Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

OBJECTIVE: To conduct a systematic review to characterise AMR patterns for bacterial causes of febrile illness in Africa and Asia. METHODS: Published literature from 1980 through 2015 based on data extracted from two recent systematic reviews of non-malarial febrile illness from Africa, South and Southeast Asia were included in the study. Selection criteria included articles with full bacterial identification (ID) and antimicrobial susceptibility testing (AST) results for key normally sterile site pathogen-drug combinations. Pooled proportions of resistant isolates were combined using random effects meta-analysis. Study data quality was graded using the Microbiology Investigation Criteria for Reporting Objectively (MICRO) framework. RESULTS: From 3,475 unique articles included in the previous reviews, 371 included the target pathogen-drug combinations. Salmonella enterica tested against ceftriaxone and ciprofloxacin were the two highest reported combinations (30,509 and 22,056 isolates, respectively). Pooled proportions of resistant isolates were high for 3rd generation cephalosporins for K. pneumoniae and E. coli in all regions. The MICRO grading showed an overall lack of standardisation. CONCLUSION: This review highlights a general increase in AMR reporting and in resistance over time. However, there were substantial problems with diagnostic microbiological data quality. Urgent strengthening of laboratory capacity and standardised testing and reporting of AST results is required to improve AMR surveillance.

Original publication




Journal article


Int J Infect Dis

Publication Date



Africa, Antimicrobial resistance, Diagnostic, Febrile illness, Fever, South Asia, Southeast Asia