A meta- analysis of antibiotic resistance prevalence among hospital and community- acquired infections

Abstract

Antibiotic resistance and prevalence of hospital (HAI) and community-acquired (CAI) infections are significantly increasing in the world, though very few studies are addressing this topic in Lebanon. Therefore, this meta-analysis aims to identify antibiotic (AB) resistance prevalence among hospital and community acquired infections. Literature databases were searched for antibiotic resistance, HAI, and CAI in Lebanon from 2010 to 2020. To be eligible for inclusion, studies had to report data in Lebanon published between 2010 and 2020, antibiotic resistance in microorganisms responsible for either HAI or CAI. Consequently, data published out of this time frame, other than Lebanese population, and consortiums were excluded. Thus, sixty-six articles were identified at first, from which six articles were duplicates, and 46 studies excluded. Following full-text assessment, only seven studies were included and used to compile the metadata. Data were analyzed using Review Manager (Cochran RevMan) with the random effects-model for dichotomous data, Mantel-Haenszel, and 95% CI. Antibiotic resistance was more prevalent (p˂0.00001) in HAI than CAI. Gram-positive and gram-negative bacteria showed significant (p˂0.0001) resistance to AB. However, analysis of microorganisms’ sensitivity to multiple antibiotics was significant (p<0.00001) despite the high heterogeneity (I2=98%) of the data. Our results indicate that antibiotic resistance is more prevalent in HAI compared to CAI. Gram-negative and gram-positive bacteria both showed resistance to antibiotics whereas antibiotics are still considered to be effective and susceptible by the organisms. Therefore, in order to overcome high rates of antibiotic resistance and maintain the effectiveness of antibiotics, awareness about such life-threatening topic and adherence to international guidelines should be more frequent.