Journal Article

Prevalence of multidrug-resistant bacteria in healthcare and community settings in West Africa: systematic review and meta-analysis

Diop, Moustapha, Lakhe, Ndeye Aissatou, Bassoum, Oumar, Ndong, Abdourahmane, Youbong, Tracie, Faye, Adama, Mbacké Daffé, Sokhna Moumy, Fall, Bécaye, Wone, Fatimata, Gueye, Mamadou Wagué, Ghogomu Tamouh, Ajuamendem, Radji, Romziath Olouwakemi, Ndoye, Maguette, Ba, Papa Samba

2025

Overview

Background Multidrug-resistant (MDR) bacteria are a global health threat, notably in low- and middle-income countries. The aim of this review was to estimate the prevalence of multidrug-resistant bacteria in healthcare and community settings in West Africa. Methods In accordance with PRISMA guidelines, we searched PubMed, CINAHL, African Index Medicus, and other databases for studies published from 2010 onward. Data on MDR bacterial prevalence, study characteristics, and infection types were extracted and analyzed via R software. Subgroup analyses were performed to explore differences in prevalence across infection settings and sample types. Results Out of the 5,320 articles identified, 50 studies from 13 West African countries met the inclusion criteria, with the majority from Nigeria (34%) and Ghana (22%). Among the 35,820 bacteria isolated in these studies, gram-negative bacteria (GNB), particularly Escherichia coli and Klebsiella sp., were the most frequently isolated species, accounting for 63.3% of the bacteria. The overall prevalence of MDR bacteria was 59% (95% CI: 48-69%), with significant heterogeneity between studies (I² = 98%, p  < 0.001). Subgroup analysis revealed a 7% increase in MDR bacteria prevalence from the first five-year period to the last two five-year periods, and a greater prevalence of MDR bacteria in nosocomial infections (65%, 95% CI: 45-81%) than in community-acquired infections (53%, 95% CI: 31-74%). The prevalence of MDR bacteria in mixed infection settings was 58% (95% CI: 44-71%). The MDR prevalence was highest in the urine samples (72%, 95% CI: 57-84%) and superficial skin samples (69%, 95% CI: 29-92%), whereas it was lowest in the nasopharyngeal samples (26%, 95% CI: 21-33%). Conclusion The high prevalence of MDR bacteria in West Africa underscores the need for strengthened infection control measures, improved surveillance, and stricter antibiotic use policies. Enhanced regional collaboration is essential to mitigate the spread of AMR in both healthcare and community settings. PROSPERO registration number CRD42023470363.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Africa, Western - epidemiology / Analysis / Anti-Bacterial Agents - pharmacology / Antibiotics / Antimicrobial agents / Bacteria / Bacteria - classification / Bacteria - drug effects / Bacteria - isolation & purification / Bacterial infections / Bacterial Infections - epidemiology / Bacterial Infections - microbiology / Coliforms / Community-acquired infections / Community-Acquired Infections - epidemiology / Community-Acquired Infections - microbiology / Cross infection / Cross Infection - epidemiology / Cross Infection - microbiology / Drug resistance / Drug resistance in microorganisms / Drug Resistance, Multiple, Bacterial / E coli / Global health / Gram-negative bacteria / Health aspects / Health care / Health risks / Heterogeneity / Humans / Infection / Infections / Infectious Diseases / Internal Medicine / Klebsiella / MDR bacteria / Medical Microbiology / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Meta-analysis / Methicillin / Microbiological research / Mixed infection / Multidrug resistance / Multidrug resistant organisms / Nosocomial infection / Nosocomial infections / Parasitology / Population / Prevalence / Prevalence studies (Epidemiology) / Public health / Risk factors / Software / Statistics / Subgroups / Surveillance / Systematic Review / Tropical Medicine / West Africa