World Health Organization Regional Office for Africa Cité du Djoué, Brazzaville P.O. Box 06, Congo
Ambele Judith Mwamelo
World Health Organization Regional Office for Africa Cité du Djoué, Brazzaville P.O. Box 06, Congo
Sheick Oumar Coulibaly
World Health Organization Regional Office for Africa Cité du Djoué, Brazzaville P.O. Box 06, Congo
Fausta Shakiwa Mosha
World Health Organization Regional Office for Africa Cité du Djoué, Brazzaville P.O. Box 06, Congo
Olga Perovic
WHO Collaborating Centre for AMR, National Institute for Communicable Diseases (NICD), a Division of National Health Laboratory Service, Johannesburg 2192, South Africa
Antimicrobial resistance (AMR) is a significant global public health threat. This review presents the most recent in-depth review of the situation of the main AMR types in relation to the most commonly prescribed antibiotics in the World Health Organization (WHO) African Region. Underlying genes of resistance have been analyzed where possible. A search to capture published research data on AMR from articles published between 2016 and 2020 was done using PubMed and Google Scholar, with rigorous inclusion/exclusion criteria. Out of 48003 articles, only 167 were included. Among the tested gram-negative bacteria species, Klebsiella spp. remain the most tested, and generally the most resistant. The highest overall phenotypic resistance for imipenem was reported in E. coli, whereas for meropenem, E. coli and Haemophilus spp. showed an equal resistance proportion at 2.5%. For gram-positive bacteria, Streptococcus pneumoniae displayed high resistance percentages to trimethoprim/sulfamethoxazole (64.3%), oxacillin (32.2%), penicillin (23.2%), and tetracycline (28.3%), whereas Staphylococcus aureus contributed to 22.8% and 10% resistance to penicillin and oxacillin, respectively. This review shows that AMR remains a major public health threat. The present findings will help public health decision-makers in developing efficient preventive strategies and adequate policies for antibiotic stewardship and surveillance in line with the global action plan for AMR.
