Table 1.
Summary of included studies.
| Citation | Study Country | Study design | Study setting | Migrant type | No of migrants. | Study details | Method of analysis | Outcome measure | Quality assessment score |
|---|---|---|---|---|---|---|---|---|---|
| Aro et al. (2018)17 | Finland | Cohort | Hospital | Forced Migrants | 447 | Screening of asylum seekers and refugees for MRSA and MDRGN bacteria; samples were collected as swabs from the nostrils, pharynx, rectum and wound infections. | Laboratory culture of swab samples in pre-enrichment media and susceptibility testing. Statistical analyses were conducted with SPPS. Univariate analysis for categorical variables, chi-squared test, or binary logistic regression analysis. | MDR bacteria 45% (201/447), ESBL-PE 32.9% (147/447), MRSA 21.3% (95/447). Carriage rate by region for migrants was Middle East (56%), Asia (38.6%), sub-Saharan Africa (24.4%), and Europe (15.4%). | 72% |
| Costa et al. (2018)18 | Italy | Cohort | Hospital | Other Migrants | 354 | Migrant children who underwent cardiac surgery conducted in 2015–2016 were screened upon hospital admission to identify multi-resistant organisms. Nasal and rectal swabs were collected. | MDRO proportions were compared in Italian and non-Italian children with Z-test. | MDRO colonisation rate was significantly different in the non-Italian and Italian groups (61.9% vs 24.8%, P < 0.001). The rate of ESBL-producing Enterobacteriaceae was 60.5%. | 81% |
| Creutz et al. (2022)19 | Germany | Cross-sectional | Community | Forced Migrants | 161 | Voluntary screening of refugees living in a communal area for nasal carriage of S. aureus. Each participant provided a nasal swab. | Isolates were phenotypically examined for resistance and virulence by PCR and whole genome sequencing. | 2.5% colonisation rate with MRSA | 100% |
| Ehlkes et al. (2019)20 | Germany | Cross-sectional | Community | Forced Migrants | 1544 | Asylum seekers with a median age of 25 years were sampled for antibiotic-resistant Enterobacteriaceae. Stool samples were collected, and region of origin and demographic features were explored as risk factors for colonisation. | Univariate and multivariable logistic regression modelling to determine potential risk factors for ESBL-PE/C-PE colonisation. | 294 migrants tested positive for ESBL-PE colonisation. Asylum seekers from Afghanistan/Pakis/Iran had the highest prevalence of 29.3%, 20.4% from Syria. | 100% |
| Eiset et al. (2020)21 | Denmark | Cross-sectional | Community | Forced Migrants | 113 | Adult Syrian asylum seekers newly arriving in Denmark were screened for intestinal parasites and selected antimicrobial-resistant organisms, including Diphtheria, ESBL-PE, MRSA, and CPO. Faecal and throat swabs were collected. | Prevalence of colonisation and antimicrobial resistance were calculated with their corresponding 95% confidence interval. | Antimicrobial resistance was observed in eight individuals, including one ESBL and seven MRSA. | 100% |
| Fiorini et al. (2020)22 | Italy | Cohort | Hospital | Forced Migrants | 294 | Diagnosis and treatment of immigrant patients diagnosed with H. pylori infection in a single centre with either sequential or pylera therapy. | Means and 95% confidence intervals were derived. Eradication rates were measured by intention-to-treat (ITT) analysis and per-protocol (PP) analysis. Fisher's exact Chi-square test was used to compare treatment groups. | Latin American immigrants had the highest resistance to metronidazole, tetracycline, levofloxacin, and clarithromycin. | 63.6% |
| Garriga et al. (2021)23 | Spain | Cohort | Hospital | Other Migrants | 48 | Identification of S.aureus in patients aged 0–16years managed in pediatric emergency departments | Using SPSS, descriptive and inferential statistical analysis were performed to identify potential risk factors associated with morbidity and mortality. | MRSA in children born in Spain was 13.3% versus 52% in those born outside Spain. | 81.8% |
| Hertting et al. (2021)24 | Sweden | Cross-sectional | Hospital | Forced Migrants | 160 | Antimicrobial screening and identification of reasons for hospitalisation in asylum-seeking children less than 18 years. | A severity measure was based on the number of events leading to acute care admission, screening records of MRSA and ESBL-pe colonisation rate among asylum-seeking children/adolescents and compared with the resident population. A Chi-square test was used. | The colonisation rate for MRSA and ESBL-PE was 12% (27) and 17% (19), respectively. | 87.5% |
| Kenfak-Foguena et al. (2021)25 | Switzerland | Cross-sectional | Hospital | Forced Migrants | 59 | Screening of asylum seekers in two different hospitals. Nasal, rectal and throat swabs were collected. | Identification and incubation of bacteria cells with whole genome sequencing. | No association between colonisation with MDR bacteria and with hospitalisation or recent (<3 months) arrival in Switzerland (P = 0.41) | 62.5% |
| Lemoine et al. (2022)26 | France | Cohort | Hospital | Forced Migrants | 139 | Unaccompanied refugee minors <18 years arriving in Angiers, western France were screened for intestinal and multi-drug resistant bacteria after arrival. Rectal swabs were collected. | Colonisation rates of bacterial isolates with molecular typing. | Only two bacteria species were identified. Rates of ESBL-PE carriage was 25.7%, and five people were confirmed with klebsiella pneumonia | 72.7% |
