Review Article

A systematic review of healthcare-associated infections in Africa: An antimicrobial resistance perspective

Emmanuel O. Irek, Adewale A. Amupitan, Temitope O. Obadare, Aaron O. Aboderin
African Journal of Laboratory Medicine | Vol 7, No 2 | a796 | DOI: https://doi.org/10.4102/ajlm.v7i2.796 | © 2018 Emmanuel Oladayo Irek, Adewale Alex Amupitan, Temitope Oyewole Obadare, Aaron Oladipo Aboderin | This work is licensed under CC Attribution 4.0
Submitted: 01 March 2018 | Published: 06 December 2018

About the author(s)

Emmanuel O. Irek, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
Adewale A. Amupitan, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
Temitope O. Obadare, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
Aaron O. Aboderin, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria, and, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria


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Abstract

Background: Healthcare-associated infection (HCAI) is a global health challenge, not only as an issue of patient safety but also as a major driver of antimicrobial resistance (AMR). It is a major cause of morbidity and mortality with economic consequences.

Objective: This review provides an update on the occurrence of HCAI, as well as the contribution of emerging AMR on healthcare delivery in Africa.

Methods: We searched PubMed, Cochrane database, African Journals Online and Google Scholar for relevant articles on HCAI in Africa between 2010 and 2017. Preferred reporting items of systematic reviews and meta-analyses guidelines were followed for selection. Thirty-five eligible articles were considered for the qualitative synthesis.

Results: Of the 35 eligible articles, more than half (n = 21, 60%) were from East Africa. Klebsiella spp., Staphylococcus aureus, Escherichia coli and Pseudomonas spp. were the common pathogens reported in bloodstream infection, (catheter-associated) urinary tract infection, surgical site infection and healthcare-associated pneumonia. Among these various subtypes of HCAI, methicillin-resistant S. aureus (3.9% – 56.8%) and extended-spectrum beta-lactamase producing Gram-negative bacilli (1.9% – 53.0%) were the most reported antimicrobial resistant pathogens.

Conclusion: This review shows a paucity of HCAI surveillance in Africa and an emergence of AMR priority pathogens. Hence, there is a need for a coordinated national and regional surveillance of both HCAI and AMR in Africa.


Keywords

healthcare associated infection; Africa; nosocomial; antimicrobial resistance

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