Infections and antimicrobial resistance in intensive care units in lower-middle-income countries: a scoping review

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Infections and antimicrobial resistance in intensive care units in lower-middle-income countries: a scoping review

Antimicrobial-resistance (AMR) is one of the quickly worsening problems worldwide. It affects all the countries, but the burden is alarmingly higher in lower-middle-income countries (LMICs). Approximately fifty countries belong to the LMIC category sharing the same bracket of Gross National Income, as per the World Bank update.

Individuals admitted to Intensive care units (ICUs) are at higher risk of acquiring infections of antibiotic-resistant strains. In 2007, a survey including ICUs of 75 countries provided insights on the prevalence and outcomes of resistant infections, where only 8 LMICs participated in it. Therefore, the current scoping review presents AMR infections observed in ICUs over a 13-year period (2005-2018) in LMICs.

The rate of ICU-acquired AMR infections was approximately 10% higher in LMICs, and mortality was much higher (33.6%) than in high-income countries (20%). The study identified a continued large gap in knowledge by showing that most LMICs had not produced reports in high impact journals during this period. There is a need to perform surveillance of ICU acquired infections in order to obtain a comprehensive view. Length of ICU stay, group of pathogens, and types of bacteria causing more impact were assessed in the study. The study highlights the importance of a multidisciplinary approach and proper implementation of hospital-acquired infection control policies to prevent AMR in ICUs

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