| Mellou et al. (2021)27 | Greece | Cross-sectional | Community | Forced Migrants | 18 | Screening for multidrug-resistant Shigella isolates in a refugee and asylum seeker arrival facility. | Laboratory testing of stool samples using multiplex PCR method. | All eighteen samples were confirmed with three different Shigella species. | 87.5% |
| Kossow et al. (2018)28 | Germany | Cohort | Hospital | Forced Migrants | 225 | MRSA and MRGNB screening of refugees admitted to a hospital in Munster. | A Chi-square test was used to compare the prevalence of MRSA in refugee patients and non-refugee patients. | MRSA was seen in 9.8% refugee-patient and MDR-GNB in 12.9% | 81.8% |
| Najeem et al. (2022)29 | Germany | Cross-sectional | Hospital | Other Migrants | 3851 | Children admitted to a paediatric hospital were examined for MDRO carriage and risk factors. Swabs were taken from the rectal, throat and nasal areas. | Logistic regression models were used for analysis. | MDRO was 4.31%, MRSA 0.86%, MRGN 3.64% | 100% |
| Nurjadi et al. (2019)30 | EU | Cross-sectional | Hospital | Other Migrants | 374 | Surveillance was done in 13 travel clinics admitting patients with travel history and skin and soft tissue infections. Nasal and wound lesion swabs were taken. | Microbiological detection and molecular characterisation of bacterial isolates and regional grouping of MRSA proportions were done with Chi-square. | The prevalence of MRSA was 14%, with the highest proportion in Latin America but low in sub-Saharan Africa. | 75% |
| Ravensbergen et al. (2019)31 | The Netherland | Cohort | Hospital | Forced Migrant | 1789 | Retrospective data for asylum seekers registered in the asylum seeker centre were collected from the Certe laboratory system. These include demographic data such as age, sex, sampling date, country of origin and date of arrival in the Netherlands. Throat, rectal and nasal swabs and blood samples were collected. | Samples were screened for MRSA, MDRE, and VRE. Data were analysed with SPSS V.23.0. Descriptive statistics were used for the general characteristics and the duration of MDRO carriage. | MRSA was detected in 185 (9.3%) asylum seekers. 972 asylum seekers were all negative for VRE. 331 (18.5%) asylum seekers were positive for MDRE. | 100% |
| Reinheimer et al. (2019)32 | Germany | Cohort | Community | Forced Migrants | 109 | Evaluation of retrospective data collected from refugee patients from refugee accommodation and comparison with non-refugees admitted to the intensive care unit. All patients were screened through nasal and rectal swabs. | Chi-square test | The prevalence for MRSA was 18.3%, ESBL-coli 45.8% and MDRGN 41.3%. According to the length of stay, MDRGN declined from 72.4% (<3 months) to 21.7% (>12 months). | 81.8% |
| Rovirola et al. (2020)33 | EU | Cohort | Community | Other Migrants | 704 | Analysis of isolates and patient data reported to the European Gonococcal Surveillance Programme (Euro-GASP) 2010–2014. | Statistical significance was determined by Pearson's χ2 test or Fisher's exact test. AMR testing for ceftriaxone, cefixime azithromycin, and ciprofloxacin | AMR isolates in foreign-born patients was 52.0%, n = 366. | 72.7% |
| Saracino et al. (2020)34 | Germany | Cohort | Community | Other Migrants | 103 | Biopsies for susceptible tests, culture and histology were collected through endoscopy in migrant patients with H. pylori after failure with one treatment. | Means and 95% confidence interval, fishers test and chi-square test to compare treatment groups; eradication rates were calculated. | Resistance was recorded in 57 isolates (55.3%). | 63.6% |
| Sloth et al. (2019)35 | Denmark | Cohort | Community | Mixed | 2824 | Urine samples were collected from migrants (refugees and family-reunited migrants) and non-migrants in Denmark. | Stratified analysis was based on migrant status. Odds ratio and antibiotic-resistant patterns were calculated using multivariate logistic regression. | Among migrants, 59.9% of the isolates were Gram- + ve, while 47.2% were Gram -ve. | 100% |
| Stabler et al. (2021)36 | France | Cross-sectional | Hospital | Other Migrants | 101 | Estimation of AMR carriage and risk factors in hospitalised and recently arrived migrants | Demographic, migration and living condition and laboratory characteristics were compared between patients with or without any bacteria carriage using Chi-squared r Fishers exact test and the student or Wilcoxon ranked tests for categorical and continuous variables respectively. | Overall resistance was 20.7% including MRSA 5.4% and ESBL 16.3% | 87.5% |
| Van-Dulm et al. (2021)37 | The Netherland | Cross-sectional | Hospital | Other Migrants | 760 | Evaluation of HCV, HBV, HIV, and MRSA carriage in undocumented and uninsured migrants (median age 40) through e-swabs. | Demographics and time of exit from the country of origin and arrival to the Netherlands were retrieved. Fisher's test was used for comparison between groups. | Prevalence for MRSA was 2.0%, recorded in 15 participants. | 62.5% |
∗Abbreviations included: MDRO, multidrug-resistant organisms. MRSA, methicillin-resistant Staphylococcus aureus. VRE, vancomycin-resistant-enterococcus. ESBL, extended-spectrum β-lactamase. MRGN, multi-resistant Gram-negative bacteria. HIV, Human Immunodeficiency Virus. HCV, Hepatitis C Virus. HBV, Hepatitis B Virus.