Table 1.
Study characteristics of the included studies reporting antimicrobial resistance in invasive NTS infections in sub-Saharan Africa
| Study characteristics - population | n (%) | Study characteristics - microbiology | n (%) |
|---|---|---|---|
| Region sub-Saharan Africa | n= 53 | Number of NTS isolates | 53 |
| Central Africa | 5 (9) | 10 - 49 | 15 (28) |
| Eastern Africa | 31 (58) | 50 - 99 | 8 (15) |
| Southern Africa | 3 (6) | 100 - 199 | 12 (23) |
| Western Africa | 16 (30) | 200 - 499 | 12 (23) |
| > 500 | 6 (11) | ||
| Study design | n= 53 | ||
| Retrospective | 21 (40) | Clinical specimen | 53 |
| Prospective | 32 (60) | Blood | 43 (81) |
| CSF | 2 (4) | ||
| Duration study period | n= 53 | Blood + CSF | 4 (8) |
| <1 year | 8 (15) | Blood + CSF + other normally sterile body sites | 4 (8) |
| 1 - 2 years | 11 (21) | ||
| 2 - 5 years | 14 (26) | Method antibiotic susceptibility testing | 52 |
| 5 - 10 years | 8 (15) | Disk diffusion | 28 (54) |
| > 10 years | 12 (23) | E-test | 1 (2) |
| Automated methods | 2 (4) | ||
| Study setting | n= 48 | Disk diffusion + E-test | 17 (33) |
| Population based | 3 (6) | Automated methods + disk diffusion / E-test | 4 (8) |
| District hospital | 19 (40) | ||
| University / tertiary care hospital | 12 (25) | International guidelines for interpretation AST | 39 |
| Multicenter | 14 (29) | CLSI / NCCLS | 32 (82) |
| EUCAST | 2 (5) | ||
| Study population | n= 50 | National guidelines (French microbiological society or BSAC) | 5 (13) |
| Children | 28 (56) | ||
| Adults | 8 (16) | Version of guidelines specified | 36 (92) |
| Children and adults | 14 (28) | ||
| Definitions of fluoroquinolone non-susceptibility | 38 | ||
| HIV prevalence | n= 26 | Mixed reporting of resistance & decreased susceptibility | 10 (26) |
| ≤20% in enrolled patients / patients with invasive NTS infection | 9 (35) | Resistance & decreased susceptibility separately reported | 8 (21) |
| >20% in enrolled patients / patients with invasive NTS infection | 17 (65) | Assessed before introduction of revised breakpoints | 20 (53) |
| Number of screened cultures | n= 53 | Assessment of fluoroquinolone non-susceptibility | 38 |
| 0 - 99 | 5 (9) | Only nalidixic acid resistance reported | 1 (3) |
| 100 - 499 | 10 (19) | Only ciprofloxacin resistance reported | 25 (66) |
| 500 - 999 | 9 (17) | Nalidixic acid and ciprofloxacin resistance reported | 11 (29) |
| 1000 - 5000 | 12 (23) | Pefloxacin resistance reported | 1 (3) |
| > 5000 | 17 (32) |
NTS non-typhoidal Salmonella, CSF cerebrospinal fluid, AST antibiotic susceptibility testing, CLSI Clinical and Laboratory Standards Institute, EUCAST European Committee on Antimicrobial Susceptibility Testing, BSAC British Society of Antimicrobial Chemotherapy