Antimicrobial resistance in community-acquired enteric pathogens amongst children ≤10-years in low- and middle-income countries: a systematic review and meta-analysis

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cg.authorship.typesCGIAR and developing country instituteen
cg.authorship.typesCGIAR and advanced research instituteen
cg.contributor.affiliationInternational Livestock Research Instituteen
cg.contributor.affiliationKenyatta Universityen
cg.contributor.affiliationUniversity of Liverpoolen
cg.contributor.affiliationUniversity of Copenhagenen
cg.contributor.affiliationLondon School of Hygiene and Tropical Medicineen
cg.contributor.donorGates Foundationen
cg.contributor.donorForeign, Commonwealth and Development Office, United Kingdomen
cg.contributor.donorCGIAR Trust Funden
cg.contributor.initiativeOne Healthen
cg.coverage.countryKenyaen
cg.coverage.iso3166-alpha2KEen
cg.coverage.regionAfricaen
cg.coverage.regionEastern Africaen
cg.creator.identifierOkumu Noah: 0000-0002-5984-6444en
cg.creator.identifierDishon Muloi: 0000-0002-6236-2280en
cg.creator.identifierArshnee Moodley: 0000-0002-6469-3948en
cg.creator.identifierJoseph O. Wasonga: 0000-0003-4576-0233en
cg.creator.identifierLorren Alumasa: 0000-0002-1723-0510en
cg.creator.identifierElizabeth Cook: 0000-0001-6081-8363en
cg.howPublishedFormally Publisheden
cg.identifier.doihttps://doi.org/10.3389/fmicb.2025.1539160en
cg.isijournalISI Journalen
cg.issn1664-302Xen
cg.journalFrontiers in Microbiologyen
cg.reviewStatusPeer Reviewen
cg.subject.actionAreaResilient Agrifood Systemsen
cg.subject.ilriAMRen
cg.subject.ilriHUMAN HEALTHen
cg.subject.impactAreaNutrition, health and food securityen
cg.subject.sdgSDG 3 - Good health and well-beingen
cg.volume16en
dc.contributor.authorOkumu, Noah O.en
dc.contributor.authorMuloi, Dishon M.en
dc.contributor.authorMoodley, Arshneeen
dc.contributor.authorWatson, J.en
dc.contributor.authorKiarie, Aliceen
dc.contributor.authorOchieng, Linneten
dc.contributor.authorWasonga, Joseph O.en
dc.contributor.authorMutisya, Christineen
dc.contributor.authorAlumasa, Lorrenen
dc.contributor.authorNgeranwa, J.J.N.en
dc.contributor.authorCumming, O.en
dc.contributor.authorCook, Elizabeth A.J.en
dc.date.accessioned2025-04-29T06:33:50Zen
dc.date.available2025-04-29T06:33:50Zen
dc.identifier.urihttps://hdl.handle.net/10568/174364
dc.titleAntimicrobial resistance in community-acquired enteric pathogens amongst children ≤10-years in low- and middle-income countries: a systematic review and meta-analysisen
dcterms.abstractIntroduction: Antimicrobial resistance (AMR) is a global health priority. This systematic review summarizes the prevalence of AMR in enteric pathogens originating from the community, specifically among ≤10-year-old children in low-and middle-income countries (LMICs). In addition, it presents the proportions of pooled resistance in <i>Campylobacter</i> spp., <i>Escherichia coli</i>, <i>Shigella</i> spp., and <i>Salmonella</i> spp. (CESS) to clinically relevant antibiotics. Methods: Six online repositories, namely PubMed, Medline, Web of Science, Cochrane Library, CABI, and EMBASE were searched for articles published between January 2005 and September 2024. Random-effects meta-analysis models were constructed to estimate the pooled AMR proportions for CESS pathogens, and a subgroup analysis by region was also carried out. Results: A total of 64 publications from 23 LMICs met our inclusion criteria. The pooled estimates of <i>E. coli</i> AMR for clinically important antibiotics were as follows: sulfamethoxazole/trimethoprim (SXT) 71% [95%CI: 57–82%]; ampicillin (AMP) 56% [95%CI: 44–67%]; ciprofloxacin (CIP) 10% [95%CI: 5–20%]; and ceftriaxone (CRO) 8% [95%CI: 2–31%]. The proportions of AMR detected in <i>Shigella</i> spp. were AMP 76% [95%CI: 60–87%]; nalidixic acid (NA) 9% [95%CI: 2–31%]; CIP 3% [95%CI: 0–15%]; and CRO 2% [95%CI: 0–19%]. The proportions of <i>Salmonella</i> spp. AMR were AMP 55% [95%CI: 35–73%] and SXT 25% [95%CI: 15–38%]. The proportions of <i>Campylobacter</i> spp. AMR were erythromycin (ERY) 33% [95%CI: 12–64%] and CIP 27% [95%CI: 8–61%]. There was high variability in the regional subgroup analysis, with high interstudy and regional heterogeneity I2 ≥ 75%. Conclusion: Our results shed light on drug-resistant enteric bacterial pathogens in young children, providing evidence that CESS pathogens are becoming increasingly resistant to clinically important antimicrobials. Regional differences in resistance patterns between these community isolates highlight the need for strong national and regional surveillance to detect regional variations and inform treatment and appropriate antibiotic stewardship programs. The limitations of our findings include high regional variability, significant interstudy heterogeneity, and underrepresentation of certain LMICs.en
dcterms.accessRightsOpen Accessen
dcterms.audienceAcademicsen
dcterms.audienceScientistsen
dcterms.available2025-04-28en
dcterms.bibliographicCitationOkumu, N.O., Muloi, D.M., Moodley, A., Watson, J., Kiarie, A., Ochieng, L., Wasonga, J.O., Mutisya, C., Alumasa, L., Ngeranwa, J.J.N., Cumming, O. and Cook, E.A.J. 2025. Antimicrobial resistance in community-acquired enteric pathogens amongst children ≤10-years in low- and middle-income countries: a systematic review and meta-analysis. Frontiers in Microbiology 16: 1539160.en
dcterms.extent1539160en
dcterms.issued2025-04-28en
dcterms.languageenen
dcterms.licenseCC-BY-4.0en
dcterms.publisherFrontiers Mediaen
dcterms.subjectantimicrobial resistanceen
dcterms.subjectchildrenen
dcterms.subjecthealthen
dcterms.typeJournal Articleen

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