A meta-analysis of 34 studies across 18 countries found antimicrobial resistance (AMR) in hospitalized patients was associated with 58% higher mortality risk compared to antibiotic-sensitive infections.

The study authors looked at more than 39,000 inpatients to assess the prevalence of AMR and its association with mortality. Of these, 20,658 patients (53%) had antimicrobial sensitivities. In this 53%, the pooled prevalence of AMR was 37%, although it varied widely across studies. Mortality risk was particularly elevated in bacteremia cases and when death occurred during the same hospitalization as AMR detection.

“Previous work on AMR has largely emphasized the role of excessive antibiotic use driving resistance,” wrote lead author Nisha A. George and colleagues, of the University of Leicester, United Kingdom. “Our work highlights the direct clinical relevance of AMR for individual patients, showing a strong association with in-hospital mortality even when key founders such as age and disease severity are adjusted for.”

The study was limited in some key areas, lacking data from areas of the world noted for having a high prevalence of AMR, such as sub-Saharan Africa, Russia, the Middle-East, and India. Additionally, The study authors also noted that, “there was evidence of publication bias in estimates of both prevalence and mortality,” and, “Overall certainty of evidence of mortality was graded to be low.”

Identifying patients with AMR earlier could improve clinical decision-making and patient care, as well as global efforts to reduce AMR.

Source: The Lancet