Work

Global and regional prevalence of metallo-β-lactamases in carbapenem-resistant Acinetobacter baumannii : a systematic review and meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUND: Emergence and spread of carbapenem-resistant Acinetobacter baumannii (CRAB) producing metallo-β-lactamases (MBLs), especially New Delhi MBLs (NDMs), are concerning due to resistance to last-resort antibiotics. METHODS: PubMed and Scopus were queried for studies published between 2020 and 2024 reporting MBL prevalence in CRAB isolates. Risk of bias was assessed across the population, setting and measurement domains. Binomial-Normal mixed-effects models were applied to estimate regional and country-specific weighted MBL and NDM prevalence proportions in CRAB. Subgroup and meta-regression analyses were performed to investigate heterogeneity. RESULTS: Two hundred thirty-three studies reporting 58 676 CRAB isolates were analysed. The global MBL prevalence in CRAB was 5.3% [95% confidence interval CI), 3.3%-8.2%]. Regional variability explained a substantial portion of heterogeneity in meta-regression (R2 = 35%). MBL prevalence in CRAB was highest in the Eastern Mediterranean (42.1%; 95% CI, 28.7%-56.8%) and African (36.1%; 95% CI, 12.2%-69.8%) regions, moderately high in South-East Asia (17.9%; 95% CI, 9.6%-30.9%), and low (<1%) in Europe, the Americas and the Western Pacific region. MBL prevalence in CRAB was higher in studies conducted during 2020-2024 than during 2012-2019 (7.2% versus 4.2%; adjusted odds ratio 2.3, P = 0.024). NDM was the dominant MBL in CRAB, with a global prevalence of 1.7% (95% CI, 1.1%-2.7%) in 218 studies. CONCLUSIONS: Although its global prevalence is low, MBL-producing CRAB is common in specific regions and countries, threatening the utility of new antibiotics. Sustained surveillance, rigorous infection control and antimicrobial stewardship are required to preserve the activity of last-resort antimicrobials.

Source: Journal of Antimicrobial Chemotherapy

DOI: 10.1093/jac/dkag037

Authors: Stamatis Karakonstantis, Renatos Nikolaos Tziolos, Maria Paneta, Evangelos I Kritsotakis

Institutions: University of Crete, University Hospital of Heraklion

Language: English

Topic: Antibiotic Resistance in Bacteria

Subfield: Molecular Medicine

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,784