Academic Journal
Antibiotic resistance in the paediatric population in Pakistan (1996-2025): a systematic review and meta-analysis.
| Τίτλος: | Antibiotic resistance in the paediatric population in Pakistan (1996-2025): a systematic review and meta-analysis. |
|---|---|
| Συγγραφείς: | Kamran M; Faculty of Health and Life Sciences, Capital University of Science and Technology, Islamabad, Pakistan. Electronic address: kamranahmdani@gmail.com., Shahid A; University Institute of Medical Laboratory Technology, The University of Lahore, Lahore Pakistan., Ahmar MA; Institute of Health Sciences, Khwaja Fareed University of Engineering and Information Technology Rahim Yar Khan, Punjab Pakistan. |
| Πηγή: | The Journal of hospital infection [J Hosp Infect] 2026 Oct; Vol. 176, pp. 16-27. Date of Electronic Publication: 2026 Jul 29. |
| Τύπος έκδοσης: | Journal Article; Systematic Review; Meta-Analysis |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: W.B. Saunders For The Hospital Infection Society Country of Publication: England NLM ID: 8007166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2939 (Electronic) Linking ISSN: 01956701 NLM ISO Abbreviation: J Hosp Infect Subsets: MEDLINE |
| Imprint Name(s): | Publication: London : W.B. Saunders For The Hospital Infection Society Original Publication: New York, Academic Press. |
| Ιατρικοί όροι (MeSH): | Anti-Bacterial Agents*/pharmacology , Anti-Bacterial Agents*/therapeutic use , Drug Resistance, Bacterial*, Pakistan/epidemiology ; Sepsis/microbiology ; Humans ; Child ; Child, Preschool ; Infant ; Infant, Newborn ; Adolescent ; Microbial Sensitivity Tests ; Third Generation Cephalosporins |
| Περίληψη: | Background: Pakistan is facing a severe antimicrobial resistance (AMR) crisis, with the paediatric population at the highest risk. Despite widespread antibiotic use, there has been no long-term synthesis of paediatric-specific AMR data in the country until now. Methods: We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, searching PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies (January 1996-December 2025) reporting antibiotic susceptibility data in children aged 0-18 years in Pakistan. Where three or more studies reported comparable outcomes, proportions were pooled using a DerSimonian-Laird random-effects model with Freeman-Tukey transformation; remaining findings were synthesized narratively. Results: Twenty-five studies met inclusion criteria (1996-2025). Pooled bacteriologically confirmed sepsis/bloodstream infection positivity was 24.9% (95% confidence interval [CI]: 14.7-36.7%; k = 8), with associated in-hospital mortality of 17.5% (95% CI: 13.9-21.5%; k = 4). Among Salmonella typhi/paratyphi isolates, pooled multi-drug resistance rate was 55.2% (k = 3), rising from 46.5% in 1996 to 92.9% in 2024 across individual studies; pooled ampicillin and meropenem resistance rates were 85.9% and 0.8%, respectively. A dedicated paediatric hospital found 70.5% ceftazidime-avibactam resistance among carbapenem-resistant isolates, and extended-spectrum β-lactamase (ESBL) production reached 67.3% in neonatal sepsis isolates at another centre. Antibiotic use across point prevalence surveys ranged from 82.1% to 97%, with only 2.0% culture-guided prescribing rate in the largest survey. Conclusions: Published evidence from Pakistan confirms an increasing paediatric AMR crisis spanning carbapenem resistance, extensively drug-resistant typhoid, methicillin-resistant Staphylococcus aureus, and ESBL-producing organisms, combined by near-universal empirical prescribing prescription without culture guidance. Urgent national stewardship, surveillance expansion, and diagnostic investment are imperative. (Copyright © 2026 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.) |
| Competing Interests: | Conflict of interest statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be considered as a potential conflict of interest. |
| Contributed Indexing: | Keywords: Antibiotic Resistance; Antimicrobial Resistance (AMR); Meta-Analysis; Multidrug-Resistant Typhoid; Paediatric Population; Pakistan; Sepsis; Systematic Review |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) 0 (Third Generation Cephalosporins) |
| Entry Date(s): | Date Created: 20260728 Date Completed: 20260928 Latest Revision: 20261009 |
| Update Code: | 20261009 |
| DOI: | 10.1016/j.jhin.2026.07.022 |
| PMID: | 42520973 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!