The War Against the Resistance of Acinetobacter Baumannii: A Meta-analysis of Findings in Turkiye

Objective: Bacterial resistance to antibiotics continues to be a significant challenge to the global health system. This study was designed to examine changes in the antibiotic resistance of Acinetobacter baumannii (A. baumannii) strains isolated from various clinical samples taken between 2005 and 2020 and to support the development of new antibiotics policies for empirical treatment of multidrug-resistant isolates in Turkiye. Materials and Methods: This meta-analysis included a data search phase, determination of eligibility criteria, qualitative analysis of the studies selected, data extraction, and statistical analyses. All of the data were analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: According to Clinical and Laboratory Standards Institute and/or European Committee on Antimicrobial Susceptibility Testing standards and a random effects model, the breakpoint estimate of A. baumannii strain resistance in Turkiye for ampicillin-sulbactam, ceftazidime, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, netilmicin, colistin, and tigecycline was 90.7%, 92.1%, 86.8%, 87.3%, 72.6%, 63.7%, 88%, 91.2%, 76.7%, 27.1%, 7.9%, and 18.5%, respectively. Conclusion: The reported rates of A. baumannii resistance from different regions demonstrated heterogeneity. Unfortunately, the use of standard antibiotics is unlikely to provide effective therapy throughout Turkiye. New therapy options and protocols are needed.