SynthesisBMC infectious diseases2020
Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: a systematic review.
Synthesis in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Conflict-associated wounds and burns infected with GLASS pathogens in the Eastern Mediterranean Region: A systematic review.BMC infectious diseases · 2025Pooled it
- Progress on implementing the WHO-GLASS recommendations on priority pathogen-antibiotic sensitivity testing in Africa: AWellcome open research · 2024Pooled it
- Antimicrobial-resistant foodborne pathogens in the Middle East: a systematic review.Environmental science and pollution research international · 2021Pooled it
- A systematic review of antimicrobial resistance among World Health Organization Bacterial Priority Pathogens in Syria (2015-2025).IJID regions · 2026Article
- National surveillance of antimicrobial resistance in Iran using IAMR software: A hospital-based study.New microbes and new infections · 2026Article
- Implementation of an antimicrobial stewardship program in Alexandria University Children's Hospital: an interventional study.Italian journal of pediatrics · 2026Article
- Colistin use and outcomes in Kuwait public hospitals.Frontiers in drug safety and regulation · 2026Article
- Implementation of GLASS-AMR: An assessment in WHO's Eastern Mediterranean Region.Mass gathering medicine (Amsterdam, Netherlands) · 2025Article
- War impact on antimicrobial resistance and bacteriological profile of wound infections in Ukraine.Communications medicine · 2025Article
- Antimicrobial resistance in a protracted war setting: a review of the literature from Palestine.mSystems · 2025Review
- Abundance of clinically relevant antimicrobial resistance genes in the golden jackal (mSphere · 2025Article
- Antimicrobial resistance surveillance and trends in armed conflict, fragile, and non-conflict countries of the Eastern Mediterranean Region.Infectious diseases of poverty · 2025Article
- A systematic review on how primary care electronic medical record data have been used for antimicrobial stewardship.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Review
- Not forgetting the humanitarian contexts in the fight against antimicrobial resistance: Operational-driven reflection on knowledge and research gaps by Médecins Sans Frontières.PLOS global public health · 2025Review
- Burden and trends of antimicrobial non-susceptibility in skin and soft tissue infections: nine-year microbiological surveillance from a tertiary hospital in Riyadh, Saudi Arabia.Frontiers in microbiology · 2025Article
- Guidance for infectious disease care in the face of human conflict: a case-based narrative review.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Review
- Antibiotic susceptibility patterns at the Médecins Sans Frontières (MSF) Acute Trauma Hospital in Aden, Yemen: a retrospective study from January 2018 to June 2021.JAC-antimicrobial resistance · 2024Article
- Impact of the 4th of August Beirut explosion mass casualty incident on a university hospital microbial Flora.BMC infectious diseases · 2024Article
- Whole-genome sequencing for One Health surveillance of antimicrobial resistance in conflict zones: a case study ofApplied and environmental microbiology · 2023Article
- Antimicrobial stewardship in primary health care programs in humanitarian settings: the time to act is now.Antimicrobial resistance and infection control · 2023Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn spite of the evident general negative effects of armed conflict on countries' health systems and populations' health outcomes, little is known about similar impacts of conflicts on the spread of antimicrobial resistances (AMR). This review was to address this evidence gap and describe: 1. Patterns of AMR in the Middle East (ME) and resistance profiles of pathogens included in the Global AMR Surveillance System (GLASS) supported by the World Health Organization; 2. Differences in proportions of AMR isolates between conflict and non-conflict countries.
methodsA systematic literature review was conducted following PRISMA guidelines and searching five electronic databases. Subject heading and free text were searched for "antimicrobial resistances" and "Middle East", to identify observational studies on AMR published from January 2011 to June 2018. Data were extracted from included articles on a predefined set of variables. Percentages of AMR were analysed as median and interquartile ranges. Risk of bias was assessed using the Newcastle-Ottawa Scale.
resultsA total of 132 articles met the inclusion criteria. Included studies showed heterogeneity in study design, laboratory methods and standards for interpretation of results, and an overall high risk of bias. Main findings were the following: 1. High proportions of carbapenem resistance in Acinetobacter spp. (median 74.2%), and both carbapenem resistance (median 8.1 and 15.4% for E. coli and K. pneumoniae respectively) and ESBL-production (median 32.3 and 27.9% for E. coli and K. pneumoniae respectively) amongst Enterobacteriaceae. S. aureus isolates showed a median methicillin resistance percentage of 45.1%, while vancomycin resistance was almost absent. A median of 50% of the strains of S. pneumoniae showed non-susceptibility to penicillin. 2. Similar trends were observed in conflict and non-conflict affected countries.
conclusionsThere is a lack of standardization in the methodological approach to AMR research in the Middle East. The proportion of antibiotic resistances among specific GLASS pathogens is high, particularly among Acinetobacter spp.
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