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Cited by 23Antibiotic Resistance in BacteriaAntibiotic Use and ResistanceInfections and bacterial resistance

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Antibiotic-Resistant Acinetobacter baumannii in Low-Income Countries (2000–2020): Twenty-One Years and Still below the Radar, Is It Not There or Can They Not Afford to Look for It?

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Rizk, Soha S., Elwakil, Wafaa H., Attia, Ahmed S.·2021·Antibiotics
DOI 10.3390/antibiotics10070764PMC PMC8300836
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Abstract

Acinetobacter baumannii is an emerging pathogen, and over the last three decades it has proven to be particularly difficult to treat by healthcare services. It is now regarded as a formidable infectious agent with a genetic setup for prompt development of resistance to most of the available antimicrobial agents. Yet, it is noticed that there is a gap in the literature covering this pathogen especially in countries with limited resources. In this review, we provide a comprehensive updated overview of the available data about A. baumannii, the multi-drug resistant (MDR) phenotype spread, carbapenem-resistance, and the associated genetic resistance determinants in low-income countries (LIICs) since the beginning of the 21st century. The coverage included three major databases; PubMed, Scopus, and Web of Science. Only 52 studies were found to be relevant covering only 18 out of the 29 countries included in the LIC group. Studies about two countries, Syria and Ethiopia, contributed ~40% of the studies. Overall, the survey revealed a wide spread of MDR and alarming carbapenem-resistance profiles. Yet, the total number of studies is still very low compared to those reported about countries with larger economies. Accordingly, a discussion about possible reasons and recommendations to address the issue is presented. In conclusion, our analyses indicated that the reported studies of A. baumannii in the LICs is far below the expected numbers based on the prevailing circumstances in these countries. Lack of proper surveillance systems due to inadequate financial resources could be a major contributor to these findings.

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Figure 1 Flow diagram of the search strategy and selection of articles adopted in the current review. The databases were searched in the order (PubMed, Scopus, and Web of Science). Accordingly, articles found in the subsequent database(s) were considered a repeat and excluded.
Figure 1 Flow diagram of the search strategy and selection of articles adopted in the current review. The databases were searched in the order (PubMed, Scopus, and Web of Science). Accordingly, articles found in the subsequent database(s) were considered a repeat and excluded.CC BY · PubMed Central
Figure 2 Reports of A. baumannii infections in LICs in Sub-Saharan Africa from 2000 to 2020. A geographical map of the Sub-Saharan Africa region highlighting the numbers of reports about A. baumannii infections in the 21 first years of the 21st century. The map was generated using the MapChart web tool (https://mapchart.net/, accessed on 21 June 2021).
Figure 2 Reports of A. baumannii infections in LICs in Sub-Saharan Africa from 2000 to 2020. A geographical map of the Sub-Saharan Africa region highlighting the numbers of reports about A. baumannii infections in the 21 first years of the 21st century. The map was generated using the MapChart web tool (https://mapchart.net/, accessed on 21 June 2021).CC BY · PubMed Central
Figure 3 A heatmap of the distribution of the number of the publications about A. baumannii in LICs in the first 21 years of the 21st century. The heatmap was generated using GraphPad Prism v9 (GraphPad Software, San Diego, CA, USA).
Figure 3 A heatmap of the distribution of the number of the publications about A. baumannii in LICs in the first 21 years of the 21st century. The heatmap was generated using GraphPad Prism v9 (GraphPad Software, San Diego, CA, USA).CC BY · PubMed Central
Figure 4 Pie charts of the contributions of the different LICs to the total number of MDR (A) and the CRAB (B) strains included in the reports analyzed in the current review. The percentages were calculated by dividing the number of strains reported in each category in the respective studies divided by the total number of MDR (n = 534) and CRAB (n = 468) strains. The charts were generated using GraphPad Prism v9 (GraphPad Software, San Diego, CA, USA).
Figure 4 Pie charts of the contributions of the different LICs to the total number of MDR (A) and the CRAB (B) strains included in the reports analyzed in the current review. The percentages were calculated by dividing the number of strains reported in each category in the respective studies divided by the total number of MDR (n = 534) and CRAB (n = 468) strains. The charts were generated using GraphPad Prism v9 (GraphPad Software, San Diego, CA, USA).CC BY · PubMed Central

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Cited by

Metadata

Authors
Rizk, S. S., Elwakil, W. H., & Attia, A. S.
Affiliations
Cairo University (EG)
Corresponding author
Attia, Ahmed S.
ORCID
Venue
Antibiotics
Publisher
MDPI AG
Published
2021-06-23
Volume
10
Issue
7
Pages
764
ISSN
2079-6382 (ISSN-L)
DOI
10.3390/antibiotics10070764
PMC
PMC8300836
OpenAlex
W3176707455
Cited by
23
References
0
Citations by year
2026: 5 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 4
FWCI
0.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Antibiotics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Microbiology (medical) › Infections and bacterial resistance
Keywords
Acinetobacter baumannii, antibiotic resistance, multidrug resistance, carbapenem resistance, low-income countries, antimicrobial resistance surveillance, resistance determinants, emerging pathogens

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