OBJECTIVE The objective of this works was to assess the global prevalence of multidrug-resistance among A. baumannii causing hospital-acquired (HAP) and ventilator-associated pneumonia (VAP), and describe its associated mortality. METHODS We performed a systematic search of four databases for relevant studies. Meta-analysis was done based on United Nations geoscheme regions, individual countries and study period. We used a random-effects model to calculate pooled prevalence and mortality estimates with 95% confidence intervals (CIs), weighted by study size. RESULTS Among 6445 reports screened, we identified 126 relevant studies, comprising data from 29 countries. The overall prevalence of multidrug-resistance among A. baumannii causing HAP and VAP pooled from 114 studies was 79.9% (95% CI 73.9-85.4%). Central America (100%) and Latin America and the Caribbean (100%) had the highest prevalence, whereas Eastern Asia had the lowest (64.6%; 95% CI, 50.2-77.6%). The overall mortality estimate pooled from 27 studies was 42.6% (95% CI, 37.2-48.1%). CONCLUSIONS We observed large amounts of variation in the prevalence of multidrug-resistance among A. baumannii causing HAP and VAP and its mortality rate among regions and lack of data from many countries. Data from this review can be used in the development of customized strategies for infection control and antimicrobial stewardship.

中文翻译：

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鲍曼不动杆菌引起医院获得性和呼吸机相关性肺炎及其相关死亡率的多药耐药性全球流行：系统评价和荟萃分析。

目的这项工作的目的是评估全球鲍曼不动杆菌引起医院获得性肺炎（HAP）和呼吸机相关性肺炎（VAP）的多药耐药性，并描述其相关死亡率。方法我们对四个数据库进行了系统搜索以进行相关研究。荟萃分析是根据联合国地球化学区域，个别国家和研究时期进行的。我们使用随机效应模型以95％的置信区间（CI）计算合并的患病率和死亡率，并按研究规模加权。结果在筛选的6445份报告中，我们鉴定了126项相关研究，其中包括来自29个国家的数据。从114项研究中汇总的引起HAP和VAP的鲍曼不动杆菌的多药耐药总体患病率为79.9％（95％CI 73.9-85.4％）。中美洲（100％），拉丁美洲和加勒比海（100％）患病率最高，而东亚最低（64.6％； 95％CI，50.2-77.6％）。来自27项研究的总死亡率估算为42.6％（95％CI，37.2-48.1％）。结论我们观察到引起HAP和VAP的鲍曼不动杆菌的多药耐药性流行率存在很大差异，并且各地区之间的死亡率也存在差异，并且许多国家缺乏数据。此次审查的数据可用于制定感染控制和抗菌管理的定制策略。结论我们观察到引起HAP和VAP的鲍曼不动杆菌中多药耐药的发生率存在很大差异，并且各地区之间的死亡率也存在差异，并且许多国家缺乏数据。此次审查的数据可用于制定感染控制和抗菌管理的定制策略。结论我们观察到引起HAP和VAP的鲍曼不动杆菌中多药耐药的发生率存在很大差异，并且各地区之间的死亡率也存在差异，并且许多国家缺乏数据。此次审查的数据可用于制定感染控制和抗菌管理的定制策略。