Assessment of Antibiotic Resistance Trends Across Regions Through a 10 Year Retrospective Data Analysis

Abstract

Antibiotic resistance (AMR) poses a major global health threat. We examined trends in AMR over the past decade by region, emphasizing Africa and Libya. We combined data from global surveillance (e.g. WHO GLASS), interactive databases (OneHealth’s ResistanceMap), and published studies. A focal dataset from 14 African countries (2016-2019) comprised ~820,000 culture records, with 187,832 culture-positive isolates. Overall, resistance remained high with no significant decline over time. The highest resistance levels were found among third-generation cephalosporin-resistant Enterobacterales, and lowest among carbapenem-resistant bacteria. Resistance was higher in hospitalized patients and older males. In Libya, a literature review (43 studies, 18,160 isolates) found urinary tract infections (61%) were most common, with Pseudomonas and Staphylococcus aureus predominating. Notably, ~8.5% of S. aureus were MRSA, and Pseudomonas showed ≈10% resistance to piperacillin. Despite lower antibiotic consumption in Africa (per WHO GLASS), AMR burden is high. Global antibiotic use has risen sharply (∼46% since 2000), driven by Asia and LMICs. In livestock, antibiotic use is extreme: ~70% of all antibiotics go to animals (Fig.5), with Asia far exceeding Europe/Africa (Fig.6). Our study highlights persistent high AMR in Africa and Libya, linked to factors like overuse in both humans and animals. Regional differences and a lack of decline underscore the urgent need for stewardship.