ArticleCommunications medicine2025
Third-generation Cephalosporin resistance in Sub-Saharan Africa: a systematic review and meta-analysis.
Article in Communications medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Epidemiology of Infections Caused by Gram-Positive Cocci-Microorganisms · 2026Review
- Molecular and environmental drivers of antimicrobial resistance: global epidemiology, resistome dynamics, and one health strategies.Archives of microbiology · 2026Review
- Article
- Article
- Surgical Site Infections in Mozambique: A Literature Review of Incidence, Antimicrobial Resistance, Risk Factors, and Surveillance Practices.Annals of global health · 2026Review
- Antimicrobial stewardship challenges at a referral Hospital in Western Kenya: insights from a Kakamega-Cambridge health partnership.Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial resistance is a critical global health threat, with Sub-Saharan Africa disproportionately affected. Third-generation cephalosporins are widely used for severe infections due to their safety, broad spectrum, and effectiveness. However, resistance to third-generation cephalosporins undermines treatment and exacerbates poor outcomes in regions with limited alternative therapies. This systematic review and meta-analysis evaluated the prevalence, temporal trends, and geographical variations of resistant pathogens in Sub-Saharan Africa.
methodsWe searched three databases from the inception until 16
resultsHere we show a total of 200 studies involving 355,136 patients. The pooled prevalence of third-generation cephalosporin resistant pathogens is 45.3% (95% CI: 36.7-54.4%). Resistance rates are highest for Klebsiella pneumoniae (57.7%) and Enterobacter spp. (54.2%). Temporal trends show an increase in resistance, with prevalence rising from 22.8% before 2009 to 42.0% in 2020-2024. Geographical disparities are evident, with higher prevalence in East (59.7%) and West Africa (49.8%) compared to Central Africa (27.0%). High-risk settings include neonatal intensive care units, surgical wards, and rural or mixed-care facilities.
conclusionsThird-generation cephalosporin resistant pathogens represent an escalating global health crisis in SSA, exacerbated by regional disparities and rising resistance rates over time. Immediate interventions are needed, including enhanced surveillance and antimicrobial stewardship programs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.