Colistin-resistance among Acinetobacter baumannii and Pseudomonas aeruginosa from clinical specimens in Africa: a systematic review and meta-analysis

This meta-analysis assessed colistin resistance in two critical multidrug-resistant pathogens—Acinetobacter baumannii and Pseudomonas aeruginosa—across Africa. Based on 42 studies, the pooled prevalence of resistance was approximately 13.8% for A. baumannii and 14.4% for P. aeruginosa, with substantial variability between countries and regions.

Resistance rates were generally higher in East and North Africa and showed a marked increase over time, particularly for P. aeruginosa (rising to over 30% in recent years). The high heterogeneity suggests differing local epidemiology, surveillance capacity, and antibiotic use practices.

Overall, the findings highlight a growing threat to last-resort treatment options, underscoring the urgent need for strengthened antimicrobial stewardship, infection prevention, and molecular surveillance systems across the continent.