{"doi":"10.1016/j.jinf.2024.106183","title":"Global antimicrobial resistance and antibiotic use in COVID-19 patients within health facilities: A systematic review and meta-analysis of aggregated participant data","abstract":null,"journal":"Journal of Infection","year":2024,"id":630150,"datarank":0.5983476069846413,"base_score":3.9889840465642745,"endowment":3.9889840465642745,"self_citation_contribution":0.5983476069846413,"citation_network_contribution":0.0,"self_endowment_contribution":0.5983476069846413,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":53,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1632354,"name":"Xiying Li","orcid":null,"position":1,"is_corresponding":false},{"id":1169132,"name":"Shengyue Qiu","orcid":"0000-0002-5170-8397","position":2,"is_corresponding":false},{"id":527262,"name":"Chaojie Liu","orcid":"0000-0003-0877-0424","position":3,"is_corresponding":false},{"id":1098691,"name":"Shanquan Chen","orcid":"0000-0002-4724-4892","position":4,"is_corresponding":false},{"id":1632356,"name":"Haohai Xia","orcid":null,"position":5,"is_corresponding":false},{"id":1632357,"name":"Yingchao Zeng","orcid":null,"position":6,"is_corresponding":false},{"id":262846,"name":"Lin Shi","orcid":"0000-0002-4934-6649","position":7,"is_corresponding":false},{"id":1435278,"name":"Jie Chen","orcid":"0000-0001-7925-3729","position":8,"is_corresponding":false},{"id":1632358,"name":"Jinkun Zheng","orcid":null,"position":9,"is_corresponding":false},{"id":1632359,"name":"Shifang Yang","orcid":null,"position":10,"is_corresponding":false},{"id":1632360,"name":"Guobao Tian","orcid":null,"position":11,"is_corresponding":false},{"id":1063859,"name":"Gordon Liu","orcid":"0000-0002-4261-9683","position":12,"is_corresponding":false},{"id":1632361,"name":"Lianping Yang","orcid":"0000-0001-6201-4318","position":13,"is_corresponding":false},{"id":846634,"name":"Xinyi Yang","orcid":"0000-0002-9020-7261","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Global antimicrobial resistance and antibiotic use in COVID-19 patients within health facilities: A systematic review and meta-analysis of aggregated participant data","abstract":"<h4>Objectives</h4>The COVID-19 pandemic has posed a significant threat to the global healthcare system, presenting a major challenge to antimicrobial stewardship worldwide. This study aimed to provide a comprehensive and up-to-date picture of global antimicrobial resistance (AMR) and antibiotic use in COVID-19 patients.<h4>Methods</h4>We conducted a systematic review to determine the prevalence of AMR and antibiotic usage among COVID-19 patients receiving treatment in healthcare facilities. Our search encompassed the PubMed, Web of Science, Embase, and Scopus databases, spanning studies published from December 2019 to May 2023. We utilized random-effects meta-analysis to assess the prevalence of multidrug-resistant organisms (MDROs) and antibiotic use in COVID-19 patients, aligning with both the WHO's priority list of MDROs and the AWaRe list of antibiotic products. Estimates were stratified by region, country, and country income. Meta-regression models were established to identify predictors of MDRO prevalence and antibiotic use in COVID-19 patients. The study protocol was registered with PROSPERO (CRD 42023449396).<h4>Results</h4>Among the 11,050 studies screened, 173 were included in the review, encompassing a total of 892,312 COVID-19 patients. MDROs were observed in 42.9% (95% CI 31.1-54.5%, I<sup>2</sup> = 99.90%) of COVID-19 patients: 41.0% (95% CI 35.5-46.6%) for carbapenem-resistant organisms (CRO), 19.9% (95% CI 13.4-27.2%) for methicillin-resistant Staphylococcus aureus (MRSA), 24.9% (95% CI 16.7-34.1%) for extended-spectrum beta-lactamase-producing organisms (ESBL), and 22.9% (95% CI 13.0-34.5%) for vancomycin-resistant Enterococcus species (VRE), respectively. Overall, 76.2% (95% CI 69.5-82.9%, I<sup>2</sup> = 99.99%) of COVID-19 patients were treated with antibiotics: 29.6% (95% CI 26.0-33.4%) with \"Watch\" antibiotics, 22.4% (95% CI 18.0-26.7%) with \"Reserve\" antibiotics, and 16.5% (95% CI 13.3-19.7%) with \"Access\" antibiotics. The MDRO prevalence and antibiotic use were significantly higher in low- and middle-income countries than in high-income countries, with the lowest proportion of antibiotic use (60.1% (95% CI 52.1-68.0%)) and MDRO prevalence (29.1% (95% CI 21.8-36.4%)) in North America, the highest MDRO prevalence in the Middle East and North Africa (63.9% (95% CI 46.6-81.2%)), and the highest proportion of antibiotic use in South Asia (92.7% (95% CI 90.4-95.0%)). The meta-regression identified antibiotic use and ICU admission as a significant predictor of higher prevalence of MDROs in COVID-19 patients.<h4>Conclusions</h4>This systematic review offers a comprehensive and current assessment of MDRO prevalence and antibiotic use among COVID-19 patients in healthcare facilities. It underscores the formidable challenge facing global efforts to prevent and control AMR amidst the backdrop of the COVID-19 pandemic. These findings serve as a crucial warning to policymakers, highlighting the urgent need to enhance antimicrobial stewardship strategies to mitigate the risks associated with future pandemics.","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38754635","pmcid":null,"openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.journalofinfection.com/article/S0163-4453(24)00117-8/pdf","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0163445324001178?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0163445324001178?httpAccept=text/plain","host_type":"publisher"}],"fields_of_study":["Humans","Anti-Bacterial Agents","COVID-19","Antimicrobial Stewardship","SARS-CoV-2","Health Facilities","Drug Resistance, Multiple, Bacterial","Global Health","Prevalence","Methicillin-Resistant Staphylococcus aureus"],"mesh_terms":["Humans","Anti-Bacterial Agents","Prevalence","Drug Resistance, Multiple, Bacterial","Health Facilities","Methicillin-Resistant Staphylococcus aureus","Global Health","Antimicrobial Stewardship","COVID-19","SARS-CoV-2"],"keywords":["Antibiotic","Antimicrobial resistance","Global Health","Multidrug-resistant Organisms","Covid-19"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-05T20:35:15.554249Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}