GLOBAL TRENDS IN ANTIMICROBIAL RESISTANCE: A SYSTEMATIC REVIEW OF SURVEILLANCE DATA

Abstract

Background: Antimicrobial resistance (AMR) has emerged as a critical global health threat, undermining the effectiveness of antibiotics and increasing morbidity, mortality, and healthcare costs worldwide. The rise in drug-resistant infections is fueled by the misuse of antibiotics in human health, agriculture, and veterinary practices, with significant disparities in surveillance capacities between high-income and low- to middle-income countries. A comprehensive understanding of global AMR trends is essential for developing effective intervention strategies and guiding international policy.

Objective: This systematic review aimed to analyze global trends in antimicrobial resistance using international surveillance data, identify emerging resistance patterns, and highlight gaps in current monitoring frameworks.

Methods: Following PRISMA guidelines, a systematic literature search was conducted across PubMed, Scopus, Google Scholar, Embase, and Web of Science from January 2018 to December 2023. Medical Subject Headings (MeSH) terms such as “antimicrobial resistance,” “global surveillance,” and “drug-resistant infections” were used. Studies were selected based on predefined inclusion and exclusion criteria, and a random-effects meta-analysis was performed. Effect sizes were presented as odds ratios (OR) with 95% confidence intervals (CIs), while heterogeneity was assessed using the I² statistic.

Results: A total of 10 studies were included, with sample sizes ranging from 300 to 1,200 participants. The pooled analysis revealed significant AMR trends, with odds ratios ranging from 1.3 to 2.5 across different regions. Resistance rates for Escherichia coli and Klebsiella pneumoniae reached up to 60% in low-income countries. Heterogeneity among studies was moderate to high (I² = 45%–78%), and no significant publication bias was detected (p > 0.05).

Conclusion: Global trends indicate a rising burden of AMR, particularly in resource-limited regions. Strengthening surveillance systems, fostering international collaboration, and implementing effective antimicrobial stewardship are crucial to mitigate this escalating threat.