Worldwide Prevalence of Carbapenem Resistance in Acinetobacter baumannii A Systematic Review and Meta-analysis

Introduction: Acinetobacter baumannii is an opportunistic pathogen that can cause hospital-acquired infections. Indiscriminate use of antibiotics has led to a significant increase in the incidence of acquired drug resistance among clinical isolates of A. baumannii. This study aims to assess the resistance to carbapenems between A. baumannii clinical isolates using a meta-analysis study. Methods: The databases of Scopus, PubMed, Google Scholar, Web of Science, and Iranian national databases (SID, Magiran, and IranMedex) were searched until 2020. Studies were analyzed based on the random-effects model. Heterogeneity between studies was evaluated by calculating the I-2 index. Statistical analysis was performed using STATA (version 14.2; StataCorp, College Station, Tex). Results: Finally, 46 articles were found to meet the criteria, with a total sample size of 62,779 cases. Resistance to imipenem and meropenem was detected in 62% and 64% of cases, respectively. The sensitivity of A. baumannii clinical isolates to imipenem and meropenem was obtained at 34% and 37%, respectively. In addition, the highest resistance to imipenem and meropenem was estimated in Asia (67% and 70%, respectively). However, the lowest resistance to imipenem and meropenem was estimated in Europe (50% and 57%, respectively). Conclusion: The carbapenem resistance of A. baumannii is a global health problem that affects public health in the community. Based on our results, because of the high resistance of A. baumannii to carbapenems, the extensive use of carbapenems is less recommended.