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Review
. 2022 Apr 19;4(2):dlac036.
doi: 10.1093/jacamr/dlac036. eCollection 2022 Apr.

Risk factors for carriage of antimicrobial-resistant bacteria in community dwelling-children in the Asia-Pacific region: a systematic review and meta-analysis

Yi Qi Chan  1 , Kailin Chen  1   2 , Gilbert T Chua  3 , Peng Wu  2   4 , Keith T S Tung  3 , Hing Wai Tsang  3 , David Lung  5 , Patrick Ip  3 , Celine S L Chui  2   4   6
Affiliations
Review

Risk factors for carriage of antimicrobial-resistant bacteria in community dwelling-children in the Asia-Pacific region: a systematic review and meta-analysis

Yi Qi Chan et al. JAC Antimicrob Resist. .

Abstract

Background: Antimicrobial resistance is an increasingly important issue in public health as antibiotics are overused. Resistance to antimicrobial agents can pose significant challenges to infection treatment.

Objectives: To evaluate risk factors associated with carriage of antimicrobial-resistant (AMR) bacteria in children in the Asia-Pacific region to consolidate evidence for future implementation of antibiotic prescribing practice.

Methods: Three electronic databases-PubMed, EMBASE and Cochrane Library-were searched. Observational studies that investigated the risk factors for carriage of MRSA, penicillin-resistant Streptococcus pneumoniae, ESBL-producing Escherichia coli and Klebsiella pneumoniae among the paediatric population in community settings in the Asia-Pacific region were considered eligible. Summary statistics from the identified studies were pooled using meta-analyses.

Results: From the 4145 search results, 25 papers were included in this review. Sixteen papers were included in the meta-analysis based on reported risk factors. Young age of 2-6 months compared with children aged 7-60 months (OR 2.74, 95% CI: 1.75-4.29), antibiotic use within the past 3 months (OR 2.65, 95% CI: 1.70-4.12), daycare attendance (OR 1.49, 95% CI: 1.17-1.91) and hospital admission within the past 3 months (OR 3.43, 95% CI: 2.13-5.51) were found to be significant risk factors for AMR bacterial carriage, whilst breastfeeding (OR 0.69, 95% CI: 0.60-0.81) and concurrent colonization of S. pneumoniae (OR 0.59, 95% CI: 0.38-0.91) are protective factors.

Conclusions: The findings support that there are a number of significant risk factors associated with carriage of AMR bacteria in the Asia-Pacific paediatric population. To combat antimicrobial resistance in the future, these risk factors should be considered, and measures taken to mitigate associated carriage.

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