Work

Tackling the disparities in surgical site infections and related antimicrobial resistance in low- and middle-income countries

Year: 2025

Type: article

Abstract: Background and purpose: The financial burden, morbidity, and mortality of surgical site infection (SSI) is a global issue. Incidence rates of SSI are high in low- and middle-income countries (LMICs), with evidence of surge in antimicrobial resistance (AMR) in these regions. This mini review aimed to collect and analyze existing data on SSI incidence and the associated AMR in LMICs to address some concerns about causes and control strategies. Methods: MEDLINE, Embase, the Cochrane Library, Scopus, AMED, Biosis, and CINAHL were all searched for this study until June 8, 2025. We included all studies comparing disparities in surgical site infections and related antimicrobial resistance in low- and middle-income countries. Results: The overall SSI incidence in LMICs is higher than in high-income countries . The intertwined relationship between SSI and the rising AMR burden further complicates the issue. The emergence of AMR is driven by inappropriate antibiotic use, poor regulatory oversight and stewardship, inadequate healthcare infrastructure, economic limitations that result in incomplete or informal treatments, weak surveillance systems, and environmental contamination from hospitals, agriculture, and wastewater. Vaccination, sanitation and hygiene, infection control, education, alternative therapies consideration of, antimicrobial stewardship, and prevention, are strategies to prevent and reduce the development of AMR. Conclusion: AMR is a dire global problem that requires immediate action to combat its spread. Effective AMR surveillance from a "One Health" viewpoint is needed in LMICs to map and track the spread of resistance. Environmental resistome sample is required to detect the factors influencing resistance. Searching for solution to colistin resistance, a last resort antibiotic, is critical.

Source: Surgery in Practice and Science

DOI: 10.1016/j.sipas.2025.100315

Authors: Rana Farsakoury, Massimo Sartelli, Susu M Zughaier

Institutions: Hamad Medical Corporation, Qatar University, Ospedale di Macerata

Language: English

Topic: Surgical site infection prevention

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $2,020