Burden and global distribution of antimicrobial resistance in non-bloodstream infections among adults with cirrhosis: A systematic review and proportional meta-analysis.
Int J Antimicrob AgentsMay 27, 2026 (epub)
Cansu Ozdemir, Tuhin Paul, Kasope Egoh et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis examined antimicrobial resistance (AMR) in non-bloodstream infections among adults with cirrhosis, analyzing data from 31 studies involving 2781 infections. The study found that the overall pooled proportion of multidrug-resistance (MDR) was 23%, with significantly higher rates in lower-middle-income countries, highlighting the predominance of Gram-negative bacteria.
Key findings
- The overall pooled MDR proportion was 23% (95% CI: 13-37).
- In lower-middle-income countries, MDR was 56% compared to 15%-41% in higher-income regions.
- Gram-negative bacteria accounted for 60% of isolates, with Escherichia coli at 29%.
- Spontaneous bacterial peritonitis was the most common infection, comprising 89% of cases.
Why it matters
Understanding the distribution and resistance patterns of bacterial pathogens in cirrhosis patients is crucial for guiding effective empirical antimicrobial therapy, especially in regions with high MDR rates.