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This systematic review and meta-analysis assessed the prevalence, temporal changes, and geographic differences of third-generation cephalosporin-resistant pathogens across sub-Saharan Africa, using pooled estimates and subgroup analyses.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/third-generation-cephalosporin-resistance-in-sub-saharan-africa-a-systematic-review-and-meta-analysis/450269/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/third-generation-cephalosporin-resistance-in-sub-saharan-africa-a-systematic-review-and-meta-analysis/450269.png","ImageObject",300,407,{"name":42,"@type":43},"Riley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-07","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What threat does the study focus on?","Question",{"text":62,"@type":63},"The study focuses on antimicrobial resistance, particularly resistance to third-generation cephalosporins in sub-Saharan Africa.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How did the researchers assess third-generation cephalosporin resistance?",{"text":67,"@type":63},"They searched three databases for observational studies reporting third-generation cephalosporin-resistant infections in sub-Saharan Africa and pooled prevalence using random-effects meta-analysis.",{"name":69,"@type":60,"acceptedAnswer":70},"What do the results show about resistance levels and trends?",{"text":71,"@type":63},"Across 200 studies with 355,136 patients, the pooled prevalence of resistant pathogens was 45.3%. Resistance increased over time and was higher in East and West Africa than in Central Africa.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},450269,1791368048,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":123,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","| A Nature Portfolio journal | |\n| --- | --- |\n| [https://doi.org/10.1038/s43856-025-01243-5](https://doi.org/10.1038/s43856-025-01243-5) |  |\n| Third-generation Cephalosporin resistance in Sub-Saharan Africa: a systematic review and meta-analysis\u003Cbr> Check for updates |  |\n\nGiacomo Guido 1 , Luisa Frallonardo1, Muhammad Asaduzzaman 2,3, Ferenc Balázs Farkas 4,5, Elda De Vita1, Amir Seni6, Sergio Cotugno 1, Roberta Papagni1, Elmano Gomonda6,  \nFrancesco Vladimiro Segala 1, Emanuele Nicastri 7, Federico Gobbi8,9, Laura B. Nellums10, Roberta Iatta11, Kajal Chhaganlal6, Nicola Veronese12, Giovanni Putoto 13, Carlo Torti14,  \nAnnalisa Saracino1 & Francesco Di Gennaro1  \n\n| Abstract |  | Plain language summary |\n| --- | --- | --- |\n| Background Antimicrobial resistance is a critical global health threat, with Sub-Saharan Africa disproportionately affected. Third-generation cephalosporins are widely used for severe infections due to their safety, broad spectrum, and effectiveness. However, resistance to third-generation cephalosporins undermines treatment and exacerbates poor outcomes in regions with limited alternative therapies. This systematic review and metaanalysis evaluated the prevalence, temporal trends, and geographical variations of resistant pathogens in Sub-Saharan Africa.\u003Cbr>Methods We searched three databases from the inception until 16th August 2024 for observational studies reporting third-generation cephalosporin resistant infections in SubSaharan Africa. Eligible studies reported prevalence data for confirmed infections in SSA. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using random-effects meta-analysis, with subgroup analyses by pathogen, region, clinical setting, and publication year.\u003Cbr>Results Here we show a total of 200 studies involving 355,136 patients. The pooled prevalence of third-generation cephalosporin resistant pathogens is 45.3%(95% CI: 36.7–54.4%) . Resistance rates are highest for Klebsiella pneumoniae (57.7%) and Enterobacterspp. (54 .2%) . Temporal trends show an increase in resistance, with prevalence rising from 22.8% before 2009 to 42.0% in 2020–2024. Geographical disparities are evident, with higher prevalence in East (59.7%) and West Africa (49.8%) compared to Central Africa (27.0%) . High-risk settings include neonatal intensive care units, surgical wards, and rural or mixed-care facilities.\u003Cbr>Conclusions Third-generation cephalosporin resistant pathogens represent an escalating global health crisis in SSA, exacerbated by regional disparities and rising resistance rates over time. Immediate interventions are needed, including enhanced surveillance and antimicrobial stewardship programs. |  | Antimicrobial resistance occurs when bacteria develop the ability to withstand the effects of antibiotics, making common infections increasingly difficult to treat. This is a serious problem worldwide and especially in sub-Saharan Africa, where population often have limited access to effective medicines. We reviewed results from 200 studies including more than 350,000 patients to see how common this problem is. We found that almost half of serious infections caused by Gram-negative bacteria no longer respond to third-generation cephalosporins, which are among the most important antibiotics used for severe illness. Resistance is highest in East and West Africa and has increased over the last 20 years, particularly in hospitals and neonatal units. These results show the urgent need for better infection control, careful use of antibiotics, and new treatment options. |\n| Antimicrobial resistance (AMR) is a global health crisis, threatening to reverse decades of progress in the treatment of bacterial infections1. While AMR poses a universal challenge, its impact is particularly devastating in fragile healthcare systems, such as those in resource-limited settings across Africa and Asia. In these regions, limited access to diagnostics, unregulated | inappropriate antibiotic ","cbCaieNON8lkZb1o","https://ap.wps.com/l/cbCaieNON8lkZb1o","pdf",1791277,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Plain language summary","[{\"question\":\"What threat does the study focus on?\",\"answer\":\"The study focuses on antimicrobial resistance, particularly resistance to third-generation cephalosporins in sub-Saharan Africa.\"},{\"question\":\"How did the researchers assess third-generation cephalosporin resistance?\",\"answer\":\"They searched three databases for observational studies reporting third-generation cephalosporin-resistant infections in sub-Saharan Africa and pooled prevalence using random-effects meta-analysis.\"},{\"question\":\"What do the results show about resistance levels and trends?\",\"answer\":\"Across 200 studies with 355,136 patients, the pooled prevalence of resistant pathogens was 45.3%. Resistance increased over time and was higher in East and West Africa than in Central Africa.\"}]","Third-generation Cephalosporin resistance in Sub-Saharan Africa - a systematic review and meta-analysis | PDF",1790732685,25]